Barriers and facilitators when implementing midwifery continuity of carer: a narrative analysis of the international literature.

Background: Midwifery continuity of carer (MCoC) is a model of care in which the same midwife or small team of midwives supports women throughout pregnancy, birth and the postnatal period. The model has been prioritised by policy makers in a number of high-income countries, but widespread implementation and sustainability has proved challenging.

Methods: In this narrative review and synthesis of the global literature on the implementation and sustainability of midwifery continuity of carer, we identify barriers to, and facilitators of, this model of delivering maternity care.

Maternal and neonatal outcomes among spontaneous vaginal births occurring in or out of water following intrapartum water immersion: The POOL cohort study.

Objective: Warm water immersion during labour provides women with analgesia and comfort. This cohort study aimed to establish among women using intrapartum water immersion analgesia, without antenatal or intrapartum risk factors, whether waterbirth is as safe for them and their babies as leaving the water before birth.

Design: Cohort study with non-inferiority design.

Integrating qualitative research within a clinical trials unit: developing strategies and understanding their implementation in contexts.

Background/aims: The value of using qualitative methods within clinical trials is widely recognised. How qualitative research is integrated within trials units to achieve this is less clear. This paper describes the process through which qualitative research has been integrated within Cardiff University's Centre for Trials Research (CTR) in Wales, UK.

Establishing a veterinary anatomy core syllabus through a modified Delphi process.

Anatomy forms a key component of veterinary curricula, but, in the context of an evolving profession, curricula are adapting and changing accordingly. There is a lack of guidance for educators regarding the levels of anatomical knowledge required for a graduate to be considered safe or competent. A formal review of veterinary anatomy learning outcomes (LOs) is therefore timely to support curriculum development in this rapidly evolving field.

Supporting collaborative dissection through the development of an online wiki positively impacts the learning of veterinary anatomy.

An innovative series of dissections of the canine abdomen was created to facilitate social distancing in the dissection room following COVID-19 restrictions imposed in the UK. In groups of six, first-year veterinary students took turns dissecting selected parts of the canine abdomen while maintaining social distancing and documenting their work with video and photographs. Here, students learned about the canine abdominal anatomy by dissecting, recording the dissections of others in their group, and compiling the recorded material into a collaborative electronic media portfolio (Wiki).

Acceptability and feasibility of a planned preconception weight loss intervention in women with long-acting reversible contraception: the Plan-it mixed-methods study.

Background: Women with overweight (a body mass index of ≥ 25 kg/m) or obesity (a body mass index of ≥ 30 kg/m) are at greater risk of experiencing complications during pregnancy and labour than women with a healthy weight. Women who remove their long-acting reversible contraception (i.e.

The acceptability of asking women to delay removal of a long-acting reversible contraceptive to take part in a preconception weight loss programme: a mixed methods study using qualitative and routine data (Plan-it).

Background: Having a body mass index (BMI) which is classified as overweight (BMI ≥ 25) or obese (BMI ≥ 30) increases the risk of complications during pregnancy and labour. Weight-management interventions which target excess gestational weight gain during pregnancy have had limited success. Women who use long-acting reversible contraception (LARC) are in contact with services as part of their preparation for conception, creating a potential opportunity to offer a preconception weight-loss intervention.

Anatomy in Practice: How Do Equine and Production Animal Veterinarians Apply Anatomy in Primary Care Settings?

To successfully prepare veterinary undergraduates for the workplace, it is critical that anatomy educators consider the context in which developing knowledge and skills will be applied. This study aimed to establish how farm animal and equine general practitioners use anatomy and related skills within their daily work. Qualitative ethnographic data in the form of observations and semi-structured interviews were collected from 12 veterinarians working in equine or farm animal first-opinion practice.

The impact of a specialist home-visiting intervention on the language outcomes of young mothers and their children: a pragmatic randomised controlled trial.

Background: Young mothers are more likely to provide a suboptimal early language environment for their children who in turn show impairments in their language development, yet few studies have used observational methods to assess the effectiveness of home-visiting programmes in improving the language outcomes of young mothers and their children. The Family Nurse Partnership (FNP) is a licensed home-visiting intervention developed in the USA and introduced into practice in England. The intervention involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained Family Nurses.

Nurse-led home-visitation programme for first-time mothers in reducing maltreatment and improving child health and development (BB:2-6): longer-term outcomes from a randomised cohort using data linkage.

Objectives: Measure effectiveness of family nurse partnership (FNP) home-visiting programme in reducing maltreatment and improving maternal health and child health, developmental and educational outcomes; explore effect moderators, mediators; describe costs.

Design: Follow-up of BB:0-2 trial cohort (ISRCTN:23019866) up to age 7 years in England using record linkage.

Participants: 1618 mothers aged 19 years or younger and their firstborn child(ren) recruited to BB:0-2 trial at less than 25 weeks gestation and not mandatorily withdrawn from trial or opted out.

What are the challenges when recruiting to a trial in children's social care? A qualitative evaluation of a trial of foster carer training.

Background: Randomised controlled trials (RCTs) are comparatively rare in UK social work, but can offer distinct advantages. Confidence in Care (CiC) is an RCT with embedded process evaluation evaluating Fostering Changes (FC), a 12-week training programme for foster and kinship carers to increase skills and coping strategies. In order to mitigate challenges in participant recruitment, an engagement strategy was designed to maximise this.

Childbirth Related Labial Trauma Management in the UK: A Brief Report.

Trauma to the labia occurs in up to 49% of vaginal births. Trauma to the perineal body resulting from childbirth is well defined using widely used categories, and recommended management of perineal body trauma is based on high level evidence. Currently no similar evidence exists to inform the classification or management of labial trauma.

Effect of gamified perceptual learning on visual detection and discrimination skills in equine gait assessment.

Background: Visual assessment of equine lameness is an everyday veterinary task suffering from poor diagnostic accuracy. The aim of this study was to quantify the impact of the perceptual learning game 'LamenessTrainer' on skill development.

Methods: Thirty-six undergraduate veterinary students engaged in four game modules teaching the assessment of fore- and hindlimb lameness.

Establishing the safety of waterbirth for mothers and babies: a cohort study with nested qualitative component: the protocol for the POOL study.

Introduction: Approximately 60 000 (9/100) infants are born into water annually in the UK and this is likely to increase. Case reports identified infants with water inhalation or sepsis following birth in water and there is a concern that women giving birth in water may sustain more complex perineal trauma. There have not been studies large enough to show whether waterbirth increases these poor outcomes.

Factors influencing water immersion during labour: qualitative case studies of six maternity units in the United Kingdom.

Background: Water immersion during labour can provide benefits including reduced need for regional analgesia and a shorter labour. However, in the United Kingdom a minority of women use a pool for labour or birth, with pool use particularly uncommon in obstetric-led settings. Maternity unit culture has been identified as an important influence on pool use, but this and other possible factors have not been explored in-depth.

Qualitative process evaluation of the Fostering Changes program for foster carers as part of the Confidence in Care randomized controlled trial.

Background: Fostering Changes is an in-service training program for foster carers designed to enhance carer skills, coping strategies and carer-child relationships. The training program has been evaluated in a randomised controlled trial comparing Fostering Changes to usual care.

Objective: To conduct a qualitative process evaluation drawing on stakeholder perspectives to describe the logic model of Fostering Changes, identify potential mechanisms of impact of the program and enhance understanding of the trial results.

A pragmatic randomised controlled trial of the fostering changes programme.

Background: Many looked after young people in Wales are cared for by foster or kinship carers, usually as a consequence of maltreatment or developmentally traumatising experiences within a family context. Confidence in Care is a pragmatic unblinded individually randomised controlled parallel group trial evaluating a training programme to improve foster carer self-efficacy, when compared to usual care.

Objective: To determine whether group-based training improves foster carer self-efficacy.

Do home visiting programmes improve children's language development? A systematic review.

Objectives: This review examines home visiting programmes that specifically provide home based support to vulnerable, socially disadvantaged women who are either pregnant or have recently become a new parent. Home visiting programmes often report multiple outcomes. The purpose of this review is to systematically summarise how effective home visiting programmes are at improving young children's language development.

What Use is Anatomy in First Opinion Small Animal Veterinary Practice? A Qualitative Study.

Despite the uncontested importance of anatomy as one of the foundational aspects of undergraduate veterinary programs, there is still limited information available as to what anatomy knowledge is most important for the graduate veterinarian in their daily clinical work. The aim of this study was therefore to gain a deeper understanding of the role that anatomy plays in first opinion small animal veterinary practice. Using ethnographic methodologies, the authors aimed to collect rich qualitative data to answer the question "How do first opinion veterinarians use anatomy knowledge in their day-to-day clinical practice?" Detailed observations and semi-structured interviews were conducted with five veterinarians working within a single small animal first opinion practice in the United Kingdom.

Acute kidney injury and adverse outcomes of critical illness: correlation or causation?

Critically ill patients who develop acute kidney injury (AKI) are more than twice as likely to die in hospital. However, it is not clear to what extent AKI is the cause of excess mortality, or merely a correlate of illness severity. The Bradford Hill criteria for causality (plausibility, temporality, magnitude, specificity, analogy, experiment & coherence, biological gradient and consistency) were applied to assess the extent to which AKI may be causative in adverse short-term outcomes of critical illness.

Pregnancy and weight monitoring: A feasibility study of weight charts and midwife support.

Around half of pregnant women in the United Kingdom are overweight or obese. The antenatal period provides an opportunity for encouraging women to adopt positive lifestyle changes, and in recent years, this has included development of strategies to support women in avoiding excessive gestational weight gain. The objective of this interventional cohort study was to incorporate individualised gestational weight monitoring charts supported by motivational interviewing (MI)-based conversations into midwifery-led antenatal care and assess potential of the intervention for further development and evaluation.