What factors influence midwives to provide obstetric high dependency care on the delivery suite or request care be escalated away from the obstetric unit? Findings of a focus group study.

Background: In the United Kingdom, midwives will engage in discussions with the multidisciplinary team as to whether they can provide Obstetric High Dependency Care (OHDC) on the Delivery Suite or whether a woman's care should be escalated to the critical care team. This study aimed to explore the question: What factors influence midwives to provide OHDC or request care be escalated away from the obstetric unit in hospitals remote from tertiary referral centres?

Methods: Focus groups were undertaken with midwives (n = 34) across three obstetric units in England, with annual birth rates ranging from 1500 to 5000 per annum, in District General Hospitals. Three scenarios in the form of video vignettes of handover were used as triggers for the focus groups.

The diagnosis and lived experience of polycystic ovary syndrome: A qualitative study.

Aims: To explore the impact of the diagnosis of polycystic ovary syndrome on health/ill health identity, how women experience this diagnosis and their health beliefs.

Background: Polycystic ovary syndrome is a common and heterogeneous condition, giving rise to a wide range of different health concerns. Previous research on polycystic ovary syndrome has been dominated by the medical perspective and less is known about the experiences and needs of women.

"Renewed" "older" motherhood/mothering: a qualitative exploration.

This UK-based qualitative study explored multiparous women's experiences of being "older" mothers. Respondents were "renewed mothers" who had a child/children relatively early in their reproductive careers and then again after 35 years of age. Key themes arising from the empirical data were: instrumental role of male partners in post-35 mothering, purported "renewal" of self in the face of menopause/diminution of mothering, caring for teenagers and babies/toddlers simultaneously, and subjection to criticisms of "wrong-aged" motherhood.

A longitudinal investigation into the functional and physical durability of insoles used for the preventive management of neuropathic diabetic feet.

Background: Insoles are commonly used to assist in the prevention of diabetic neuropathic foot ulceration. Insole replacement is often triggered only when foot lesions deteriorate, an indicator that functional performance is comprised and patients are exposed to unnecessary ulcer risk. We investigated the durability of insoles used for ulcer prevention in neuropathic diabetic feet over 12 months.

Raising awareness of polycystic ovary syndrome.

Aim: To identify women's experience of receiving information about polycystic ovary syndrome (PCOS), and develop an information booklet.

Method: Women from Cornwall with a diagnosis of PCOS participated in focus groups to discuss their experiences of the condition.

Findings: Participants described difficulties in sourcing credible and helpful information about PCOS.

Pregnant women with pre-existing diabetes: family support in managing the pregnancy process.

In this paper, we report on findings from a Diabetes UK funded qualitative research project concerned to explore daughter/mother relationships during pregnancy and the transition to motherhood of women with pre-existing diabetes. In-depth qualitative interviews took place with 12 pregnant women with pre-existing diabetes and four of their mothers, three (male) partners and one father. The study was exploratory in nature and aimed to consider what support pregnant women felt they needed and what support they received from their mothers and other family members to discover policy and practice needs and identify further research concerns.

A comparison of customised and prefabricated insoles to reduce risk factors for neuropathic diabetic foot ulceration: a participant-blinded randomised controlled trial.

Background: Neuropathic diabetic foot ulceration may be prevented if the mechanical stress transmitted to the plantar tissues is reduced. Insole therapy is one practical method commonly used to reduce plantar loads and ulceration risk. The type of insole best suited to achieve this is unknown.

Effects of diabetes on women's reproductive health.

Diabetes is a serious public health concern in the UK. For women this long-term condition poses challenges throughout life, particularly in relation to sexual and reproductive health. Healthcare professionals need to have an understanding of how diabetes affects women's reproductive health to provide appropriate advice, thereby empowering women, their partners and families to make appropriate decisions.

Women with pre-existing diabetes and their experiences of maternity care services.

Aims And Objectives: the aims of the study were to explore the experience of maternity care services used by women whose pregnancy is complicated by pre-existing diabetes, to gain a deeper understanding of service use and to identify aspects of services that women with pre-existing diabetes would like improved.

Background: for women with pre-existing diabetes; pregnancy, birth and the transition to motherhood can be complex and even chaotic. The aim of specialist diabetes care given during pregnancy and delivered by a specialist team of health-care professionals is to optimise pregnancy outcome.

Assessing the impact of nurse and allied health professional consultants: developing an activity diary.

Aims: To construct and test an activity diary designed to measure the impact and explore the activities of nurse and allied health professional consultants in relation to each speciality and function of the role.

Background: This was part of a funded feasibility study to assess the contribution of nurse and allied health professional consultants.

Design: This was an exploratory study.

Effectiveness of insoles used for the prevention of ulceration in the neuropathic diabetic foot: a systematic review.

Context: Ulceration can be a debilitating and costly complication of the neuropathic diabetic foot. Insoles inserted into footwear are routinely used in clinical practice to help to prevent ulceration. AIM AND SCOPE OF THE REVIEW: This review evaluated the effectiveness of insoles used for the prevention of ulcer in the neuropathic diabetic foot.

Identifying women requiring maternity high dependency care.

The prompt identification of clinical deterioration and referral for appropriate care are key issues in the management of women who become critically ill during pregnancy, labour and the postpartum period. The Intensive Care Society has developed designated levels of care in relation to adult patient care, which may not be appropriate for use in midwifery. Therefore, exploring the midwifery, nursing and medical literature related to levels of care and detection of clinical deterioration may highlight the need for these to be modified and adapted for the development of midwifery-specific levels of care that are appropriate for this cohort.

Mother/daughter relationships during pregnancy and the transition to motherhood of women with pre-existing diabetes: raising some issues.

In pregnancies complicated by pre-existing diabetes, there is a higher incidence of adverse pregnancy outcome. Several reports including the Confidential Enquiry into Maternal and Child Health, Diabetes in Pregnancy--are we providing the best care? (2007) highlighted the need for family involvement before/during pregnancy and in early motherhood with the aim of making pregnancy and the transition to motherhood a positive and fulfilling experience. Exploring the midwifery, sociological and diabetes literature may assist in gaining a better understanding of the complexities surrounding conception, pregnancy, childbirth and motherhood within the context of diabetes.

Measuring the contribution and complexity of nurse and physiotherapy consultants: a feasibility study.

Advanced practice roles in nursing and other health professions have become integral to a range of healthcare services world-wide providing experienced practitioners with the opportunity to extend their roles and influence decision making whilst maintaining patient contact. However, there has been limited research to evaluate the impact on health services of these advanced practice roles.The aim of this feasibility study was to analyse Nurse and Allied Health Professionals (AHP) Consultant activity in the four functions of the role (education, expert practice, leadership, research).

The physical characteristics of materials used in the manufacture of orthoses for patients with diabetes.

Background: Neuropathic diabetic foot ulceration may be prevented if the mechanical stress transmitted to the plantar tissues can be modified. Orthotic therapy is one practical method commonly used to maintain tissue integrity. Orthotic design must consider the materials chosen for use in fabrication and profile of the device because both aspects influence the performance and durability of the device.

A systematic review and meta-synthesis: evaluating the effectiveness of nurse, midwife/allied health professional consultants.

Aim: This paper presents the findings of a systematic review and meta-synthesis, which was undertaken to identify and assess studies that evaluated the nurse/midwife/allied health professional consultant role.

Background: As part of the modernization agenda in the National Health Service the United Kingdom government proposed 'Consultant' posts for nurses/midwives and allied health professionals as an opportunity for experienced practitioners to extend their roles. Four key functions were identified as being significant to this role development: expert practice, leadership, education and research.

Neighborhood deprivation and preterm birth in Plymouth, UK.

Objective: To assess the relationship between neighborhood deprivation and the preterm birth rate in Plymouth, UK, using routinely collected data from a clinical information system.

Methods: We used a clinic-based prospective case register study of all births in Plymouth UK between 1 January 1996 and 31 December 1997 combined with indices of neighborhood deprivation to assess the relationship between neighborhood deprivation and the preterm birth rate. Areas (n = 43) were classified according to the Townsend index, measuring material deprivation.

Gestational diabetes mellitus in Plymouth, U.K.: prevalence, seasonal variation and associated factors.

Objective: To estimate the prevalence of and associated factors in gestational diabetes mellitus (GDM) and its seasonal variation.

Study Design: A clinic-based, prospective, case register study was conducted from January 1996 to December 1997. A total of 4,942 consecutive Caucasian, pregnant women aged 15-46 years,free of a history of diabetes mellitus, underwent random plasma glucose screening and a 75-g, 2-hour oral glucose tolerance test in Plymouth, U.

How well do midwives estimate the date of delivery?

Objective: to compare expected date of delivery (EDD) and gestational age (GA) obtained by midwives with those calculated using the Confidential Enquiry into Stillbirths and Death in Infancy (CESDI) recommended formula.

Design: retrospective study of obstetric records and prospective study of clinical cases examined by multiple midwives.

Setting: postnatal wards, Maternity Unit, Plymouth, Devon, UK.