A before and after study of the impact of simulation training on practitioner confidence in complex operative deliveries.

The aim of this before and after study was to evaluate the efficacy of a complex operative obstetrics course in improving practitioner confidence. The course covered rotational instrumental vaginal delivery, vaginal breech delivery, cervical cerclage, management of postpartum haemorrhage, and complex caesarean section. Participants filled in a pre- and postcourse questionnaire using a Likert scale to rate confidence from 1 (not confident) to 5 (very confident) in 15 key skills.

Teaching undergraduate medical students virtual consultation skills: a mixed-methods interventional before-and-after study.

Objectives: To evaluate the impact and transferability of a novel teaching method on virtual communication skills for final year medical students.

Design: Mixed-methods, interventional before-and-after study.

Setting: NHS Lanarkshire, Scotland.

Emergency surgical obstetrics simulation training: an ex vivo low-cost model using bovine uterus and porcine bladder for haemostatic uterine brace suture techniques.

Postpartum haemorrhage remains a leading cause of maternal mortality and morbidity. While conventional obstetrics training curricula describe at length the management of postpartum haemorrhage, obstetrics trainees rarely have exposure to surgical management of postpartum haemorrhage in emergency situations due to reduced hours of training. Procedures such as the transverse or longitudinal haemostatic uterine brace sutures are recognised to be safe, simple and allow for the preservation of the uterus.

The use of the V-Care laparoscopic uterine manipulator to facilitate total abdominal hysterectomy: a novel approach and case-series.

Hysterectomy remains mostly performed via the abdominal route in the United Kingdom, despite advances in minimal access techniques and increased training in laparoscopic hysterectomy. The use of uterine manipulators remains a key component of the laparoscopic approach. During abdominal surgery, access to the pelvis can be challenging on occasion, and there may be a higher incidence of intraoperative complications.

Promoting Face-to-Face Dialogue for Community Engagement in a Digital Age.

Background Health researchers in urban centers recognize the need to engage with inner-city community-based organizations. Funding for face-to-face engagement is often limited because most work done by agencies and academics now focuses on the use of digital technology. Purpose This article presents reflections from a grant project aimed at establishing community engagement between academic health researchers and interdisciplinary inner-city community health and social service providers.

Outcomes of induction of labour in women with previous caesarean delivery: a retrospective cohort study using a population database.

Background: There is evidence that induction of labour (IOL) around term reduces perinatal mortality and caesarean delivery rates when compared to expectant management of pregnancy (allowing the pregnancy to continue to await spontaneous labour or definitive indication for delivery). However, it is not clear whether IOL in women with a previous caesarean section confers the same benefits. The aim of this study was to describe outcomes of IOL at 39-41 weeks in women with one previous caesarean delivery and to compare outcomes of IOL or planned caesarean delivery to those of expectant management.

Outcomes of elective induction of labour compared with expectant management: population based study.

Objective: To determine neonatal outcomes (perinatal mortality and special care unit admission) and maternal outcomes (mode of delivery, delivery complications) of elective induction of labour compared with expectant management.

Design: Retrospective cohort study using an unselected population database.

Setting: Consultant and midwife led obstetric units in Scotland 1981-2007.

Nursing issues related to patient selection, vascular access, and education in quotidian hemodialysis.

Background: Increased interest in quotidian hemodialysis (HD) programs requires that nephrology nurses have a larger role in transitioning patients to more frequent HD. Nursing issues include the selection, training, and education of patients before they begin more frequent HD therapy.

Methods: The London Daily/Nocturnal Hemodialysis Study directly compared data from patients undergoing either short daily HD (n = 11) or long nocturnal HD (n = 12) with those undergoing conventional thrice-weekly HD (n = 22).

The second stage of labour.

Obstetric intervention in the second stage of labour is frequently indicated. An appreciation of the physiology of the second stage and an awareness of the range of interventions with their appropriate selection and application will contribute towards ensuring a safe delivery.