The SIMCA Study Protocol: Factors influencing the implementation of the Midwifery Continuity of Carer (MCoC) model of care in NHS maternity care in England: A mixed methods cross case analysis involving clinicians, women and policy makers.

Background: During pregnancy, labour and early motherhood, most women in the UK receive care from different midwives. NHS policy change in England sought to introduce a model of care whereby each woman is cared for by the same midwife throughout antenatal, intrapartum and postnatal periods, supported by a small team of midwives to cover off-duty periods. This model is called the Midwifery Continuity of Carer (MCoC).

Recent genetic drift in the co-diversified gut bacterial symbionts of laboratory mice.

Laboratory mice (Mus musculus domesticus) harbor gut bacterial strains that are distinct from those of wild mice but whose evolutionary histories are unclear. Here, we show that laboratory mice have retained gut bacterial lineages that diversified in parallel (co-diversified) with rodent species for > 25 million years, but that laboratory-mouse gut microbiota (LGM) strains of these ancestral symbionts have experienced accelerated accumulation of genetic load during the past ~ 120 years of captivity. Compared to closely related wild-mouse gut microbiota (WGM) strains, co-diversified LGM strains displayed significantly faster genome-wide rates of nonsynonymous substitutions, indicating elevated genetic drift-a difference that was absent in non-co-diversified symbiont clades.

Addressing uncertainty in identifying pregnancies in the English CPRD GOLD Pregnancy Register: a methodological study using a worked example.

Introduction: Electronic health records are invaluable for pregnancy-related studies. The Clinical Practice Research Datalink (CPRD) Pregnancy Register (PR) identifies pregnancies in primary care records, including uncertain cases.

Objectives: This paper outlines a method to reduce uncertainty in identifying pregnancies within CPRD GOLD PR data, exemplified through a study investigating the provision of pre-pregnancy care.

Less is more: evaluating the impact of transitions of care pharmacist-led optimization on discharge antibiotic therapy duration in the emergency department.

Background: Patients discharged from emergency departments (ED) with antibiotics for common infections often receive unnecessarily prolonged durations, representing a target for transition of care (TOC) antimicrobial stewardship intervention.

Methods: This study aimed to evaluate the effectiveness of TOC pharmacists' review on decreasing the duration of discharge oral antibiotics in patients discharged from the ED at an academic medical center. Pharmacist interventions were guided by an antibiotic duration of therapy guidance focused on respiratory, urinary, and skin infections developed and implemented by the antimicrobial stewardship program.