Advanced physical assessment: the role of the district nurse.

This article describes an initiative by an NHS trust to support its district nurses in developing and using physical examination skills as part of patient assessment. The article outlines the process and suggests that the initiative is important to help meet the needs of older patients with long-term conditions.

A hospital-based doula program and childbirth outcomes in an urban, multicultural setting.

Objectives: The objective of this study is to determine whether there are differences in birth and breastfeeding outcomes for women who received labor support through a hospital-based doula program, compared with those who did not receive doula support in labor.

Methods: We conducted a retrospective program evaluation to compare differences in birth outcomes between births at 37 weeks or greater with doula support and births at 37 weeks or greater without doula support through the first seven years of a hospital-based doula support program. Log-binomial regression models were used to compare differences in cesarean delivery rates, epidural use, operative vaginal delivery, Apgar scores, breastfeeding intent and early breastfeeding initiation after controlling for demographic and medical risk factors.