This paper explores a practical approach to pelvic floor health called the Skilling technique. Unlike the commonly recommended "squeezing upwards" method which teaches a woman to voluntarily squeeze upwards (a learnt technique), the Skilling method is entirely reflex: the squatting-based exercises on which it is based, strengthen the three reflex pelvic muscle forces which pull against the suspensory ligaments pubourethral ligament (PUL) and uterosacral ligament (USL) to: close the urethra during effort (control of stress incontinence), open the urethra during micturition, and stretch the vagina in opposite directions to control inappropriate activation of the micturition reflex [overactive bladder (OAB)]. The strengthened ligaments better support the pelvic visceral plexuses (VPs), which unsupported, can fire off impulses which the brain interprets as "chronic pelvic pain". This review investigates the impact of the Skilling technique on pain, bladder and bowel symptoms in women. In premenopausal women, results show a 50% symptom improvement in 68% to 82% of women who have chronic pelvic pain, urge, frequency, nocturia, abnormal emptying, and post-void residual urine. A modified Skilling technique was applied in children aged 6-11 years with day/night enuresis. Remarkably, an 86% cure rate was achieved over 4 months. It was hypothesized that this accelerated cure, which is achieved naturally with age, may be connected to the reinforcement of collagen which occurs with the increase in pubertal hormones. In summary, the Skilling technique is a promising and accessible method to enhance pelvic floor health for both women and children, offering a practical alternative to traditional approached like Kegel exercises.
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http://dx.doi.org/10.21037/atm-23-1768 | DOI Listing |
BMJ Open
January 2025
Faculty of Medical Sciences, University College London, London, UK.
Introduction: An ageing population and a workforce crisis have triggered an ambitious UK strategy for sustained delivery of healthcare. In perioperative care (the management of patients from contemplation of surgery until full recovery), it is recognised that interventions are needed to place the workforce on a more sustainable footing through cross-functionality and skill-shifting, namely with advanced practice roles. However, despite some reports and reviews in the literature, it is unclear how skills development efforts may potentially support workforce transformation for an effective and resilient perioperative care workforce.
View Article and Find Full Text PDFJ Eval Clin Pract
February 2025
Academic Unit of Population and Lifespan Sciences, School of Medicine, Clinical Sciences Building, University of Nottingham, Nottingham, Nottinghamshire, UK.
J Adv Nurs
November 2024
St Vincent's Hospital Sydney Homeless Health Service, Darlinghurst, New South Wales, Australia.
Aim: To explore specialist homeless health professionals' perceptions of gaps in homeless health care and understand whether these might be addressed through existing nursing scopes of practice.
Design: Qualitative descriptive study.
Methods: Semi-structured interviews and focus groups with a purposive sample of 22 staff in nursing (11) and non-nursing (11) roles, engaged with a Homeless Health Service.
J Feline Med Surg
October 2024
Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
Objectives: Sedation before veterinary visits is advocated to help reduce fear and anxiety in cats and facilitate safe handling. The aim of this study was to evaluate the effectiveness of trazodone, gabapentin and a trazodone/gabapentin combination for oral sedation in healthy feline patients before blood donation.
Methods: A total of 21 cats were included in the study.
Disaster Med Public Health Prep
October 2024
Johns Hopkins University School of Public Health; University of Hong Kong.
Surge capacity-the ability to acquire additional workers and resources during unexpected increases in service demand-is often perceived as a luxury. However, the COVID-19 pandemic necessitated an urgent expansion of surge capacity within health systems globally. Health systems in Bangladesh, Nepal, and Sri Lanka managed to scale up their capacities despite severely limited budgets.
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