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An audit of supervisors of midwives' (SoMs') experience of supervision and their understanding of their role as leaders in clinical practice was undertaken. Particular attention was paid to their experiences as newly appointed SoMs during the preceptorship period. The amount of protected time that SoMs have to undertake the role was explored, including how the SoMs achieved the expectations of being leaders in clinical practice.An online audit questionnaire was sent to all the SoMs within the local supervising authority. The findings of the audit demonstrated that a significant number of SoMs did not have preceptorship or supernumerary time as newly-appointed SoMs. The audit results confirmed the findings of previous research illustrating that SoMs had inadequate time to undertake their role. There was a variation in engaging with different leadership aspects of supervision depending on the SoM's substantive post. The SoMs participating in the audit gave examples of factors that impede them in achieving the standards for their role as set out by the Nursing and Midwifery Council. The SoMs participating in the audit expressed the empowering effect of being able to facilitate women's birth choices and supporting midwives to provide high quality midwifery care.

Pain is a significant concern in people with chronic wounds. A systematized approach is recommended for the management of wound-associated pain with the objectives to address pain relief, increase function, and restore overall quality of life.

BACKGROUND: Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. METHODS: We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ2) analyses. RESULTS: Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. INTERPRETATION: For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit.

Supervision of midwives is a statutory responsibility which provides a mechanism to support and guide practising midwives. The preparation course to become a supervisor of midwives (SoM) at the University of Hertfordshire requires a midwife to be nominated by her peers and to undertake a course at Masters level over two semesters. A learning strategy on the preparation course is ‘action learning’ (AL), whereby groups of six or seven student supervisors compulsorily attend six action learning sessions. AL requires skills of analysis, scrutiny and reflexivity. An exploration of AL as a teaching strategy on the SoM preparation course led to the conclusion that this is an appropriate and high-quality teaching method which develops the reflective skills of the participants as well as developing self awareness and communication skills to a high standard.

The lymphotoxins (LT) α and β, members of the tumor necrosis factor (TNF) cytokine superfamily, are implicated as important regulators and developmental factors for the immune system. LTα is secreted as a homotrimer and signals through two TNF receptors of 55–60 kDa (TNFR60) or 75–80 kDa (TNFR80). LTα also assembles with LTβ into a membrane-anchored, heterotrimeric LTα1β2 complex that engages a distinct cognate receptor, the LTβ receptor (LTβR). To investigate the role of the LTα subunit in the function of the membrane LTα1β2 complex, gene transfer via baculovirus was used to assemble LTα and -β complexes in insect cells. LTα containing mutations at D50N or Y108F are secreted as homotrimers that fail to bind either TNF receptor and are functionally inactive in triggering cell death of the HT29 adenocarcinoma cell line. In contrast, these mutant LTα proteins retain the ability to co-assemble with LTβ into membrane-anchored LTα1β2 complexes that engage the LTβR and trigger the death of HT29 cells. Membrane-anchored LTβ expressed on the cell surface in absence of the LTα subunit binds the LTβR but is functionally inactive in the cell death assay. These results indicate that the TNF receptor-binding regions of the LTα subunit are not necessary for engagement of the LTβR, but the LTα subunit is required for the assembly of LTβ into a functional heteromeric ligand.

Selecting books for young children can not only be a fun and rewarding experience but also a little daunting, considering the number of books available. Frequent collaboration between an author and a public librarian has produced valuable insights about how to begin reading with very young children. Suggestions are offered for how parents and educators can choose books that will encourage and motivate lifelong readers. Six research‐based areas defined by the Every Child Ready to Read @ your library program provide the framework: vocabulary, narrative connections, print motivation, print awareness, letter knowledge, and phonological awareness. Parents and teachers can evaluate various books based on this model. Several examples of books are described, and strategies for instruction and engagement are included with each.

The article discusses about a gradual reopening, audiences enjoy watching films together on the big screen in the majority of cinemas.

The article presents the views and acknowledgement of the author on the International Union of Cinemas countries in CinemaCon 2020.

This article focuses on the author's experience of a painful birth. The author had been having slight period pain twinges since 14.00, which came and went every 7 to 10 minutes or so. The author figured that, being 40 plus weeks pregnant, having had a bit of a show a few days before, and also feeling more emotional than usual, this could actually be the start of something. Ironically the author really did have to convince herself even to the point where her husband was worried that the author would have the baby with only him.

In this article, the author discusses CineEurope annual convention of International Union of Cinemas (UNIC). Topics to be discussed at convention include session on Emerging Global Markets, which promises to provide fascinating insights into the industry, possibilities of digital retail and the industry's efforts toward harnessing its appetite for innovation in sustainability and premium experiences, direct-view displays, and other technological developments.

BACKGROUND: Although documentation of children’s pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children.OBJECTIVES: To describe health care professionals’ use of written language related to the quality and quantity of pain experienced by hospitalized children.METHODS: Free-text pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized on 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was used.RESULTS: Pain narratives were documented a total of 5390 times in 1518 of the 3822 children’s medical records (40%). Overall, word choices represented objective and subjective descriptors. Two major categories were identified, with their respective subcategories of word indicators and associated cues: indicators of pain, including behavioural (eg, vocal, motor, facial and activities cues), affective and physiological cues, and children’s descriptors; and word qualifiers, including intensity, comparator and temporal qualifiers.CONCLUSIONS: The richness and complexity of vocabulary used by clinicians to document children’s pain lend support to the concept that the word ‘pain’ is a label that represents a myriad of different experiences. There is potential to refine pediatric pain assessment measures to be inclusive of other cues used to identify children’s pain. The results enhance the discussion concerning the development of standardized nomenclature. Further research is warranted to determine whether there is congruence in interpretation across time, place and individuals.

Jennifer Worth has written this novel based on her own experiences as a midwife working in London's East End in the 1950s. Working with an order of nuns practicing since the 1870s, she brings the poverty stricken conditions alive. The dedication of the midwives is quite humbling and the honesty of Ms Worth's writing is emotionally moving. The novel is an important piece of work detailing midwiferyhistory which would otherwise be lost to one incredible woman's memory. There is a beautiful description of the authors first breech birth at home, a 26-week old baby born prematurely who survived withkangaroo care at home, and a woman having her 25th baby in as many years.

The most shocking fact about Naomi Wolf’s book is that it is necessary at all. Much of what she has described as the USA way of birth in the 1990s was revealed by Suzanne Arms 20 years previously, and by other authors since. However it is vital that it is said again, and by women of influence, and crucially by a feminist.