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Perineal trauma requiring suturing is increasing, along with the associated physiological and psychological morbidities for women. Provider training appears to focus more on technical aspects rather than respectful, relational care for women. Studies exploring women's experiences have identified that how women are cared for can significantly impact upon overall experiences. To identify areas of improvement to the perineal suturing process and provide robust recommendations for urgent change by investigating what aspects are most traumatic to women and which are most supportive. A pragmatic qualitative analysis of data generated from 15 in-depth interviews with women who were sutured following birth. Regardless of tear severity, what was identified as helpful included anything that made the process better by increasing feelings of trust and reassurance, and providing women with a sense of being seen and heard. Harmful experiences were identified as those that worsened the experience, by increasing feelings of fear and vulnerability and leaving women with a sense of being disregarded or disrespected. The study confirmed that how the suturing process is conducted can have a significant detrimental impact upon women's short- and longer-term physical and psychological well-being. An improved experience for women is most likely with kind professionals who explain the process as it goes along, check-in regularly and validate how the women feel. Women prefer to be sutured by a known professional, only if this provider is also kind and respectful. [ABSTRACT FROM AUTHOR]

Objective: Increased exposure to post‐graduate rural medical training is associated with increased likelihood of future rural practice. Training rotations in rural emergency departments provide a possible avenue for such exposure, but have been under‐investigated. This study aimed to compare junior medical officers' emergency department experiences in a metropolitan and a rural hospital to inform rural health workforce initiatives. Design: Mixed‐method case‐study design. Setting: Two 10‐week periods in the respective emergency departments. Participants: Four junior medical officers at the rural site and 22 junior medical officers at the metropolitan hospital. Main outcome measures: Caseloads extracted from electronic medical records and training experience. Results: Data were collected over 142 days. The average number of patients seen per day, per junior medical officer, was significantly higher at the rural hospital emergency department (7.2 patients per day) in comparison with the metropolitan hospital (4.3 patients per day). Junior medical officers at the rural hospital saw relatively more lower acuity patients. The seven junior medical officers who were interviewed provided consistently positive responses regarding their training experiences in both locations. This was particularly evident in the rural hospital and was attributed to one‐on‐one supervision. Conclusions: Most junior medical officers agreed that their expectations for support and learning opportunities were met and/or exceeded. However, junior medical officers reported feeling more supported at the rural hospital due to direct contact and communication with senior medical officers. Placement in a smaller hospital emergency department did not disadvantage the junior medical officers' training in this case‐study and provided a positive rural training experience. These findings support workforce policies which encourage rural hospital emergency department training. [ABSTRACT FROM AUTHOR]

Participation in qualitative research frequently relies upon recall and verbal expression, which may be difficult for some people with dementia. While the use of arts-based and visual methods are transforming dementia care, exploratory research and evaluation methods have lagged behind with regard to the use of innovative qualitative approaches. This scoping review identified innovative qualitative methods that have been used to effectively engage and involve people with dementia in social and health research. Systematic searches of academic databases, Google Scholar, and hand searches identified 24 peer-reviewed articles published since 2010 for inclusion. Analysis focused on a description of both the motivation and methods ascribed by the researchers and how the capacities of people with dementia were engaged as part of the research process. The most frequently used innovative method was Photovoice. Action research, case study, narrative production, ethnography, participatory filmmaking and theater, co-research, and mixed methods were also used. Regardless of methodology, most studies used a participatory approach that incorporated visual methods alongside adapted semistructured or unstructured interviews. Researchers were focused on inclusion, empowerment, selfexpression, flexibility, and communication when selecting methods. Providing an appropriate research environment and committing time for repeat contact, observation, and engagement were important considerations. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the relationship between the birth environment and the practice of midwifery using the theoretical approach of critical realism. BACKGROUND: The practice of midwifery has significant influence on the experiences and health outcomes of childbearing women. In the developed world most midwifery takes place in hospitals. The design and aesthetics of the hospital birth environment have an effect on midwives and inevitably play a role in shaping their practice. Despite this, knowledge about midwives' own thoughts and feelings regarding the design of hospital birth environments is limited. METHODS: An exploratory descriptive methodology was used and 16 face-to-face photo-elicitation interviews were conducted with practicing midwives. Audio recordings were made of the interviews and they were transcribed verbatim. Thematic analysis, informed by the theoretical framework of critical realism, was undertaken. RESULTS: Midwives identified cognitive and emotional responses to varied birth environments and were able to describe the way in which these responses influenced their practice. The overarching theme of "messages from space" was developed along with three sub-themes: messages, feelings, and behaviors. Midwives' responses aligned with the three domains of a critical realist world-view and indicated that a relationship existed between hospital birth environments and midwifery practice. CONCLUSIONS: The design of hospital birth rooms may shape midwifery practice by generating cognitive and emotional responses, which influence the activities and behaviors of individual midwives. [ABSTRACT FROM AUTHOR]

Abstract: Background: Research indicates that midwives and their practice are influenced by space and place and that midwives practice differently in different places. It is possible that one mechanism through which space and place influence midwifery practice is via neurobiological responses such as the production and release of oxytocin, which can be triggered by experiences and perceptions of the physical environment. Aim: To articulate the significance of space and place to midwifery and explore the relationship between the birth environment, neurobiology and midwifery practice. Discussion: Quality midwifery care requires the facilitation of trusting social relationships and the provision of emotionally sensitive care to childbearing women. The neuropeptide oxytocin plays a critical role in human social and emotional behaviour by increasing trust, reducing stress and heightening empathy, reciprocity and generosity. Principle conclusion: Through its role as a trigger for oxytocin release, the birth environment may play a direct role in the provision of quality midwifery care. [Copyright &y& Elsevier]