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Background In several countries, midwifery students undertake continuity of care experiences as part of their pre-registration education. This is thought to enable the development of a woman-centred approach, as well as providing students with the skills to work in continuity models. A comprehensive overview of factors that may promote optimal learning within continuity experiences is lacking. Aim To identify barriers and facilitators to optimal learning within continuity experiences, in order to provide a holistic overview of factors that may impact on, modify and determine learning within this educational model. Methods An integrative literature review was undertaken using a five-step framework which established the search strategy, screening and eligibility assessment, and data evaluation processes. Quality of included literature was critically appraised and extracted data were analysed thematically. Findings Three key themes were identified. A central theme was relationships, which are instrumental in learning within continuity experiences. Conflict or coherence represents the different models of care in which the continuity experience is situated, which may conflict with or cohere to the intentions of this educational model. The final theme is setting the standards, which emerged from the lack of evidence and guidance to inform the implementation of student placements within continuity experiences. Conclusion The learning from continuity experiences must be optimised to prepare students to be confident, competent and enthusiastic to work in continuity models, ultimately at the point of graduation. This will require an evidence-based approach to inform clear guidance around the intent, implementation, documentation and assessment of continuity experiences.

To translate and validate a Spanish-language version of the Birth Satisfaction Scale-Revised (BSS-R) and describe key measurement properties.A cross-sectional instrument validation design examining factor structure, validity and reliability.Three public hospital sites in Spain.202 women who had given birth within the past four weeks provided complete questionnaire data for analysis.Measures included the Spanish version of the BSS-R (S-BSS-R) and the Perceived Stress Scale (PSS). The tri-dimensional measurement model of the BSS-R was found to offer a good fit to Spanish data. Known-groups discriminant validity was found to be excellent with women experiencing a non-intervention delivery having higher S-BSS-R scores (p 0.05) compared to those having an intervention. Women who had no pain control were found to have greater S-BSS-R total and S-BSS-R women's attributes and stress experienced sub-scale scores compared to those who received pain control (p 0.05). Total scale internal reliability was also found to be acceptable. Evidence for good divergent and convergent validity was also found across total and sub-scale S-BSS-R scores.The S-BSS-R was found to have generally good to excellent psychometric properties and represents a valid and reliable translation of the original version of the BSS-R for use in Spanish-speaking populations. The development of the S-BSS-R enables comparison of birth satisfaction with international study data where the BSS-R is used.The relationship of both delivery type and pain control to birth satisfaction represent important areas for further research.

There is a growing need and demand to redesign neonatal services to place a focus on family-centered care provided locally. Early discharge training programs that prepare parents to tube-feed and care for their preterm infant at home may offer a viable option, but these are understudied. A narrative review of relevant literature was undertaken. The key findings highlighted that within the discharge programs there was no increase in readmission rates caused through home tube-feeding, infant weight gain was adequate and parental satisfaction was reported as high when 24-hour access to staff was available. Further, an increased duration of breastfeeding was associated with a reduced risk of readmission. The review highlights the potential of this service as an alternative to in-patient care for infants requiring short-term tube-feeding during their transition to full oral-feeding.

Background: Compassion fatigue and burnout can impact on performance of nurses. This paper explores the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life, and wellbeing among community nurses.\ud Aim: To measure associations between self-compassion, compassion fatigue, wellbeing, and burnout in community nurses.\ud Method: Quantitative data were collected using standardised psychometric questionnaires: (1) Professional Quality of Life Scale; (2) Self-Compassion Scale; (3) short Warwick Edinburgh Mental Wellbeing Scale; (4) Compassion For Others Scale, used to measure relationships between self-compassion, compassion fatigue, wellbeing, and burnout. \ud Participants: A cross sectional sample of registered community nurses (n=37) studying for a postgraduate diploma at a University in the North of England took part in this study.\ud Results: Results show that community nurses who score high on measures of self-compassion and wellbeing, also report less burnout. Greater compassion satisfaction was also positively associated with compassion for others, and wellbeing, whilst also being negatively correlated with burnout. \ud Conclusion: High levels of self-compassion were linked with lower levels of burnout. Furthermore when community nurses have greater compassion satisfaction they also report more compassion for others, increased wellbeing, and less burnout. The implications of this are discussed alongside suggestions for the promotion of greater compassion. \ud \ud Key words: burnout, compassion fatigue, district nurses, compassion, self-compassion, wellbeing

Background: Compassion fatigue and burnout can impact on the performance of midwives, with this quantitative paper exploring the relationship between self-compassion, compassion fatigue, self-judgement, self-kindness, compassion for others, professional quality of life and well-being of student midwives. Method: A quantitative survey measured relationships between self-compassion, compassion fatigue, well-being, and burnout using questionnaires: (1) Professional Quality of Life Scale; (2) Self-Compassion Scale; (3) Short Warwick and Edinburgh Mental Well-being Scale; (4) Compassion For Others Scale. Participants: A purposive and convenience sample of student midwives (n=103) studying at university participated in the study. Results: Just over half of the sample reported above average scores for burnout. The results indicate that student midwives who report higher scores on the self-judgement sub-scale are less compassionate towards both themselves and others, have reduced well-being, and report greater burnout and compassion fatigue. Student midwives who report high on measures of self-compassion and well-being report less compassion fatigue and burnout. Conclusion: Student midwives may find benefit from ‘being kinder to self’ in times of suffering, which could potentially help them to prepare for the emotional demands of practice and study. Implications: Developing, creating and cultivating environments that foster compassionate care for self and others may play a significant role in helping midwives face the rigours of education and clinical practice during their degree programme.

Background In 2016, the World Health Organization (WHO) labelled 13% of the world's adult population as obese. This increase in obesity is accompanied by mortality and morbidity problems, with maternal obesity and its accompanying risk for mother and infant requiring to be carefully managed. Aim To explore childbearing women with a high BMI (>35 kg/m2) perceptions of risk and its potential impacts upon pregnancy and outcome. Method Qualitative Interpretative Phenomenological Analysis (IPA) was used to gain deeper understanding of the lived experiences of childbearing women with a BMI>35 kg/m2 and perceptions of their risk and potential pregnancy outcome. Findings One of the superordinate themes that emerged was (1) Risk or no risk, and its associated three subthemes of (1a) Emotional consequences of her risky position, (1b) Recognition of high-risk complicationsfinally sinking in, and (1c) Accepting the risk body. Recommendations for practice In general, health care professionals are uncomfortable about discussing obesity-associated risks with pregnant women. The participants in this study did not classify themselves as obese, with this absence of acknowledgement and 'risky talk' leaving participants' unaware of their obesity-associated risk. This downplaying of obesity related talk requires to be corrected, simply because women in denial will perceive no need to engage with health promotion messages. In response, directives are required to be embedded into policy and practice. Conclusion Specific training is required to teach maternity care professionals how to have difficult, sensitive conversations about obesity related risks with childbearing women with high BMI's. In addition, this risk information needs to be accompanied by relevant advice and support.

The most recent Confidential Enquiry into Maternal Deaths (CMACE, 2011) identified human errors, specifically those of midwives and obstetricians/doctors as a fundamental component in contributing to maternal death in the U.K. This paper discusses these findings and outlines a project to provide training in Maternal-Acute Illness Management (M-AIM) to final year student midwives. Contents of the program are designed to educate and simulate AIM skills and increase confidence and clinical ability in early recognition, management and referral of the acutely ill woman. An outline of the Maternal-AIM program delivered at the University of Salford (Greater Manchester, UK) is presented to illustrate how this particular institution has responded to a perceived need voiced by local midwifery leaders. It is proposed that developing this area of expertise in the education system will better prepare student midwives for contemporary midwifery practice.

Background: The NMSF (2009) reported that 74 Trusts (40%) in the UK lack expertise in delivering maternity based bereavement care. In response, 3 midwifery lecturers were issued with a small grant from NHS Scotland to devise and evaluate an interactive workbook intended to develop student midwives understanding of how to deliver high quality bereavement care. \ud Aim: To develop a workbook called - an interactive workbook to shape bereavement care for midwives in clinical practice - and evaluate it for effectiveness at delivering learning objectives developed from the literature and from prior written lesson plans.\ud Method: An evaluative audit was carried out using a scored questionnaire -Understanding Bereavement Evaluation Tool (UBET) - to gather data before and post workbook completion. The UBET was purposely designed to gather data about participants’ perceived level of learning before and post workbook completion. Participants were student midwives (n=179) in their second/third year of study on a 3 year midwifery degree program at one of 3 universities. \ud Findings: The mean pre-workbook UBET score equalled 16.04 (SD = 3.81) and post-intervention 26.45 (SD = 2.16). A significant main effect of observation point was observed (p < 0.001), with post-intervention scores considerably higher than pre-intervention.\ud Discussion: Findings demonstrate that the workbook is an effective method for teaching bereavement care to student midwives (it is available from the first author).

Background Noroviruses (NoV) are a leading cause of gastroenteritis worldwide. Few epidemiological data regarding the NoV strains circulating in African countries are available. Objectives To determine the prevalence of NoV in Bobo Dioulasso (Burkina Faso) in both symptomatic and asymptomatic gastroenteritis patients. Study design Patients both with and without gastro-intestinal disorders were selected. Clinical and epidemiological data, as well as stool samples, were collected through March to April 2011. NoV molecular detection (genogrouping and genotyping) and viral load quantification were also performed for all samples. Results NoV were detected in 22.2% of the 418 collected stool samples (21.2% and 24.8% from the 293 symptomatic patients (SP) and the 125 asymptomatic patients (ASP) respectively). Genogroup (G) distribution was 7.5%, 10.2% and 3.4% for GI, GII and both GI/GII respectively among SP and 12.0%, 11.2% and 1.6% for GI, GII and both GI/GII, respectively, among ASP. Average viral load values were higher in SP than in ASP for GI ( p = 0.03) but not for GII. Phylogenic analysis showed a high degree of genotype diversity in SP and ASP. One recombinant GII.7/GII.6 sequence was, to the best of our knowledge, detected for the first time. Conclusions This study enabled identification of the specific molecular epidemiology of NoV strains circulating in a representative country in Eastern Africa, and additionally showed that ASP could play an important “reservoir” role. A high strain diversity was detected with a surprisingly high proportion of NoV GI compared to the common genotypes usually reported in comparable epidemiological studies.

AIM: While contraceptive methods increased in number the number of abortions has remained stable. The aim of this study was to estimate the satisfaction of women toward a contraceptive implant (Implanon((R))) available in France in order to clarify prescription. METHOD: The survey concerned 127 women who visited Angers and Nantes family planning centres between January2009 and January2010 in two implant prescription contexts (postabortion or not). They agreed to answer a first questionnaire describing the reasons for their choice. A second questionnaire was sent six months after to assess its tolerance. RESULTS: In our study 82% of patients were using a contraceptive method prior to implant (68% in postabortion and 88% in the other group). The first reason for choosing the implant was the fear of forgetting - it was more important in the postabortion group (88% vs. 61%). The main side effects were amenorrhea (50%) weight gain (30%) and mood disorders (19%). More than one in two women (54%) was very satisfied by the implant. It should be noted that in one quarter of cases women seek early withdrawal of the contraceptive implant (23% in postabortion and 21% in the other group) a rate that is 39% in patients under 25years and 47% in patients who reported a mood disorder. CONCLUSION: There is a tendency to better tolerance of the implant out of a context of abortion. Furthermore mood disorders appear to be poorly tolerated. These elements encourage greater caution in prescribing the contraceptive implant in postabortion situation in which patients have already psychological disorders and even more among younger patients. Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

Objective: To assess changes in the cost and availability of a standard basket of healthy food items (the Healthy Food Access Basket [HFAB]) in Queensland. Methods: Analysis of five cross-sectional surveys (1998, 2000, 2001, 2004 and 2006) describes changes over time. Eighty-nine stores in five remoteness categories were surveyed during May 2006. For the first time a sampling framework based on randomisation of towns throughout the state was applied and the survey was conducted by Queensland Treasury. Results: Compared with the costs in major cities, in 2006 the mean cost of the HFAB was $107.81 (24.2%) higher in very remote stores in Queensland, but $145.57 (32.6%) higher in stores more than 2,000 kilometres from Brisbane. Over six years the cost of the HFAB has increased by around 50% ($148.87) across Queensland and, where data was available, by more than the cost of less healthy alternatives. The Consumer Price Index for food in Brisbane increased by 32.5% over the same period. Conclusions and Implications: Australians, no matter where they live, need access to affordable, healthy food. Issues of food security in the face of rising food costs are of concern particularly in the current global economic downturn. There is an urgent need to nationally monitor, but also sustainably address the factors affecting the price of healthy foods, particularly for vulnerable groups who suffer a disproportionate burden of poor health Refereed/Peer-reviewed

Hollins Martin [Social influence effects on midwives’ practice. Presentation at the British Psychological Society Social Psychology Section Annual Conference, 10th–12th September, 2003: London] developed the Social Influence Scale for Midwifery (SIS-M) to measure social influence of a senior midwife on a junior midwife’s decisions. First, midwives were asked to answer SIS-M questions in a postal survey. Second, in interviews, a senior midwife attempted to influence SIS-M responses in a conformist direction. The results of the Hollins Martin (2003) study showed that a senior midwife was able to significantly influence change to many midwives decisions, F(1,57) = 249.62, p = 0.001. The present study aims to ascertain whether decision changes were caused by social components of the relationship between interviewer and interviewee, or education shared during discussion. This is achieved by removing social influence of the senior midwife at interview. For this purpose, a workbook was devised that replicated the exact content of interview. This workbook was posted to a differing group of 60 midwives, who had also previously completed a private postal SIS-M. Overall, analysis of variance (ANOVA) showed no significant difference between the postal workbook scores and the private SIS-M scores, (F(1,57) = 0.31, p = 0.58). In other words, participants gave similar responses to the SIS-M questions in the workbook as the private postal condition. Results exclude possibility that education during the Hollins Martin (2003) interviews adjusted participants’ schema in relation to decisions made. Furthermore, this indicates that the social relationship, in part, caused the large social influence effect during interviews. The implications for practice are: first, that a senior midwife is profoundly capable of influencing decisions that junior midwives make; second, educational content plays little part in this process. Moreover, many of the SIS-M decisions should not be the choice of a senior midwife, but the preference of the childbearing women.

This special edition offers unique insight into concepts of education within midwifery practice. One of the aims of delivering midwifery education is to advance the evidence-base and improve the quality of maternity care provided by midwives. In addition, childbearing women require accurate, accessible, evidence-based information from which to make decisions about their care. Pivotal to this approach is providing accurate information on which midwives can base their clinical decisions.