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Background: Urinary incontinence is a common and impactful condition. Despite the availability of incontinence pads specifically designed for the male form, many men use pads designed to fit the female anatomy. Aim: This clinical audit-based study compares female/unisex and male incontinence pads in male community patients with urinary incontinence. Method: A survey was used to collect Likert-scale data on overall satisfaction and satisfaction with specific aspects of female/unisex and male incontinence pads, as well as with their health and wellbeing and situation and attitudes before and after intervention. Qualitative data were collected on positive features of, reasons for dissatisfaction with and suggested changes to each pad. Results: Among 18 participants, and in all but one domain, satisfaction scores were higher for male pads overall, with the greatest increases in score (1-5) for physical coverage of genital area (1.5), ability to hold urine without leaks (1.4) and level of comfort when wet (1.3). Using a male pad had a positive impact on participants' sense of health and wellbeing. Positive qualitative feedback focused on comfort, ease of use and reliability, as well as the anatomical fit of the male pad. Conclusions: Sex-specific fit is an important factor in the acceptability of an incontinence pad for men with urinary incontinence. Wearing pads specifically designed for the male anatomy provides men with a greater sense of comfort and confidence. [ABSTRACT FROM AUTHOR]

Background: Limb strength is a central component of neurological assessment and monitoring in nursing practice, yet there is a lack of research examining the tools used by nurses or challenges nurses encounter when using these tools. The evidence base is lacking to inform effective practice and the underpinning educational approaches. Aim: To determine which tools are used by UK and Irish neuroscience nurses in the assessment of limb strength and the associated challenges and variations in practice. Methods: This study used an online self-reported survey design to ascertain which tools neuroscience nurses used and their experience of using these (n=160). Findings: Practices varied, with a dominance of two tools being used in practice: the Medical Research Council scale and the 'normal power' to 'no movement' scale found on the neurological observation chart. Most respondents used the same tool across all conditions. Conclusion: This study highlights variations in assessment practice and the absence of a sound evidence base behind choice of motor limb strength assessment tools used. [ABSTRACT FROM AUTHOR]

Introduction: Airway management, including endotracheal intubation, is one of the cornerstones of care of critically ill patients. Internationally, health professionals from varying backgrounds deliver endotracheal intubation as part of their critical care role. This article considers the development of airway management skills within a single advanced critical care practitioner (ACCP) team and uses case series data to analyse the safety profile in performing this aspect of critical care. Skills were acquired during and after the ACCP training pathway. A combination of theoretical teaching, theatre experience, simulation and work-based practice was used. Case series data of all critical care intubations by ACCPs were collected. Audit results: Data collection identified 675 intubations carried out by ACCPs, 589 of those being supervised, non-cardiac arrest intubations requiring drugs. First pass success was achieved in 89.6% of cases. A second intubator was required in 4.3% of cases. Some form of complication was experienced by 42.3% of patients; however, the threshold for complications was set at a low level. Conclusions: This ACCP service developed a process to acquire advanced airway management skills including endotracheal intubation. Under medical supervision, ACCPs delivered advanced airway management achieving a first pass success rate of 89.6%, which compares favourably with both international and national success rates. Although complications were experienced in 48.3% of patients, when similar complication cut-offs are compared with published data, ACCPs also matched favourably. [ABSTRACT FROM AUTHOR]

Background: this article reports on a study of continence education and training for students and qualified nurses. Aims: to understand how nurses and nursing students gain their knowledge in continence education and training, to examine nurses' understanding of bladder and bowel care and to discover to what degree nurses are confident in their knowledge of bladder and bowel care. Methods: this was a qualitative enquiry and a case study methodology was used to frame the research. The data were captured through a questionnaire and group discussions. Findings: continence education comprised support through self-learning, classroom instruction, skills laboratory sessions and on the wards. Feedback from participants indicated that, although continence education enhanced learning, they thought continence education sessions were either too short or did not go into enough detail. Two key factors that limited learning in the workplace were time and work priorities. Conclusion: it is recommended that a combination of learning strategies is useful and valuable in developing the nurse's skills and knowledge of continence care, if time and funding are available. [ABSTRACT FROM AUTHOR]

Airway assessment and management skills are vital in an emergency department (ED) as they are the most sensitive indicator of patient deterioration. Problems as common as head injury or alcohol intoxication are associated with an inadequate airway or diminished respiratory function and can cause a patient's condition to decline rapidly. Maintaining a patient's airway and facilitating breathing is the main priority in any emergency situation, although achieving airway control can be difficult. All health professionals need to be able to safely undertake airway management. The key is a thorough assessment to determine whether the airway is patent or not. This paper will discuss the importance and practicalities of airway management and assessment in the emergency and intensive care. [ABSTRACT FROM AUTHOR]

There are many ethical issues regarding kidney transplantation as the supply of cadaveric (deceased) organs does not meet the increasing demand for organs. The proportion of organs from living donors is increasing in the UK. This has many benefits for the recipient but raises many ethical issues. The aim of this article is to outline these ethical issues that the nurse and other members of the multidisciplinary team need to consider when caring for both donors and recipients of living kidney transplantations. [ABSTRACT FROM AUTHOR]

A cohort of patients presented to Queen Victoria Hospital, UK, with iatrogenic toe ischaemia following application of a different, newly available post-procedure dressing with different properties to those usually used. This resulted in ischaemia with extensive skin and soft tissue damage, requiring debridement surgery and, in some cases, skin grafting. We aim to highlight the risk of morbidity from dressing application to the digits. This is a key learning skill for anyone who may either perform dressings or evaluate dressings on digits in the community and across multiple specialties in hospital. This article follows a thorough root cause analysis and addresses other possible causes of an acutely painful erythematous toe post-Zadek's procedure. [ABSTRACT FROM AUTHOR]

Intermittent self-catheterisation (ISC) is a safe and effective treatment in the management of neuropathic bladder, voiding dysfunction and urinary incontinence in women. ISC has been shown to improve quality of life when used appropriately. It provides freedom for individuals who require bladder drainage as they can choose where and when to catheterise to empty the bladder. ISC requires minimum equipment, is a more discreet solution than an indwelling catheter and is relatively easy to teach in one patient visit. There are a range of different ISC catheters available on prescription. Many have been designed specifically for women and patient choice regarding product selection is an important consideration. This article describes a UK patient-satisfaction survey evaluating the female patient's perspective of learning ISC using a silicone intermittent catheter called HydroSil Go™ that is manufactured by C.R. Bard, Inc. [ABSTRACT FROM AUTHOR]

This article considers the anatomy and physiology of the skin,wound healing, excoriation, maceration, peristomal skin and the importance of periwound protection. The results of a 54-patient study of the use of barrier film forming skin protection in periwound skin are presented and a 10-patient healthy volunteer experimental evaluation. The results confirm the effectiveness of barrier protection in healthy skin in an experimental evaluation and a 54-patient study requiring periwound protection. [ABSTRACT FROM AUTHOR]

It is estimated that around one in 500 people in the UK are living with a stoma, with approximately 21 000 operations that result in stoma formation being performed each year (Colostomy Association, 2016). These people face a unique set of challenges in maintaining the integrity of their peristomal skin. This article explores the normal structure and function of skin and how the care and management of a stoma presents challenges for maintaining peristomal skin health. Particular focus is paid to the incidence of skin problems for those living with a stoma, whether it is temporary or permanent, and the factors that contribute to skin breakdown in this population. Wider factors such as the central role of the clinical nurse specialist and the impact of product usage on positive outcomes and health economics are also considered. [ABSTRACT FROM AUTHOR]

Approximately 10000 new colostomies are formed each year (IMS, 2006), most of which will be permanent. There is currently a wide range of colostomy products available, and new appliances are constantly coming onto the Drug Tariff. While this gives colostomates greater choice and ensures that their various needs are met, it can make the selection of an appropriate appliance difficult. This article discusses the merits of, and indications for, the one- and two-piece colostomy appliances currently available in the UK. It gives a brief overview of the anatomy and physiology of the gastrointestinal tract in relation to colostomy formation, and outlines the more common types of operation that may result in the formation of a colostomy. [ABSTRACT FROM AUTHOR]

Recognition and treatment of the acutely ill patient, by Phil Jevon [ABSTRACT FROM AUTHOR]

Considers guidance on hospital postmortems and proposals in relation to the removal, retention and storage of organs taken from patients who died in British hospitals. Case scenario; Guidelines published by the British Department of Health regarding postmortem examinations; Law on postmortem examination requested by the coroner.

Approximately 450 000 people use long-term urinary catheters in the UK. Permanent catheters are used by 3% of the community population and occupy an estimated 4% of a district nurse’s caseload in the UK. Catheterisation is defined as ‘drainage or aspiration of the bladder or urinary reservoir' and can be intermittent or indwelling. Long-term indwelling catheterisation can be transurethral or suprapubic via the anterior abdominal wall. This article will discuss the safe and effective use of different forms of catheterisation for patients in the community setting. [ABSTRACT FROM AUTHOR]

Chronic wounds affect millions of people worldwide. In the UK alone, the cost of their treatment is estimated to be between £4.5bn and £5.1bn. The implementation of wound-bed preparation strategies remove the barriers to healing and wound debridement is a key component in preparing the wound bed for wound progression. This article aims to review one of the several debridement methods available to clinicians: autolytic debridement. Autolysis (i.e. autolytic debridement) uses the body’s own enzymatic mechanisms to remove devitalised tissue in order to remove the barriers to healing. This review aims to provide clinicians working in wound care with a better understanding of the mechanisms and implications of autolytic debridement. [ABSTRACT FROM AUTHOR]

Pressure ulcers are a frequent, but often preventable, occurrence among patients in acute care facilities, and the heel is one of the anatomical locations most commonly affected. Multiple clinical guidelines recommend the use of robust assessments to identify at-risk patients and the application of heel protection devices to reduce the likelihood of developing heel pressure ulcers. A quality improvement initiative involving robust skin-assessment practices, staff education, and the use of heel protection devices was analysed retrospectively to evaluate the effiˆcacy of current practice interventions. These analyses revealed that the incidence of heel pressure ulcers was inversely correlated with the number of heel protectors used at two large acute NHS teaching hospitals in inner London, and that the consistent and early use of heel protectors improved patient outcomes and reduced costs of care. [ABSTRACT FROM AUTHOR]

Keith Cutting, Clinical Research Consultant, Hertfordshire, summarises presentations on the seated patient and benefits of wheelchair cushions that are designed to prevent pressure ulceration in such patients [ABSTRACT FROM AUTHOR]

Heel pressure ulcers are the second most common site for pressure ulceration; although their assessment and treatment can be complex, and they often require additional consideration over and above core principles of pressure ulcer prevention and management. Recent international pressure ulcer prevention and treatment guidelines developed jointly in Europe and the USA have provided greater clarity by achieving international consensus on how to care for patients at risk of heel pressure ulceration, and also on the management of such patients if a pressure ulcer develops. Health professionals should embrace these guidelines and embed them in their everyday clinical practice and within local guidance and protocols to ensure that patients are provided with evidence-based care supported by international collaboration and agreement. [ABSTRACT FROM AUTHOR]

The article discusses some tools that could be used by midwives to boost their skills. Topics covered include the development of a perineum model known as woolgina for midwives. Also mentioned is the use of the model to help students and other care professionals learn the pelvic floor and perineum anatomy.

Decoronation of high risk mandibular third molars (M3Ms) has become common practice in parts of UK and USA. With the introduction of Cone Beam CT scanning, there has been an evolution in the practice, with avoidance of unnecessary coronectomies based on CBCT findings. Also, additional anatomical features found only on CBCTs have introduced possible additional indications to undertake intentional coronectomy. Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico-legal implications. Iatrogenic injuries to the third division of the trigeminal nerve remain a common and complex clinical problem. Altered sensation and pain in the orofacial region may interfere with speaking, eating, kissing, shaving, applying make-up, toothbrushing and drinking; namely just about every social interaction we take for granted. Usually after oral rehabilitation, the patient expects and experiences significant improvements, not only regarding jaw function, but also in relation to dental, facial, and even overall body image. Thus these injuries have a significant negative effect on the patient's self-image and quality of life and the iatrogenesis of these injuries lead to significant psychological effects. [ABSTRACT FROM AUTHOR]

The treatment for xerosis (dry skin) is the repeated use of moisturizers to hydrate the skin. Their use is based on sound evidence of the importance of maintaining the skin's water content. Although the skin on the plantar surface of the foot is very thick, it is highly visco-elastic and copes with high levels of frictional, compressive and shear stresses applied to it by being supple and well hydrated. Problems arise when the skin becomes dry and loses its elastic properties. Fissures can occur which are often painful and can act as portals for infection. This article describes a double-blind clinical study to evaluate and compare the effectiveness of two commonly used moisturizers and to see if one was significantly better than the other at hydrating the skin of the feet. The two creams used were Aqueous Cream BP and CCS Foot Care Cream. Skin hydration levels were measured before any application of moisturizer and again after two weeks of twice daily application. Results showed that the regular use of both moisturizers had a significant hydrating effect on the skin. However, CCS Foot Care Cream had a significantly greater hydrating effect than Aqueous Cream BP. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of non-invasive biofeedback electrical stimulation on symptomatic abnormal skin scars. Method: Thirty patients with over 140 scars with long-term pain and itch were recruited into the study. Patients monitored the intensity of symptoms (pain and itching) on a numerical rating scale. In addition, a modified Manchester scar scale was used to objectively assess digital photographs of each scar in terms of colour, contour, distortion and texture, while a non-invasive spectrophotometric intracutaneous analysis was used to monitor the scars' physical characteristics. Results: The electrical stimulation device resulted in a clinically and statistically significant (p<0.05) reduction of symptoms and scar scores. Pain and itch scores were both reduced to a median score of 0 by 2 months, from a baseline of 7 and 6 respectively. Scar scores were reduced from a baseline of 14 to a median score of 11 by 2 months. l Conclusion: These results give a preliminary indication of the potential role of non-invasive biofeedback electrical stimulation in the management of chronic scar pain and itch. However, further large scale controlled studies are warranted to elucidate its overall efficacy and mechanistic action. [ABSTRACT FROM AUTHOR]

The article discusses on how and where to check a pulse relative to dental surgery in Great Britain. It offers information on the ABCDE approach which stands for airway, breathing, circulation, disability and exposure. It states that the common site for checking the pulse of an adult is the radial artery, while in infants and children, it is the brachial artery. It also presents a suggested procedure for checking a patient's radial pulse.

Comments on the breach of trust following the retention and storage of human organs at Adler Hey and Bristol Royal Infirmary in Great Britain. Actions taken by the Department of Health in responding to the grief of the relatives affected; Details of the Human Tissue Act 1961 and Anatomy Act 1984; Issues related to transplants from live donors.

The article offers information on how to evaluate the breathing of patients in the dental practice through the Airway, Breathing, Circulation, Disability and Exposure (ABCDE) approach outlined by the Resuscitation Council UK in Great Britain. Assessment of breathing include noting patients' appearances, colors and respiratory rate. The author then suggested ways to manage breathless patients by clearing their airway, assisting them to an upright position and administering oxygen.

This article reports the finding of a small non-controlled evaluation over a 2-week period in three different care settings: a residential care home, an acute stroke unit and a community intermediate care hospital. At initial recruitment 30 patients were identified by clinical assessment as being at high risk of developing a heel pressure ulcer. Further inclusion criteria were identifying heels that had signs of pressure damage occurring, blanching and non-blanching erythema, blistering and category 2 ulceration. In all, 15 patients fully completed the evaluation over a 14-day period. The mean age was 86 years. The low-friction bootee was worn constantly while in bed and seated in chairs, only being removed for heel checks and hygiene care. No patients were independently mobile during the evaluation; products were not worn to walk in due to a risk of falling—patients in the community hospital who had to mobilise for rehabilitation removed the bootees for this activity. All had pressure mapping and ultrasound of pedal pulses prior and after evaluation by the tissue viability specialist nurse. Results of pressure mapping showed a reduction of peak heel pressures on application of the bootees and a final review of reduction in visual signs of heel damage, reduced pain, increased comfort and ease of use. These results indicate that a standardised care pathway approach to heel protection using low-friction heel bootees is effective in all care settings for the reduction and prevention of heel pressure damage. [ABSTRACT FROM AUTHOR]

The article provides information about the Wound Care Society (WCS) Essential Skin Care/National Nursing Home initiative in Great Britain. The initiative includes the development of a specific resource pack related to skin care and the creation of a conference which covers topics related to anatomy, physiology and skin assessment. Further information about the conference is offered on their Web site www.woundcaresociety.com.

Clinical examination skills are vital for the accurate assessment and diagnosis of patients. These skills also allow clinicians to differentiate between pathology requiring investigation or treatment and normal anatomy or physiology. This allows clinicians to avoid unnecessary tests and to be able to reassure a patient that their symptoms do not require treatment. However, an incomplete or faulty clinical examination can lead to missed diagnoses and patient harm. Although comprehensive clinical examination skills training is provided in the undergraduate curriculum of medical schools in the UK, little is known in relation to the teaching provided for nurses and allied health professions working in advanced practice roles. This survey sought to explore this phenomenon and uncover clinicians' experiences with regard to being taught a selection of specific clinical examination skills in theory and in practice, those skills being the core system examinations (respiratory, cardiovascular and peripheral vascular, abdominal, central and peripheral nervous systems) and a number of focused examinations (digital rectal and examination, thyroid, breast and genital examination for males and females). The findings demonstrate a concerning variability of educational experiences and a lack of educational coverage of some of the basic clinical examination skills in both theoretical and practical terms. These findings provide an insight into areas of future higher education curricula development as well as workplace mentoring and learning. [ABSTRACT FROM AUTHOR]

This research study was undertaken to elicit a group of final-year student nurses' perceptions of their motivations and approaches to learning, and the implications of their views. It is important to explore this subject because students' motivations and approaches to learning can potentially impact patient care. This study was part of a larger research project. The sample consisted of 18 final-year student nurses at a large UK university. Students completed semi-structured interviews that used a qualitative constructivist approach to explore their educational experience. Students described what motivated them to learn, and how they approached their learning because of their understanding of which subjects they believed were and were not important. Students felt that clinical skills were the most important subjects, and topics such as health promotion, law and ethics, were less important and therefore they approached these subjects in a superficial way, learning just enough to pass their course. Clinical skills were perceived as more useful because they would be used directly in clinical practice. The findings of this study are significant to inform nurse educators as they plan curricula and provide an insight into what may potentially adversely affect patient care when students become registered nurses. [ABSTRACT FROM AUTHOR]

The article focuses on issues related to nursing in Great Britain. It mentions the importance to nurses of achieving national recognition by state registration. It cites the important role played by nurses in treating fractured limbs. It offers notes on methods of lifting and moving helpless patients.

Focuses on the basic provisions of the Human Tissue Act 2004 and its implications for midwives in Great Britain. Details on the proposals for new legislation on human organs and tissue; Regulation of activities involving human tissue; Accounts on the fundamental principle underpinning the lawful retention and use of body parts, organs and tissues from the living or deceased persons.

The article reports that Osteoarthritis (OA) is the commonest cause of disability in Great Britain, but it is still not a government priority. Many see it as a condition "you just have to live with." A community survey of older people with OA identified that 43 percent had difficulty with household activities and 33 percent with hobbies and leisure activities. Lifestyle changes can make a huge difference to the health and quality of life of people with OA, as well as reducing health-care costs. In total, 0.5 million have moderate-severe knee OA and a third to a half of all knee OA is theoretically preventable through regular exercise, weight control and using joint protection during activities that could lead to joint injury and development of OA.

The Wound Care Association UK (WCAUK) is committed to supporting both the accurate and consistent delivery and reporting of pressure ulcers/injuries based on the best available research and evidence. It is known that strategic and clinical guidance to support the delivery of evidence-based care does have a significant impact. Recent proposals to change pressure ulcer categorisation led the WCAUK to undertake a questionnaire survey of its members. This article outlines the importance of evidence-based guidance on the categorisation and assessment of pressure ulcer, highlighted by the responses to published changes to pressure ulcer categorisation for nurses in England, and presents the results of the survey. The article concludes that, although the discipline of tissue viability is constantly developing, the changes must be based on evidence, and clinicians must be supported strategically and practically to implement any proposed changes. Since publication of the new guidance the document has become the subject of further discussion, following concerns raised by tissue viability nurse specialists with strategic responsibility for change, as well as generalists who are expected to implement the changes. [ABSTRACT FROM AUTHOR]

Colostomy patients have distinct needs that require specialised pathways for optimal care. Recognising that these needs vary, based on the type and configuration of the stoma, is crucial. Specialist nurses play a vital role in providing long-term support and expertise. While many stoma nursing services in the UK offer patient pathways, these often lack specificity for different stoma types. Tailoring pathways to colostomy patients can prevent complications, reduce hospital readmissions and enhance quality of life. Community nurses and other healthcare professionals are essential in supporting colostomy patients through individualised care. Their involvement ensures that patients receive appropriate preparation for life with a stoma and are adequately educated about their specific needs. This multidisciplinary approach fosters a comprehensive care environment, addressing both the physical and emotional aspects of living with a colostomy. By focusing on personalised care and life-long support, healthcare professionals can significantly improve patient outcomes and overall well-being. [ABSTRACT FROM AUTHOR]

Aim: To provide insights into the optimal use of virtual reality (VR) in nursing education by evaluating pre-registration nursing students' experiences in conducting holistic patient assessments while interacting with artificial intelligence (AI)-led patients. Specifically, this project evaluation compares the use of two different VR scenarios, one employing a menu-based interface and another using AI voice-controlled technology. Methods: Eleven pre-registration adult nursing students from two UK universities were selected through purposeful sampling to participate in the two VR simulations. Data collection and analysis: This included qualitative insights gathered from three focus group sessions, audio-recorded and thematically analysed to classify and describe students' experiences. Findings: Four key themes emerged: technological literacy, VR as a learning tool, the road of learning, and transition to independence. Advantages across both methods of VR-AI interaction and their particular challenges were identified and described for each key theme. Conclusion: VR with AI-led patient technology in pre-registration nursing education positively contributes to the curriculum by exposing students to problem-based learning situations and use of a multiplicity of skills in a safe environment. Although both methods are relevant for developing proficiencies around holistic patient assessment, there are advantages and limitations to each. Students perceived the voice-controlled technology as more intuitive with a more natural method of communication, whereas the menu-based interaction gave students more structure and guidance. [ABSTRACT FROM AUTHOR]

Background/Aims: NHS tongue tie service provision throughout the UK has previously been described as a 'post code lottery'. A 2021 survey was conducted, with the aim to provide an update to a 2016 survey of tongue tie services in the UK. Methods: A total of 179 trusts or health boards were approached with similar survey questions to a 2016 survey and achieved a response rate of 72% (n=130). Results: There were similarities to the findings of the previous National Childbirth Trust survey, although there was an overall increase in NHS services provided. There is still variation in terms of the lead professional involved in delivering tongue tie services at the point of contact with the mother and baby, the criteria used for referral, the waiting time for assessment and treatment and the follow-up processes. Evidence supporting most aspects of care is limited, which causes much professional discussion. Conclusions: The provision of NHS tongue tie services is still a 'post code lottery' and inequitable for mothers and babies. [ABSTRACT FROM AUTHOR]

Coronary heart disease is the most common cause of death in the United Kingdom, accounting for approximately 94,000 deaths per year (Allender et al, 2008). Coronary angiography is currently regarded as the gold standard technique for evaluation of patients with suspected coronary heart disease and for defining coronary anatomy (Di Mario and Sutaria, 2005; Edmond et al, 2008). When caring for patients undergoing coronary angiography, it is essential to ensure that all aspects of nursing care are evidence-based so that the nurse can perform safe and accountable practice (NMC, 2008). The aim of this article is to update the nurse's knowledge and skills on caring for a patient undergoing coronary angiography. The indications, contra-indications and complications will be reviewed. All aspects of nursing care and patient education will be discussed and a rationale for nursing actions will be provided. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation affects an estimated 200 million women and girls worldwide. This article examines a midwife-led service that integrates health advocates and counsellors into a model of holistic woman-centred care and was the blueprint for new national clinics opened in 2019. Methods: This retrospective case note review examined referral patterns, clinical findings and interventions over 11 years at a UK specialist clinic for non-pregnant women with female genital mutilation. Results: More than 2000 consultations were conducted. Two thirds of women had type 3 mutilation. Most were Somali (73.4%) with 18 other ethnic backgrounds represented. Women presented with dysuria, dyspareunia/apareunia, dysmenorrhea, recurrent infections, post-traumatic stress disorder, nightmares, flashbacks and psychosexual issues. Interventions included deinfibulation under local anaesthetic (many as same day walk-in cases), clinical reports for asylum applications and trauma counselling. One in 10 attendees were healthcare professionals/carers. Nearly 5% were refugees/asylum seekers. There were 12 safeguarding referrals, three cases of mandatory reporting duty and two protection orders. Intersectional violence was frequently reported among women of West African origin. Conclusions: Significant numbers of non-pregnant women require specialist help. Innovative means to publicise clinics and routine enquiry during gynaecological consultations and GP registration, could ensure earlier signposting to services. Deinfibulation can be safely performed by an expert midwife in a community or outpatient setting. [ABSTRACT FROM AUTHOR]

The article focuses on musculoskeletal injuries relating to moving and handling in the dental practice. Topics discussed include information on statistics, tasks that may lead to injury, and manifestations of injury, the anatomy and physiology relevant to this injury, the definition of moving and handling from Health Service Executive (HSE) 2004, the provisions of the Health and Safety at Work Act 1974 and the Manual Handling Operations Regulations 1992, and the importance of risk assessment.

The incidence of obstetric anal sphincter injury in the UK is rising. This condition leads to significant morbidity in otherwise healthy women. Significant long-term complications of obstetric anal sphincter injury include anal incontinence, ano-vaginal or recto-vaginal fistula and psychological distress. Current management of third and fourth degree perineal tears post-vaginal birth is primary repair. This article discusses the role of a defunctioning colostomy in women with severe perineal tears in the immediate postnatal period. A defunctioning colostomy is a surgical procedure to open a section of colon (large bowel) onto the abdominal wall; a stoma bag is then worn over this to collect faeces. The rectum and anal canal are not used (defunctioned), while the stoma is in place and the perineum is healing. This article describes the purpose and operative steps of colostomy formation and reviews current published evidence of outcomes in those with colostomy formation for obstetric anal sphincter injury. It also addresses the difference in clinical approach between obstetricians and colorectal surgeons in relation to the management of severe obstetric anal sphincter injury and highlight the need for multidisciplinary input. [ABSTRACT FROM AUTHOR]

Background/Aims: Midwives are often the only professionals to examine a women after a vaginal birth. Therefore, it is important that they are trained in the detection and management of obstetric perineal trauma. This study's aim was to establish midwives' current knowledge and training in post-birth perineal trauma, including obstetric anal sphincter injuries, in the UK. Methods: An online national validated survey was distributed to UK midwives. There were 58 questions to assess midwives' knowledge and training. Univariable and multivariable analyses were conducted. Results: A total of 149 midwives participated. Only 50.3% had received training in obstetric tears. Midwives were better at classifying 3a (98.0% and 87.9% respectively) than 3b tears (79.2%, 85.9% and 84.6%) from images and descriptive text. Those who had training (P=0.02) and were a higher banding (P=0.003) were better at identifying tears. Conclusions: Although midwives' knowledge of obstetric tears was good, there was room for improvement and midwives stated that they would like more training. [ABSTRACT FROM AUTHOR]