Sensory processing in the auditory and olfactory domains is normal in laryngeal dystonia

Journal of Neurology - Abnormal sensory discriminatory processing has been implicated as an endophenotypic marker of isolated dystonia. However, the extent of alterations across the different...     

Vermessung der Cochlea mittels eines Tablet-basierten Softwarepakets: Einfluss der Bildgebungsmodalität und des Untersucherhintergrunds

HNO - Die Größe der Cochlea ist individuell unterschiedlich, was sich in der variablen Länge des Ductus cochlearis (CDL) ausdrücken lässt. In der Cochleaimplantatversorgung...     

National survey of how acupuncture education is organised for Swedish midwives

Objective

in Sweden, acupuncture education is required before midwives can use the method in clinical practice. Courses in acupuncture are usually organised by private individuals or companies, and each health facility decides on the adequacy of the educational package. Therefore, there is no overall standard or quality control for free-standing courses of acupuncture education for midwives. The aim of this study was to survey the education given to Swedish midwives in the use of acupuncture treatment in the obstetric area.

Design

a postal survey using a structured questionnaire.

Setting

organisers of acupuncture education.

Participants

18 acupuncture instructors.

Measurements and findings

acupuncture courses were usually organised outside universities and colleges. The courses were similar in terms of extent and content, and were mainly based on a Western medical approach. The recommended indications were extensive despite a lack of scientific evidence. The most common instructor profile was a midwife without any academic degree.

Key conclusions and implications for practice

courses differed considerably in the extent to which they were research based. Continuing professional education for midwives should be given at the same academic level, at least, as basic midwifery education.     

Empowerment in the midwifery context--a concept analysis

Objective

the concept empowerment is difficult to understand, define and translate into different contexts. Therefore, the purpose of this paper was to analyze the empowerment concept in the midwifery context, focused on the childbearing period, aimed at clarifying its meaning in order to enable comprehension and use in clinical practice, education and research.

Design

semi structured interviews and written text.

Setting

prenatal clinics, delivery and maternity wards in western Sweden.

Participants

nine midwives and 12 couples.

Measurements and findings

a concept analysis was undertaken according to the hybrid model which consists of the theoretical, fieldwork and analytical phases. After a literature review, the concept was empirically elucidated in the fieldwork phase. The final step was to describe criteria and attributes, illustrative cases, antecedents and consequences of the concept. The following tentative criteria and attributes of empowerment in the midwifery context are described: developing a trustful relationship; starting an awareness process, making it possible to reflect on the changing situation; acting based on the parents' situation on their own terms, getting them involved and able to make informed choices; confirming the personal significance of becoming parents. Finally, empowerment in the midwifery context was redefined.

Key conclusion

midwives use empowerment in education and research as well as strategies on both the micro and macro levels in practice.

Implications for practice

empirical findings from the concept analysis confirm the concept's relevance in the midwifery context.     

A national survey of how acupuncture is currently used in midwifery care at Swedish maternity units

Objective

it is not known how acupuncture is used in midwifery care in Sweden and what kind of requirements health-care providers have for midwives and acupuncture training programmes. The aims of this study were to survey indications for the use of acupuncture in midwifery care in Sweden, and to examine the criteria and requirements used for purchase of acupuncture education programmes.

Design

a postal survey using a structured questionnaire.

Setting

45 maternity units in Sweden.

Participants

the midwife-in-charge of the units.

Measurements and findings

the most common indications for the use of acupuncture were relaxation, pain relief, retained placenta, after pains, milk stasis during lactation, hyperemesis and pelvic instability. Specific requirement for acupuncture education were provision of a short course during weekdays including a follow-up course.

Key conclusion

acupuncture is widely used for many indications in Swedish maternity units despite weak or no evidence to support effectiveness in midwifery care. Requirements for acupuncture education did not seem to be in accordance with what might be expected for this type of qualified intervention.

Implications for practice

the use of acupuncture in midwifery care should not persist until systematic evaluation of the effect of this method is carried through.     

Androgen levels, insulin sensitivity, and early insulin response in women with polycystic ovary syndrome: a long-term follow-up study

Thirty-four women with polycystic ovary syndrome who previously had participated in studies with intravenous glucose tolerance test and hyperinsulinemic, euglycemic clamp between 1987 and 1995 underwent anthropometric, endocrine (T and sex-hormone binding globulin serum concentration), and metabolic (intravenous glucose tolerance test, hyperinsulinemic, euglycemic clamp, and androgens) measurements. Free androgen levels and β-cell function decreased over time in women with polycystic ovary syndrome, but insulin sensitivity remained unaltered.     

Safety, feasibility, and acceptability of visual inspection with acetic acid and immediate treatment with cryotherapy in rural Laos

Objective

To assess the safety, acceptability, and feasibility of visual inspection with acetic acid (VIA) followed by immediate treatment with cryotherapy as a single-visit approach for the prevention of cervical cancer among women in rural Laos.

Methods

In 2009, women from 2 provinces in Laos were recruited for cervical cancer screening using VIA. If the inspection of the cervix showed a well-defined acetowhite lesion close to the os, immediate cryotherapy was offered.

Results

Of the 1926 women who were included, 134 (7.0%) tested positive on VIA. Of these, 113 (84.3%) underwent immediate cryotherapy and none declined treatment. One year after immediate cryotherapy, 77 (68.1%) women returned for a follow-up assessment and 68 (88.3%) were now VIA-negative. There was no report of a major complication during or after treatment. The acceptance of both VIA and cryotherapy was high.

Conclusion

Visual inspection with acetic acid is a simple test that requires minimal infrastructure and expenditure. Integration of VIA with cryotherapy at the primary care level may constitute a feasible program for the prevention of cervical cancer in Laos.