Midwives and supervisors of midwives' perceptions of the statutory supervision of midwifery within the United Kingdom: A systematic review

Within the United Kingdom, the statutory supervision of midwives has a central role in both the provision of safe, high-quality maternity services and in the regulation of midwifery practice. Despite its long history, little is currently known about how midwives and their supervisors perceive and experience the statutory supervisory process.     

Evaluation of an online master’s programme in Somaliland. A phenomenographic study on the experience of professional and personal development among midwifery faculty

To record the variation of perceptions of midwifery faculty in terms of the possibilities and challenges related to the completion of their first online master's level programme in Sexual and Reproductive Health and Rights in Somaliland. The informants included in this phenomenongraphical focus group study were those well-educated professional women and men who completed the master's program. The informant perceived that this first online master's level programme provided tools for independent use of the Internet and independent searching for evidence-based information, enhanced professional development, was challenge-driven and evoked curiosity, challenged professional development, enhanced personal development and challenged context-bound career paths. Online education makes it possible for well-educated professional women to continue higher education. It furthermore increased the informants' confidence in their use of Internet, software and databases and in the use of evidence in both their teaching and their clinical practice. Programmes such as the one described in this paper could counter the difficulties ensuring best practice by having a critical mass of midwives who will be able to continually gather contemporary midwifery evidence and use it to ensure best practice. An increase of online education is suggested in South-central Somalia and in similar settings globally.     

Issues with implementing a high‐quality lung cancer screening program

Answer questions and earn CME/CNE After a comprehensive review of the evidence, the United States Preventive Services Task Force recently endorsed screening with low‐dose computed tomography as an early detection approach that has the potential to significantly reduce deaths due to lung cancer. Prudent implementation of lung cancer screening as a high‐quality preventive health service is a complex challenge. The clinical evaluation and management of high‐risk cohorts in the absence of symptoms mandates an approach that differs significantly from that of symptom‐detected lung cancer. As with other cancer screenings, it is essential to provide to informed at‐risk individuals a safe, high‐quality, cost‐effective, and accessible service. In this review, the components of a successful screening program are discussed as we begin to disseminate lung cancer screening as a national resource to improve outcomes with this lethal cancer. This information about lung cancer screening will assist clinicians with communications about the potential benefits and harms of this service for high‐risk individuals considering participation in the screening process. CA Cancer J Clin 2014;64:351–363. © 2014 American Cancer Society.     

Cardiovascular Disease and Homelessness

Cardiovascular disease (CVD) is a major cause of death among homeless adults, at rates that exceed those in nonhomeless individuals. A complex set of factors contributes to this disparity. In addition to a high prevalence of cigarette smoking and suboptimal control of traditional CVD risk factors such as hypertension and diabetes, a heavy burden of nontraditional psychosocial risk factors like chronic stress, depression, heavy alcohol use, and cocaine use may confer additional risk for adverse CVD outcomes beyond that predicted by conventional risk estimation methods. Poor health care access and logistical challenges to cardiac testing may lead to delays in presentation and diagnosis. The management of established CVD may be further challenged by barriers to medication adherence, communication, and timely follow-up. The authors present practical, patient-centered strategies for addressing these challenges, emphasizing the importance of multidisciplinary collaboration and partnership with homeless-tailored clinical programs to improve CVD outcomes in this population.     

A Comparative Analysis of Current Lipid Treatment Guidelines: Nothing Stands Still

Lipid treatment guidelines have continued to evolve as new evidence emerges. We sought to review similarities and differences of 5 lipid treatment guidelines from the American College of Cardiology/American Heart Association, Canadian Cardiovascular Society, European Society for Cardiology/European Atherosclerosis Society, U.S. Preventive Services Task Force, and U.S. Veterans Affairs/Department of Defense. All guidelines utilize rigorous evidentiary review, highlight statin therapy for primary and secondary prevention of atherosclerotic cardiovascular disease, and emphasize a clinician-patient risk discussion. However, there are differences in statin intensities, use of risk estimators, treatment of specific patient subgroups, and consideration of safety concerns. Clinicians should understand these similarities and differences in current and future guideline recommendations when considering if and how to treat their patients with statin therapy.     

‘Teaching on the Run’ with Australian midwives in a tertiary maternity hospital

Teaching On The Run (TOTR) is an Australian program for health professionals involved in clinical supervision. An amended TOTR program was evaluated with midwives acting as preceptors assisting learners integrate theory with clinical practice. A mixed method study was employed to compare midwives' perceived skills and confidence before and after completion of TOTR workshops. A secondary aim explored midwifery learners' (students and new graduates) perceptions of support from preceptors during the implementation of TOTR. Sixty five midwives completed the TOTR workshops with 46 providing data before program enrolment and 1–3 months after completion of the final TOTR workshop. Significant improvements were found for midwifery preceptors with before and after comparisons using Preceptor Self-Efficacy and Self-Evaluation Questionnaires. Using the Nursing Facilitator Clinical Questionnaire, preceptees or midwifery learners (n = 49) scored the ‘qualities of their preceptors’, ‘their clinical practice’, ‘clinical learning’ and ‘how feedback was provided’ highly with no changes between 2013 and 2014. Nineteen students then participated in three focus group interviews, analyzed using a six step systematic process. One overarching theme, ‘Guiding me through’ emerged with four themes: ‘Getting to know each other’; ‘Willingness to share knowledge’; ‘Leading by example’; and ‘The system acknowledging and valuing the preceptor role’.     

志愿服务何以持续：社团化运作的优势与路径分析

本文基于南通市“巾帼挽霞行动”社工服务项目的实践探索,通过对社区志愿者、社团志愿者及高校学生志愿者持续参与志愿服务状况的比较分析,认为志愿服务由社团来承担具有诸多的优越性。社团应逐步成为持续志愿服务的承担主体。社团的志愿服务化以及志愿者的社团化应该成为持续志愿服务管理的努力方向。