This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to supporting women and ...babies during the postnatal/neonatal period. Written in an accessible way, this book provides step-by-step processes for students to follow, and is ideal for professionals to share with the women and families in their care.
Anatomy. Bereavement – dealing with the loss of a baby. Bottle feeding. Breastfeeding. Calculating feed requirements. Changing stools. Contraception. Cord care. Developmental care. Discharge. Drugs for neonates. Emergencies. Fluid balance. Hand expression. Hypoglycaemia in the newborn. Lochia. Neonatal examination. Neonatal jaundice. Neonatal screening. Phototherapy. Post birth care. Postnatal examination. Postnatal complications. Skin to skin. Stillbirth and neonatal death. Sudden Infant Death Syndrome (SIDS). Thermoregulation of the newborn. Transient tachypnoea of the newborn. General abbreviations. Support groups
Alison Edwards is a Senior Midwifery Lecturer and Programme Director for the Shortened Midwifery programme at the University of Birmingham, UK. Alison has been a nurse and midwife for over 32 years, progressing through a BSc and Masters’ degree during that time. Current projects involve the development of virtual teaching tools including the use of avatars simulating labour scenarios, and escape room technology.
This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to antenatal care and ...related anatomy and physiology. Used as a platform for wider reading, this text is an ideal reference point for any student or professional involved with the care of childbearing women.
ABDOMINAL EXAMINATION.Amniotic fluid index,Inspection,Palpation,Auscultation,Measurement,Expected findings. ANAEMIA. ANATOMY.Fetal circulation,Female external genitalia,Uterus. ANTENATAL APPOINTMENTS. ANTENATAL SCREENING,Blood tests at booking,Follow-up blood tests,Urine,Ultrasound scans,Additional screening,Routine surveillance. BENEFITS. BISHOP’S SCORE FOR INDUCTION OF LABOUR. BLOOD PRESSURE TAKING. BLOOD VALUES. BMI. BOOKING ADVICE. BRITISH SIGN LANGUAGE. CALCULATING ESTIMATED DELIVERY DATES. CHOLESTASIS. CTG INTERPRETATION. CUSTOMISED GROWTH CHARTS. DIABETES.Type 1 diabetic women,Gestational diabetic women. DRUG ADMINISTRATION.Drugs and midwives/student midwives,Midwives exemptions and PGDS,Safe administration,Drug abbreviations,Formulas. EMERGENCIES,Adult life support for a pregnant woman,Antepartum haemorrhage,Eclampsia. FEMALE GENITAL MUTILATION. FUNCTIONS OF THE PLACENTA. METHODS OF INDUCTION. MINOR DISORDERS. PRE- ECLAMPSIA. RECORD KEEPING. SUBSTANCE MISUSE. SUPPORT GROUPS. USEFUL WEBSITES. VENEPUNCTURE.Procedure for taking blood,Vacutainer blood bottles and tests. VULNERABLE GROUPS OF WOMEN
Alison Edwards is a Senior Midwifery Lecturer and Programme Director for the Shortened Midwifery programme at the University of Birmingham, UK. Alison has been a nurse and midwife for over 32 years, progressing through a BSc and Masters’ degree during that time. Current projects involve the development of virtual teaching tools including the use of avatars simulating labour scenarios, and escape room technology.
This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to antenatal care and ...related anatomy and physiology.
This new edition of Antenatal Midwifery Skills has been updated to reflect the most up-to-date guidance around the care of childbearing women. The first in a set of three books which together guide readers along each step in the journey from pregnancy to postnatal/neonatal care, Antenatal Midwifery Skills provides all the crucial information relating to the antenatal part of the childbearing process. Students have access to revision of related anatomy and physiology alongside current national guidance. Step-by-step processes for skills relating to this area can support student learning in the practice setting. Topics include antenatal screening, managing medical conditions such as cholestasis, CTG interpretation, midwives' exemptions and much more.
Used as a platform for wider reading, this text is an ideal reference point for any student or professional involved with the care of childbearing women.
This pocket-sized book, presented in an easy to follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to supporting women and ...babies during the postnatal/neonatal period.
This new edition of Postnatal and Neonatal Midwifery Skills has been updated to reflect the most up-to-date guidance around the postnatal and neonatal care of women and newborn babies. The third and final text in a set of three which together guide readers along each step in the journey from pregnancy to postnatal/neonatal care, Postnatal and Neonatal Midwifery Skills considers the time following the birth and the care required for women and their babies in the postnatal period. While covering the key principles of postnatal care, including postnatal examinations of mother and baby alongside infant feeding information, this is the first pocket reference to include the skills for the newborn and infant physical examination.
Written in an accessible way, this book provides step-by-step processes for students to follow, and is ideal for professionals to share with the women and families in their care.
Determining the structures of nanoparticles at atomic resolution is vital to understand their structure-property correlations. Large metal nanoparticles with core diameter beyond 2 nm have, to date, ...eluded characterization by single-crystal X-ray analysis. Here we report the chemical syntheses and structures of two giant thiolated Ag nanoparticles containing 136 and 374 Ag atoms (that is, up to 3 nm core diameter). As the largest thiolated metal nanoparticles crystallographically determined so far, these Ag nanoparticles enter the truly metallic regime with the emergence of surface plasmon resonance. As miniatures of fivefold twinned nanostructures, these structures demonstrate a subtle distortion within fivefold twinned nanostructures of face-centred cubic metals. The Ag nanoparticles reported in this work serve as excellent models to understand the detailed structure distortion within twinned metal nanostructures and also how silver nanoparticles can span from the molecular to the metallic regime.
The preparation and characterization of a series of magnesium(II) iodide complexes incorporating β‐diketiminate ligands of varying steric bulk and denticity, namely, (ArNCMe)2CH− (Ar=phenyl, ...(PhNacnac), mesityl (MesNacnac), or 2,6‐diisopropylphenyl (Dipp, DippNacnac)), (DippNCtBu)2CH− (tBuNacnac), and (DippNCMe)(Me2NCH2CH2NCMe)CH− (DmedaNacnac) are reported. The complexes (PhNacnac)MgI(OEt2), (MesNacnac)MgI(OEt2), (DmedaNacnac)MgI(OEt2), (MesNacnac)MgI(thf), (DippNacnac)MgI(thf), (tBuNacnac)MgI, and (tBuNacnac)MgI(DMAP) (DMAP=4‐dimethylaminopyridine) were shown to be monomeric by X‐ray crystallography. In addition, the related β‐diketiminato beryllium and calcium iodide complexes, (MesNacnac)BeI and {(DippNacnac)CaI(OEt2)}2 were prepared and crystallographically characterized. The reductions of all metal(II) iodide complexes by using various reagents were attempted. In two cases these reactions led to the magnesium(I) dimers, (MesNacnac)MgMg(MesNacnac) and (tBuNacnac)MgMg(tBuNacnac). The reduction of a 1:1 mixture of (DippNacnac)MgI(OEt2) and (MesNacnac)MgI(OEt2) with potassium gave a low yield of the crystallographically characterized complex (DippNacnac)Mg(μ‐H)(μ‐I)Mg(MesNacnac). All attempts to form beryllium(I) or calcium(I) dimers by reductions of (MesNacnac)BeI, {(DippNacnac)CaI(OEt2)}2, or {(tBuNacnac)CaI(thf)}2 have so far been unsuccessful. The further reactivity of the magnesium(I) complexes (MesNacnac)MgMg(MesNacnac) and (tBuNacnac)MgMg(tBuNacnac) towards a variety of Lewis bases and unsaturated organic substrates was explored. These studies led to the complexes (MesNacnac)Mg(L)Mg(L)(MesNacnac) (L=THF or DMAP), (MesNacnac)Mg(μ‐AdN6Ad)Mg(MesNacnac) (Ad=1‐adamantyl), (tBuNacnac)Mg(μ‐AdN6Ad)Mg(tBuNacnac), and (MesNacnac)Mg(μ‐tBu2N2C2O2)Mg(MesNacnac) and revealed that, in general, the reactivity of the magnesium(I) dimers is inversely proportional to their steric bulk. The preparation and characterization of (tBuNacnac)Mg(μ‐H)2Mg(tBuNacnac) has shown the compound to have different structural and physical properties to (tBuNacnac)MgMg(tBuNacnac). Treatment of the former with DMAP has given (tBuNacnac)Mg(H)(DMAP), the X‐ray crystal structure of which disclosed it to be the first structurally authenticated terminal magnesium hydride complex. Although attempts to prepare (MesNacnac)Mg(μ‐H)2Mg(MesNacnac) were not successful, a neutron diffraction study of the corresponding magnesium(I) complex, (MesNacnac)MgMg(MesNacnac) confirmed that the compound is devoid of hydride ligands.
The ties that bind: The potassium reduction of β‐diketiminato magnesium(II) iodide complexes of varying steric bulk has led to two new magnesium(I) dimers (see figure). The reactivity of these (and a previously reported complex) towards Lewis bases, unsaturated organic substrates, and dihydrogen have been compared. The first structurally authenticated terminal magnesium hydride complex is also reported.
Structure-property relationships are the key to modern crystal engineering, and for molecular crystals this requires both a thorough understanding of intermolecular interactions, and the subsequent ...use of this to create solids with desired properties. There has been a rapid increase in publications aimed at furthering this understanding, especially the importance of non-canonical interactions such as halogen, chalcogen, pnicogen, and tetrel bonds. Here we show how all of these interactions - and hydrogen bonds - can be readily understood through their common origin in the redistribution of electron density that results from chemical bonding. This redistribution is directly linked to the molecular electrostatic potential, to qualitative concepts such as electrostatic complementarity, and to the calculation of quantitative intermolecular interaction energies. Visualization of these energies, along with their electrostatic and dispersion components, sheds light on the architecture of molecular crystals, in turn providing a link to actual crystal properties.
IMPORTANCE: Opportunistic screening for atrial fibrillation (AF) is recommended, and improved methods of early identification could allow for the initiation of appropriate therapies to prevent the ...adverse health outcomes associated with AF. OBJECTIVE: To determine the effect of a self-applied wearable electrocardiogram (ECG) patch in detecting AF and the clinical consequences associated with such a detection strategy. DESIGN, SETTING, AND PARTICIPANTS: A direct-to-participant randomized clinical trial and prospective matched observational cohort study were conducted among members of a large national health plan. Recruitment began November 17, 2015, and was completed on October 4, 2016, and 1-year claims-based follow-up concluded in January 2018. For the clinical trial, 2659 individuals were randomized to active home-based monitoring to start immediately or delayed by 4 months. For the observational study, 2 deidentified age-, sex- and CHA2DS2-VASc–matched controls were selected for each actively monitored individual. INTERVENTIONS: The actively monitored cohort wore a self-applied continuous ECG monitoring patch at home during routine activities for up to 4 weeks, initiated either immediately after enrolling (n = 1364) or delayed for 4 months after enrollment (n = 1291). MAIN OUTCOMES AND MEASURES: The primary end point was the incidence of a new diagnosis of AF at 4 months among those randomized to immediate monitoring vs delayed monitoring. A secondary end point was new AF diagnosis at 1 year in the combined actively monitored groups vs matched observational controls. Other outcomes included new prescriptions for anticoagulants and health care utilization (outpatient cardiology visits, primary care visits, or AF-related emergency department visits and hospitalizations) at 1 year. RESULTS: The randomized groups included 2659 participants (mean SD age, 72.4 7.3 years; 38.6% women), of whom 1738 (65.4%) completed active monitoring. The observational study comprised 5214 (mean SD age, 73.7 7.0 years; 40.5% women; median CHA2DS2-VASc score, 3.0), including 1738 actively monitored individuals from the randomized trial and 3476 matched controls. In the randomized study, new AF was identified by 4 months in 3.9% (53/1366) of the immediate group vs 0.9% (12/1293) in the delayed group (absolute difference, 3.0% 95% CI, 1.8%-4.1%). At 1 year, AF was newly diagnosed in 109 monitored (6.7 per 100 person-years) and 81 unmonitored (2.6 per 100 person-years; difference, 4.1 95% CI, 3.9-4.2) individuals. Active monitoring was associated with increased initiation of anticoagulants (5.7 vs 3.7 per 100 person-years; difference, 2.0 95% CI, 1.9-2.2), outpatient cardiology visits (33.5 vs 26.0 per 100 person-years; difference, 7.5 95% CI, 7.2-7.9), and primary care visits (83.5 vs 82.6 per 100 person-years; difference, 0.9 95% CI, 0.4-1.5). There was no difference in AF-related emergency department visits and hospitalizations (1.3 vs 1.4 per 100 person-years; difference, 0.1 95% CI, −0.1 to 0). CONCLUSIONS AND RELEVANCE: Among individuals at high risk for AF, immediate monitoring with a home-based wearable ECG sensor patch, compared with delayed monitoring, resulted in a higher rate of AF diagnosis after 4 months. Monitored individuals, compared with nonmonitored controls, had higher rates of AF diagnosis, greater initiation of anticoagulants, but also increased health care resource utilization at 1 year. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02506244
The synthesis, characterisation and reactivity of two isostructural anionic magnesium and calcium complexes is reported. By X‐ray and neutron diffraction techniques, the anionic hydrides are shown to ...exist as dimers, held together by a range of interactions between the two anions and two bridging potassium cations. Unlike the vast proportion of previously reported dimeric group 2 hydrides, which have hydrides that bridge two group 2 centres, here the hydrides are shown to be “terminal”, but stabilised by interactions with the potassium cations. Both anionic hydrides were found to insert and couple CO under mild reaction conditions to give the corresponding group 2 cis‐ethenediolate complexes. These cis‐ethenediolate complexes were found to undergo salt elimination reactions with silyl chlorides, allowing access to small unsaturated disilyl ethers with a high percentage of their mass originating from the C1 source CO.
CO has directly been transformed into small organic starting materials using earth‐abundant, anionic group 2 hydride reagents.
Although alert fatigue is blamed for high override rates in contemporary clinical decision support systems, the concept of alert fatigue is poorly defined. We tested hypotheses arising from two ...possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time.
Retrospective cohort study using electronic health record data (both drug alerts and clinical practice reminders) from January 2010 through June 2013 from 112 ambulatory primary care clinicians. The cognitive overload hypotheses were that alert acceptance would be lower with higher workload (number of encounters, number of patients), higher work complexity (patient comorbidity, alerts per encounter), and more alerts low in informational value (repeated alerts for the same patient in the same year). The desensitization hypothesis was that, for newly deployed alerts, acceptance rates would decline after an initial peak.
On average, one-quarter of drug alerts received by a primary care clinician, and one-third of clinical reminders, were repeats for the same patient within the same year. Alert acceptance was associated with work complexity and repeated alerts, but not with the amount of work. Likelihood of reminder acceptance dropped by 30% for each additional reminder received per encounter, and by 10% for each five percentage point increase in proportion of repeated reminders. The newly deployed reminders did not show a pattern of declining response rates over time, which would have been consistent with desensitization. Interestingly, nurse practitioners were 4 times as likely to accept drug alerts as physicians.
Clinicians became less likely to accept alerts as they received more of them, particularly more repeated alerts. There was no evidence of an effect of workload per se, or of desensitization over time for a newly deployed alert. Reducing within-patient repeats may be a promising target for reducing alert overrides and alert fatigue.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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