Experiences of expert midwives in a training programaimed at decreasing perineal tears,

This descriptive study explored the roles and responsibilities of expert midwives involved in teaching staff from midwifery students to senior consultants/physicians. We have earlier conducted an intervention project, aimed at decreasing the number of anal sphincter tears. During this intervention a local core team of expert midwives was established. These experts continued the training of colleagues after the midwife instructor had fulfilled the active training period. Eighteen expert midwives from the four Norwegian hospitals which took part in this training program were recruited. To explore the views and experiences of these expert midwives, a questionnaire was completed, and the results were analyzed qualitatively. Before starting the program 24% of the midwives, working at the delivery ward were negative towards the supervision and project, while 46% were positive. One year after the program's start 92% were positive. Negative feedback at the beginning of the intervention came mostly from the media and professional midwifery organizations. The expert midwives felt that doctors were the most challenging to teach. The response from pregnant women was ultimately positive. Eighteen well motivated midwives became highly appreciated experts after an intensive training program and deemed themselves better and more successful professionals than before

Should pregnant women actively train?

Background The aim of this review article is to examine the evidence in the literature with regard to the safety of exercise in pregnancy. Material and Methods A literature search revealed fourteen randomised controlled trials which were systematically reviewed. The outcome measures looked at were both short and long term consequences of training in healthy pregnant women. Results The methodology of all included studies was qualitatively evaluated, though few were graded as good. The majority were small and had variable compliance from the volunteers. There was a lack of standardisation of the training schedules: the frequency ranged from 3 - 5 times per week, training intensities varied from age related maximal heart rates of 50 - 75% and exercise periods ranged from 20 – 60 minutes in length. Overall however, the exercise could be classified as moderate. The literature revealed neither the fetus nor the mother derived harm from moderate exercise in pregnancy. Pregnant women who exercised in the above manner delivered normal healthy infants. With increasing intensity of exercise it appears the children are born with a lower percentage of body fat and thereby a lower birth weight, though still within normal range. This form of training does not appear to increase the incidence of preterm birth or caesarean section. The low number of studies and small patient numbers make it difficult to draw any conclusions with regard to teratogenic effects of hyperthermia. The exclusion of women who developed obstetric complications means it is not possible to draw any conclusions as regards exercise and the risk of placental abruption or bleeding. Conclusion Moderate exercise seems to have positive effects on pregnancy by way of improved physical well being. Moderate exercise also appears to increase psychological well being – the women feel better. Children born to mothers who exercised regularly showed no significant difference to those born to sedentary mothers in either a positive or a negative way. There was no apparent positive or negative effect on the infant at birth. From currently available data it appears that regular exercise of moderate intensity is both safe and commendable in pregnancy. Further research in this area is required to assess whether physical activity can increase the risks of obstetric complications or cause significant effects from hyperthermia, particularly where exercise intensity is greater than as described here

Specific environmental risks from repurposing oil and gas wells : Chief Scientist’s Group research report

This project examined the environmental risks from using onshore oil and gas wells for other purposes. It considered the different ways that wells can be repurposed, the challenges in doing this, and assessed the numbers of wells that could be repurposed. These findings will help the Environment Agency and others make decisions about whether repurposing is an acceptable alternative to decommissioning at the end of a well’s life