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Trochez R.,Chilterns | Waterfield M.,Maternity Unit | Freeman R.M.,Locality
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2011

Introduction and hypothesis There seems to be a temporal association between increasing use of "hands off" the perineum in labour and reduced use of episiotomy with an increasing rate of anal sphincter injuries. We aimed to determine how common the practice of "hands off" the perineum is. Methods An observational postal questionnaire study of 1,000 midwives in England in which the main objective was to obtain an estimate of the number of midwives practising either "hands on" or "hands off" was conducted. Results Six hundred and seven questionnaires were returned; 299 (49.3%, 95% CI 45.2-53.3%) midwives prefer the "hands-off" method. Less-experienced midwives were more likely to prefer the "hands off" (72% vs. 41.4%, p<0.001). A higher proportion of midwives in the "handsoff" group would never do an episiotomy (37.1% vs. 24.4%, p=0.001) for indications other than fetal distress. Conclusions The "hands off" the perineum technique is prevalent in the management of labour. We hypothesise that a possible consequence might be an increased incidence of obstetric anal sphincter injury. © 2011 The International Urogynecological Association.


Barnett A.H.,University of Birmingham | Cradock S.,Portsmouth Hospitals | Fisher M.,Royal Infirmary | Hall G.,Locality | And 2 more authors.
International Journal of Clinical Practice | Year: 2010

Hypoglycaemia and its consequences represent a significant risk for many people who have type 2 diabetes, and hypoglycaemia is currently under-recognised and commonly avoidable. Current clinical guidelines recommend the targeting of tight glycaemic control and this strategy may also be associated with an increased risk of hypoglycaemia. Hypoglycaemia impacts on morbidity, mortality and quality of life of people with type 2 diabetes, and improved recognition of the symptoms of hypoglycaemia will allow effective treatment and reduce the risk of progression to more severe episodes. A common cause of hypoglycaemia in people with type 2 diabetes is glucose-lowering medication, in particular, those which raise insulin independently of ambient glucose concentration such as sulphonylureas and exogenous insulin. The recently published National Institute for Health and Clinical Excellence guideline recommends the use of Dipeptidyl peptidase-4 inhibitors or thiazolidinediones (glitazones) as alternative second-line therapy instead of a sulphonylurea in those patients who are at significant risk of hypoglycaemia and its consequences. © 2010 Blackwell Publishing Ltd.


Showghi N.N.,Locality | Williams A.C.C.,University College London
Pain Medicine (United States) | Year: 2012

Objective. The objective of this study was to describe and evaluate the Internet resources available to patients searching for information about chronic urogenital/pelvic pain. Design. As far as possible, we applied systematic review methods to search, retrieve, sort, and critique Websites, using common search engines and terms in the English language. Evaluation from a patient viewpoint focused particularly on the quality of explanations for chronic urogenital/pelvic pain in men, and on the psychological content of the Websites. Results. While the 23 Websites reviewed were generally accessible and open, authorial attribution was largely missing and the nomenclature were inconsistent and confusing. Explanations of chronic pain were diverse and often inaccurate or only partially accurate; none represented current neurophysiologic models of chronic pain. Eight described psychological aspects of pain, five in a simple way and three with more complexity, but only one approximated a contemporary biopsychosocial model. Conclusions. As in other areas of chronic pain, there is a wealth of information available online, but much is of poor quality, and taken together, is likely to confuse more than enlighten patients attempting to understand male urogenital/pelvic pain symptoms or supplement information from health care professionals. © 2012 Wiley Periodicals, Inc.


Barker S.J.,Locality
Journal of Diabetes Nursing | Year: 2011

The link between type 2 diabetes and obstructive sleep apnoea (OSA) is now well-established. Studies suggest that nearly half of men and one fifth of women with type 2 diabetes have moderate OSA. This article looks at the links between OSA, the metabolic syndrome and type 2 diabetes, and suggests ways to use effective screening, especially in primary care, and raise awareness of apnoea, to improve quality of life and reduce cardiovascular and other serious diabetes-related complications.


Only 25% of U.S. local businesses have websites and just 10% show their prices online, but Centzy launches today to let you sort local business searches by price, open hours, and eventually quality — reviews relative to price. That means you could find the nearest dry cleaner open until 7pm that’s the cheapest but has the best customer ratings pulled from Yelp and CitySearch. Centzy uses a self-built crowdsourcing platform get humans to pull offline data online. That’s data inaccessible to any web crawler. With $800,000 in seed funding from ff Venture Capital and Lightbank, Centzy could one day monetize its crowdsourcing platform, price database, and/or a destination site for finding and purchasing from the best local businesses. Today at TechCrunch Disrupt, Centzy opens its search engine for 15 business types in San Francisco, Chicago, and New York City. So go find who’s got a great deal and who’s ripping you off. The big problem with today’s local business search is that there’s no correlation between higher prices and better customer reviews. People will give a decent $5 burger the same 4-star review as a great-but-not perfect $15 burger. Since review sites don’t provide specific pricing info, you won’t necessarily find the best value at the highest-rated business. But Centzy plans to combine review data from Yelp and CitySearch’s APIs with the pricing and open hours it collects to provide true value scores. For today’s launch, though, Centzy’s web and mobile sites let you search for hair salons, gyms, museums, oil changes and more business types, and sort by price, distance, open hours, and average rating. Listings appear on a map and you can select which product’s price you want to search for. More business types are on the way. Centzy’s Jay Shek tells me he and his technical co-founder Jeremy Clemenson have backgrounds in managing and analyzing data for San Francisco startups. They took Centzy through the Entrepreneurs Roundtable in New York last summer and decided to stay and make NYC their home base. It plans to be available in the top 10 U.S. markets by this fall, go nationwide in 2013, and now Centzy is looking for more funding to build a team including expert Ruby developers. Surprisingly, there doesn’t seem to be much competition for bringing offline prices online. The closest thing might be Priceonomics, which is a price guide for second-hand goods. I literally used Centzy for one minute and discovered a cheaper, better reviewed dry cleaner that’s closer to my apartment than the one I currently go to. The value scores aren’t ready yet but the product already works. Detailed human reviews will always be valuable, especially for restaurants. But if there’s one service that could replace Yelp for me, it’s Centzy. MC Hammer asked if businesses will use Centzy to research the prices of competitors, but Centzy’s Shek says users want more than the lowest price, they want quality. Cyan Bannister asked “doesn’t Yelp show prices?” but Shek responded that the exact price is a lot more useful than vague “$$” or “$$$$” indicators. And on how Centzy will make money, Shek says his company will be able to take a cut of purchases made through its business search.

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