scholarly journals Authors' reply re: OASI Care Bundle

2021 ◽  
Author(s):  
Dorian Martinez ◽  
Ranee Thakar
Keyword(s):  
Large Scale ◽  
Lessons Learned ◽  
Care Bundle ◽  
Good Communication ◽  
Anal Sphincter Injury ◽  
Training Materials ◽  
Hands On ◽  
Development Evaluation ◽  
Multi Stakeholder ◽  
Perineal Massage

Sir, We would like to thank Scamell and colleagues for their letter in response to our paper describing the results of the Obstetric Anal Sphincter Injury Care Bundle (OASI-CB) evaluation (1,2). We have previously addressed most of the points raised in our response to an earlier critical review of the OASI-CB by two of the signatories of this letter (3). First, Scamell and colleagues indicate that they are disappointed in the quality of the evidence that supports the components of the OASI-CB. We feel that this criticism is misdirected, because the OASI-CB project was initiated in response to this lack of high-quality evidence. We developed a care bundle and we performed a multicentre study, which produced evidence of its positive effect. A second criticism expressed by the authors is that the OASI-CB does not include warm compresses. We have previously acknowledged the evidence that warm compresses reduce the risk of OASI (3). They were not included as a standardised component of the OASI-CB partly because of variation in availability and use (4), and partly because of clinical practicalities such as the feasibility of safely heating/reheating compresses. However, we do encourage the more widespread use of warm compresses because they would further improve the prevention already provided by the OASI-CB. A third concern raised by the authors is that the OASI-CB has only a small effect: a reduction in the OASI rates from 3.3 to 3.0%. As we explained in our article, this reported reduction is very likely to be an underestimate of the true effect of the OASI-CB, given that the OASI-CB also requires a careful check of the perineum following birth for the immediate detection of OASI. Therefore, we emphatically reject the suggestion that our results could be explained by ascertainment bias. Last, the authors suggest that we did not consider women’s experiences and the acceptability of the OASI-CB. Women were–and still are–at the very heart of the development, evaluation and implementation of the care bundle (2). For example, women told us that they experienced a hands-on approach protecting the perineum as very positive and that good communication with the midwife was key to a calm birth (5). We are now performing the OASI2 study that evaluates the sustainability of the OASI-CB and its implementation in a wider group of units (www.rcog.org.uk/oasi2). Based on multi-stakeholder discussions and lessons learned from the original OASI-CB project (6), we updated the OASI-CB manual and antenatal discussion guide and improved our training materials. For example, the antenatal discussion guide now also includes antenatal perineal massage, birth position, importance of a slow birth and the use of warm compresses as discussion points alongside the OASI-CB elements. In OASI2, we will also explore women’s perspectives further via a large-scale survey. We would like to reiterate that women’s health and a positive birth experience are at the centre of the OASI-CB. Our article presents evidence of the effectiveness of the OASI-CB. It is this evidence that, together with our commitment to support women and clinicians, will empower women to make informed choices about whether or not they want the OASI-CB as part of their birth plan.

scholarly journals Women’s experiences of the OASI Care Bundle; a package of care to reduce severe perineal trauma

2021 ◽  
Author(s):  
Posy Bidwell ◽  
Nick Sevdalis ◽  
Louise Silverton ◽  
James Harris ◽  
Ipek Gurol-Urganci ◽  
...  
Keyword(s):  
Severe Form ◽  
Perineal Trauma ◽  
Care Bundle ◽  
Structured Interviews ◽  
Good Communication ◽  
Women’S Experiences ◽  
Psychosocial Disorders ◽  
Anal Sphincter Injury ◽  
Women's Experiences ◽  
Manual Perineal Protection

Abstract Introduction and hypothesis Obstetric anal sphincter injury (OASI) is a severe form of perineal trauma that can occur during vaginal birth. Long-term morbidities include anal incontinence and psychosocial disorders. To reduce these injuries within England, Scotland and Wales, the OASI Care Bundle was introduced to 16 maternity units (January 2017–March 2018). The OASI Care Bundle comprises four elements: (1) antenatal information, (2) manual perineal protection, (3) medio-lateral episiotomy (when indicated) and 4) recognition and diagnosis of tears. As part of the project evaluation, a qualitative study was conducted to explore women’s experiences of the OASI Care Bundle. Methods Semi-structured interviews were conducted with women (n = 19) who received the OASI Care Bundle as part of their maternity care. This was to explore their experience of each element. A thematic analysis of the interview data was performed. Results Three themes were identified: (1) memories of touch, whereby women reported that a ‘hands-on’ approach to perineal protection was a positive experience; (2) midwife as a supportive guide, where women reported that good communication facilitated a calm birth and post-birth diagnosis; (3) education: women need more information about perineal trauma. Conclusion This study contributes to the literature through its exploration of women’s experiences of perineal protection techniques and diagnosis of perineal trauma. Interviewed women indicated that they did not experience any of the care bundle elements as an intrusion of their physical integrity. Additionally, an urgent need was identified for more information about perineal trauma in terms of risk, prevention and recovery.

scholarly journals The OASI care bundle quality improvement project: lessons learned and future direction

2021 ◽  
Author(s):  
Magdalena Jurczuk ◽  
Posy Bidwell ◽  
Ipek Gurol-Urganci ◽  
Jan van der Meulen ◽  
Nick Sevdalis ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Royal College ◽  
Lessons Learned ◽  
Care Bundle ◽  
Sphincter Injury ◽  
Improvement Project ◽  
Mediolateral Episiotomy ◽  
Anal Sphincter Injury ◽  
Manual Perineal Protection ◽  
Future Direction

AbstractRising rates of obstetric anal sphincter injury (OASI) led to a collaborative effort by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) to develop and evaluate the OASI Care Bundle (OASI-CB). The OASI-CB comprises four practices (antenatal discussion about OASI, manual perineal protection, mediolateral episiotomy at 60° from the midline, and systematic examination of the perineum, vagina and ano-rectum after vaginal birth) and was initially implemented as part of a quality improvement (QI) project—“OASI1”—in 16 maternity units across Great Britain. Evaluation of the OASI1 project found that the care bundle reduced OASI rates and identified several barriers and enablers to implementation. This paper summarises the key findings, including strengths, limitations and lessons learned from the OASI1 QI project, and provides rationale for further evaluation of the OASI-CB.

scholarly journals An Autoethnographic Study of Interprofessional Education Partnerships

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Samantha Hurst ◽  
Karen A. Macauley ◽  
Linda Awdishu ◽  
Kathleen M Sweeney ◽  
Sophie S Hutchins ◽  
...  
Keyword(s):  
Interprofessional Education ◽  
Large Scale ◽  
Opportunity To Learn ◽  
Public University ◽  
Shared Vision ◽  
Lessons Learned ◽  
Faculty Members ◽  
Joint Effort ◽  
Hands On ◽  
Returns On Investment

Background: Thiis qualitative longitudinal study describes an Interprofessional Education (IPE) collaboration between a public university with medical and pharmacy schools and a private, non-affiliated university with a nursing school. The study explores the dynamics of the IPE partnership and lessons learned over a three-year period in which members of the collaborative directed three IPE simulations.Methods and Findings: An autoethnographic inquiry technique was used to interview eight collaborators who designed and implemented a large-scale IPE simulation for approximately 300 students and 100 faculty members annually for three years. Two, 90-minute group narrative interviews were conducted and audio recorded for transcription and analysis. Five themes emerged: Natural Collaboration, Shared Vision and Commitment, Integrations and Synergy, All Hands on Deck, and Lasting Foundations. Collaborators agreed the joint effort was a positive experience with multidimensional returns on investment. They applied teamwork competencies to build the partnership, develop the IPE simulation, and overcome implementation challenges.Conclusions: Thiis article provides readers with the opportunity to learn from those who have been intimately involved in the design and implementation of a large-scale IPE collaboration to enhance the shared learning process for health students and faculty. Findings highlight the complexity of building an IPE collaborative and the necessity to build partnerships with facilitators committed to communication.

Digital newspaper preservation through collaboration

2016 ◽  
Vol 32 (2) ◽  
pp. 73-87 ◽  
Author(s):  
Ana Krahmer
Keyword(s):  
Large Scale ◽  
Lessons Learned ◽  
Free Access ◽  
Active Member ◽  
Texas History ◽  
Digital Repository ◽  
Content Type ◽  
Hands On ◽  
Digital Newspaper

Purpose The Texas Digital Newspaper Program (TDNP) supports newspaper preservation and access for any title in Texas, from any date, any location and representing any community. As an active member of the Texas Press Association, TDNP also supports large-scale preservation of born-digital newspaper PDF issues for member publishers. This paper aims to explore how the early days of TDNP built a strong foundation of collaboration and support for large-scale preservation projects, including support for preserving a state press association PDF newspaper collection. Design/methodology/approach This paper is a case study of a collaborative endeavor to create a large-scale, statewide digital newspaper preservation hub in Texas. This paper details how individual partnerships led to new and larger partnerships. Figures and tables represent numbers of partner institutions served, numbers of newspapers preserved and screenshots of how these items appear within collections on the digital repository environment of The Portal to Texas History. This paper concludes with recommendations for groups interested in developing their own collaborative projects. Findings As a case study, the data explored include numbers of partnering institutions, materials contributed by partnering institutions and how these numbers help to forward the TDNP agenda. Practical Implications The final recommendations are lessons learned through collaboration, and the implications are real-world advice from the partners developed through the TDNP. Originality/value Hosting over 3.25 million pages of newspapers, the TDNP has become an enormous hub of newspaper preservation in Texas, and it is unique in the numbers of partners it supports and the numbers of pages it is able to host for free access via The Portal to Texas History. This paper is intended to help other groups across the world build their own collaborative preservation efforts, and it offers pragmatic advice derived from hands-on experience.

Post-disaster reconstruction in Christchurch: a “build back better” perspective

2018 ◽  
Vol 9 (3) ◽  
pp. 239-248 ◽  
Author(s):  
Tinu Rose Francis ◽  
Suzanne Wilkinson ◽  
Sandeeka Mannakkara ◽  
Alice Chang-Richards
Keyword(s):  
Mixed Methods Research ◽  
Large Scale ◽  
Central Government ◽  
Lessons Learned ◽  
Content Type ◽  
Qualitative And Quantitative ◽  
Multi Stakeholder ◽  
Post Disaster ◽  
Restoration Measures

Purpose The 2010/2011 Canterbury earthquakes were one of the most devastating events in New Zealand’s history. Due to the large scale of disruption and losses, the central government created a separate body, the Canterbury Earthquake Recovery Authority (CERA), to manage and oversee recovery activities. Working with local authorities and stakeholders, CERA plays a major role in driving the recovery in Christchurch. This paper aims to analyse CERA’s decision-making process and the effects of some of its critical decisions on the recovery outcomes. The paper takes a “build back better” (BBB) perspective to understand the decisions taken and processes used. Design/methodology/approach The case study adopted a mixed-methods research design (Creswell, 2013) and was conducted by reviewing official CERA documents and publications related to its recovery assessments and by conducting interviews with key officials from CERA. Collecting data from both qualitative and quantitative data sources enabled the process of triangulation. Findings Lessons learned from the Canterbury experience in terms of recovery best practices are reported. CERA’s recovery policy aimed to give confidence to the community and renew and revitalise the damaged city. Compared with the BBB theory, the community-driven recovery strategy and the multi-stakeholder approach worked well. Other critical decisions aligned with the BBB theory include land zoning, empowering community and integration with existing developmental plans. Originality/value BBB can be used as a tool for the implementation of recovery and restoration measures following a large disaster. However, a set of practical indicators to measure the level of BBB is needed.

Experiences With and Lessons Learned From Developing, Implementing, and Evaluating a Support Program for Older Hearing Aid Users and Their Communication Partners in the Hearing Aid Dispensing Setting

2020 ◽  
Vol 29 (3S) ◽  
pp. 638-647 ◽  
Author(s):  
Janine F. J. Meijerink ◽  
Marieke Pronk ◽  
Sophia E. Kramer
Keyword(s):  
Large Scale ◽  
Hearing Aid ◽  
Critical Discussion ◽  
Lessons Learned ◽  
Research Note ◽  
Support Program ◽  
Large Sample Size ◽  
Long Term Effects ◽  
Communication Program ◽  
Communication Partners

Purpose The SUpport PRogram (SUPR) study was carried out in the context of a private academic partnership and is the first study to evaluate the long-term effects of a communication program (SUPR) for older hearing aid users and their communication partners on a large scale in a hearing aid dispensing setting. The purpose of this research note is to reflect on the lessons that we learned during the different development, implementation, and evaluation phases of the SUPR project. Procedure This research note describes the procedures that were followed during the different phases of the SUPR project and provides a critical discussion to describe the strengths and weaknesses of the approach taken. Conclusion This research note might provide researchers and intervention developers with useful insights as to how aural rehabilitation interventions, such as the SUPR, can be developed by incorporating the needs of the different stakeholders, evaluated by using a robust research design (including a large sample size and a longer term follow-up assessment), and implemented widely by collaborating with a private partner (hearing aid dispensing practice chain).

scholarly journals The graph neural networking challenge

2021 ◽  
Vol 51 (3) ◽  
pp. 9-16
Author(s):  
José Suárez-Varela ◽  
Miquel Ferriol-Galmés ◽  
Albert López ◽  
Paul Almasan ◽  
Guillermo Bernárdez ◽  
...  
Keyword(s):  
Machine Learning ◽  
Computer Networks ◽  
Real World ◽  
Large Scale ◽  
Lessons Learned ◽  
Educational Resources ◽  
Global Competition ◽  
International Telecommunication Union ◽  
International Telecommunication ◽  
Broad Audience

During the last decade, Machine Learning (ML) has increasingly become a hot topic in the field of Computer Networks and is expected to be gradually adopted for a plethora of control, monitoring and management tasks in real-world deployments. This poses the need to count on new generations of students, researchers and practitioners with a solid background in ML applied to networks. During 2020, the International Telecommunication Union (ITU) has organized the "ITU AI/ML in 5G challenge", an open global competition that has introduced to a broad audience some of the current main challenges in ML for networks. This large-scale initiative has gathered 23 different challenges proposed by network operators, equipment manufacturers and academia, and has attracted a total of 1300+ participants from 60+ countries. This paper narrates our experience organizing one of the proposed challenges: the "Graph Neural Networking Challenge 2020". We describe the problem presented to participants, the tools and resources provided, some organization aspects and participation statistics, an outline of the top-3 awarded solutions, and a summary with some lessons learned during all this journey. As a result, this challenge leaves a curated set of educational resources openly available to anyone interested in the topic.

scholarly journals Scaling Up Delivery of Biofortified Staple Food Crops Globally: Paths to Nourishing Millions

2021 ◽  
pp. 037957212098250
Author(s):  
Jennifer K. Foley ◽  
Kristina D. Michaux ◽  
Bho Mudyahoto ◽  
Laira Kyazike ◽  
Binu Cherian ◽  
...  
Keyword(s):  
Pearl Millet ◽  
Large Scale ◽  
Scale Up ◽  
Lessons Learned ◽  
Raw Material ◽  
Micronutrient Deficiencies ◽  
Seed Systems ◽  
Public And Private ◽  
Context Specific ◽  
Public And Private Sector

Background: Micronutrient deficiencies affect over one quarter of the world’s population. Biofortification is an evidence-based nutrition strategy that addresses some of the most common and preventable global micronutrient gaps and can help improve the health of millions of people. Since 2013, HarvestPlus and a consortium of collaborators have made impressive progress in the enrichment of staple crops with essential micronutrients through conventional plant breeding. Objective: To review and highlight lessons learned from multiple large-scale delivery strategies used by HarvestPlus to scale up biofortification across different country and crop contexts. Results: India has strong public and private sector pearl millet breeding programs and a robust commercial seed sector. To scale-up pearl millet, HarvestPlus established partnerships with public and private seed companies, which facilitated the rapid commercialization of products and engagement of farmers in delivery activities. In Nigeria, HarvestPlus stimulated the initial acceptance and popularization of vitamin A cassava using a host of creative approaches, including “crowding in” delivery partners, innovative promotional programs, and development of intermediate raw material for industry and novel food products. In Uganda, orange sweet potato (OSP) is a traditional subsistence crop. Due to this, and the lack of formal seed systems and markets, HarvestPlus established a network of partnerships with community-based nongovernmental organizations and vine multipliers to popularize and scale-up delivery of OSP. Conclusions: Impact of biofortification ultimately depends on the development of sustainable markets for biofortified seeds and products. Results illustrate the need for context-specific, innovative solutions to promote widespread adoption.

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