Caesarean wound care for midwives

With a rise in caesarean births there is a rise in wound care management issues for midwives and the potential for surgical site infections (SSIs). The burden of SSIs include increases in maternal mortality, morbidity, length of hospital stay and cost. Sepsis is currently the leading cause of maternal mortality, with 50 per cent of the women who die having had a caesarean birth (Centre for Maternal and Child Enquiries (CMACE) 2011). Wound management and the prevention of sepsis are therefore issues of great concern to midwives. This article considers the incidence of wound infections and presents the guidance available to help address this problem.

Those who can, teach. 'A teacher affects eternity; she can never tell where her influence stops'

Teachers can have a profound effect on us all, both good and bad. In this paper the effect two individual midwives had on my evolution as a midwife will be examined. They were very different: one was formal and the other informal. The classroom was the setting for one, the clinical area for the other. Each had her own unique style and way of looking at the world. One was very different from the other in manner and in approach. However they each shared a philosophy of women centred, normal birth which they espoused in all aspects of their working lives.

Conceptual designs of multi-degree of freedom compliant parallel manipulators composed of wire-beam based compliant mechanisms

This paper proposes conceptual designs of multi-degree(s) of freedom (DOF) compliant parallel manipulators (CPMs) including 3-DOF translational CPMs and 6-DOF CPMs using a building block based pseudo-rigid-body-model (PRBM) approach. The proposed multi-DOF CPMs are composed of wire-beam based compliant mechanisms (WBBCMs) as distributed-compliance compliant building blocks (CBBs). Firstly, a comprehensive literature review for the design approaches of compliant mechanisms is conducted, and a building block based PRBM is then presented, which replaces the traditional kinematic sub-chain with an appropriate multi-DOF CBB. In order to obtain the decoupled 3-DOF translational CPMs (XYZ CPMs), two classes of kinematically decoupled 3-PPPR (P: prismatic joint, R: revolute joint) translational parallel mechanisms (TPMs) and 3-PPPRR TPMs are identified based on the type synthesis of rigid-body parallel mechanisms, and WBBCMs as the associated CBBs are further designed. Via replacing the traditional actuated P joint and the traditional passive PPR/PPRR sub-chain in each leg of the 3-DOF TPM with the counterpart CBBs (i.e. WBBCMs), a number of decoupled XYZ CPMs are obtained by appropriate arrangements. In order to obtain the decoupled 6-DOF CPMs, an orthogonally-arranged decoupled 6-PSS (S: spherical joint) parallel mechanism is first identified, and then two example 6-DOF CPMs are proposed by the building block based PRBM method. It is shown that, among these designs, two types of monolithic XYZ CPM designs with extended life have been presented.

A completely kinematostatically decoupled XY compliant parallel manipulator through new topology structure

This paper deals with a completely kinematostaticaly decoupled XY compliant parallel manipulator (CPM) composed of exactly-constrained compliant modules. A new 4-PP XY translational parallel mechanism (TPM) with a new topology structure is firstly proposed where each two P (P: prismatic) joints on the base in two non-adjacent legs are rigidly connected. A novel 4-PP XY CPM is then obtained by replacing each traditional P join on the base in the 4-PP XY TPM with a compound basic parallelogram module (CBPM) and replacing each traditional P joint on the motion stage with a basic parallelogram module (BPM). Approximate analytical model is derived with comparison to the FEA (finite element analysis) model and experiment for a case study. The proposed novel XY CPM has a compact configuration with good dynamics, and is able to well constrain the parasitic rotation and the cross-axis coupling of the motion stage. The cross-axis motion of the input stage can be completely eliminated, and the lost motion between the input stage and the motion stage is significantly reduced.