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Despite the increasing number of doctorally prepared midwives in Europe, particularly after the Bologna Declaration 1999, little is known about the context and experiences of their doctoral education.
To explore European initially qualified midwives' experiences with doctoral education; and the context of their education through their professional associations.
An exploratory descriptive observational survey.
An ethically approved web-based survey was used to collect data from midwifery associations and midwives in 33 European countries between October and December 2024. Descriptive statistics and inductive thematic analysis were used to analyse the responses.
Twenty-two midwifery associations from 19 European countries and 207 midwives from 23 European countries participated. Over the last two decades, there has been an increase in the number of doctorally prepared midwives. Common reasons to gain doctoral qualifications included an interest in research, career progression, in particular in education, and improving healthcare. Midwives reported growing availability of European-wide opportunities for doctoral programmes, alongside an increase in the number of doctoral midwifery programmes and supervisors with midwifery expertise. Although many barriers were reported, effectively combining study with their personal life and support from family, friends and colleagues was highlighted as crucial factors in completing their doctoral studies.
This is the first study exploring the experiences of European midwives pursuing a doctoral degree. The findings highlight a need for universities to improve the collaboration with midwives' supportive networks as well as for the profession to reduce intraprofessional hostilities to enhance doctoral midwifery students' well-being.
Implications for the profession: Acknowledging challenges faced by these midwives is necessary to improve professional and institutional support in academia and midwifery.
Findings of this study inform strategies to improve doctoral education for midwives and, in this way, strengthen the contributions of midwives to maternal evidenced-based care development and healthcare innovations.
The Consensus-Based Checklist for Reporting of Survey Studies (CROSS) was used to guide reporting.
This study did not include patient or public involvement in its design, conduct or reporting.
Transition of care from hospital is a period when the risks of medication errors and adverse events are high, with 50% of adults discharged having at least one medication-related problem. Pharmacist-led medication reviews can reduce medication errors and unplanned readmission when completed promptly post-discharge; however, they are underutilised. A Transition of Care Stewardship pharmacist has been proposed to facilitate and coordinate a patient’s discharge process and facilitate a timely post-discharge medication review. Access to pharmacist medication review in rural and regional areas can be limited. This protocol describes a randomised controlled trial (RCT) to determine whether a virtual Transition of Care Stewardship pharmacist reduces medication-related harm in rural and regional Australia.
Multicentre RCT involving patients at high risk of medication-related harm discharged from regional and rural hospitals to a domiciliary residence. Eligible patients must be aged≥18 years, admitted under a medical specialty, be discharged to a domiciliary setting, have a regular general practitioner (GP) or be willing to visit a GP or an Aboriginal Medical Service after discharge for medical follow-up, have a Medicare card and be at high risk of readmission. High risk of readmission is defined as either a previous admission to the hospital or Emergency Department (ED) presentation in the past 6 months AND≥three regular medications OR on at least ONE high-risk medication. A total of 922 participants will be recruited into the study. Enrolled participants will be randomised to the intervention or control (usual care). The intervention will include a virtual Transition Of Care Stewardship pharmacist to ensure that patients receive discharge medication reconciliation, medication counselling, medication list and communicate directly with primary care providers to facilitate a timely post-discharge medication review. Usual care will include informing the patient’s clinical inpatient treating team that the patient is at high risk of medication misadventure and may benefit from a post-discharge Home Medicines Review (a GP-referred pharmacist medication review funded by the Australian Government).
Data analysis will be performed on a modified intent-to-treat basis. The primary outcome assessed is a composite of a first unplanned medication-related hospitalisation or ED presentation within 30 days of hospital discharge. Comparisons between the intervention and usual care groups for the primary outcome will be made using a mixed-effects logistic regression model, adjusting for site-level clustering as a random effect.
This study is approved to be conducted at the Western New South Wales Local Health District via the Research Ethics and Governance Information System (approval number: 2023/ETH00978). To ensure the needs of Aboriginal and Torres Strait Islander patients are appropriately addressed, ethics for this study were submitted and approved by the Aboriginal Health and Medical Research Council (approval number: 2148/23). Manuscripts resulting from this trial will be submitted to peer-reviewed journals. Results may also be disseminated at scientific conferences and meetings with key stakeholders.
ACTRN12623000727640.
Treatment of the node negative contralateral neck in oropharyngeal cancer (OPC) remains debated, with no clear consensus. Prophylactic contralateral neck treatment (either surgically or via irradiation) is generally recommended when the estimated risk of occult nodal metastasis is >20%. Unfortunately, patients undergoing bilateral neck treatment often require long-term supportive care for swallowing dysfunction. Reducing the impact of treatment on long-term quality of life is key in patients with OPC who have a good prognosis and tend to be young and fit at presentation. Lymphatic mapping and the use of free-hand single photon emission CT (fhSPECT) combined with sentinel lymph node biopsy is a novel approach to address this clinical need. The Lymphatic mapping Of Oropharyngeal Cancer trial aims to (a) validate a lymphatic mapping protocol in OPC using new technology (fhSPECT) with radiotracers and (b) establish lymphatic drainage patterns and the occult metastatic rate in the contralateral neck in OPC.
The design is a prospective multicentre cohort trial to understand the lymphatic drainage pattern in 150 patients with OPC and unilateral neck metastases. The trial has two phases: (1) imaging phase (n=75)—aim: develop an imaging protocol to establish the lymphatic drainage pattern in a population of patients with proven unilateral neck metastasis from OPC. The intervention will involve peritumoural injection of radiotracer followed by fhSPECT scan under general anaesthesia (GA) (at time of examination under anaesthetic). A SPECT/CT scan (gold standard for lymphatic mapping) will be carried out subsequently as a comparator. The primary outcome is the rate of contralateral drainage. Secondary outcome is the accuracy of fhSPECT versus SPECT/CT. The number of contralateral nodes on SPECT/CT will be used as the denominator in calculating the sensitivity of fhSPECT in independently verified images. fhSPECT should achieve sensitivity >94%. A minimum number of 20/75 patients will be required to demonstrate contralateral drainage to proceed to the surgical stage. An imaging substudy (n=20) aims to develop a secondary imaging protocol in the event of Surgical phase (n=75)—aim: demonstrate the utility of surgically staging the contralateral neck using sentinel node biopsy (SNB). The primary outcome of this surgical phase is the occult metastatic rate of contralateral nodes (positive SNB). The contralateral drainage rate will be identified during the imaging phase, with an expected SNB positive rate of excised nodes ranging from 25% to 40%.
The outcome of this trial will provide a validated protocol and evidence to inform the design of future research in which management of the contralateral neck is based on surgical staging. Ethical approval was granted by the Yorkshire & The Humber-South Yorkshire Research Ethics Committee (REC ref: 20/YH/0111). Results from the trial will be presented to the scientific community at appropriate meetings and international journals. Patients and the public will be informed via patient groups, cancer charities and social media/press releases.
This study aims to provide an in-depth analysis of the symptoms, coexisting conditions and service utilisation among people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID. The major research questions include the clustering of symptoms, the relationship between key factors and diagnosis time, and the perceived impact of National Institute for Health and Care Excellence (NICE) guidelines on patient care.
Cross-sectional survey using secondary data analysis.
Community-based primary care level across the UK, incorporating online survey participation.
A total of 10 458 individuals responded to the survey, of which 8804 confirmed that they or a close friend/family member had ME/CFS or long COVID. The majority of respondents were female (83.4%), with participants from diverse regions of the UK.
Primary outcomes included prevalence and clustering of symptoms, time to diagnosis, and participant satisfaction with National Health Service (NHS) care, while secondary outcomes focused on symptom management strategies and the perceived effect of NICE guidelines.
Fatigue (88.2%), postexertional malaise (78.2%), cognitive dysfunction (88.4%), pain (87.6%) and sleep disturbances (88.2%) were the most commonly reported symptoms among participants with ME/CFS, with similar patterns observed in long COVID. Time to diagnosis for ME/CFS ranged widely, with 22.1% diagnosed within 1–2 years of symptom onset and 12.9% taking more than 10 years. Despite updated NICE guidelines, only 10.1% of participants reported a positive impact on care, and satisfaction with NHS services remained low (6.9% for ME/CFS and 14.4% for long COVID).
ME/CFS and long COVID share overlapping but distinct symptom clusters, indicating common challenges in management. The findings highlight significant delays in diagnosis and low satisfaction with specialist services, suggesting a need for improved self-management resources and better-coordinated care across the NHS.
FreshRSS 