In this paper attention is focused on home delivery in the Netherlands, which still accounts for 36% of the total number of births delivered. Compared to countries with a similar level of socio-economic development, home delivery plays an important role within Dutch obstetric care. To understand this unique situation, one needs to have insight into the organization and structure of Dutch obstetric care which is described in the first part of this paper. In the second part of this paper regional differentiation in the relative importance of home delivery is described. Finally regression analysis is used in order to explain the observed regional pattern. A brief abstract from the vast amount of Dutch literature on the discussion between advocates and adversaries of home delivery is included in an appendix.

This case study will discuss the treatment of a malignant fungating wound and the effects that it had on a patient and his family. The article also demonstrates how interprofessional working has benefits for patients, carers and staff.

Bilateral clavicle fractures are not frequently seen. To treat these injuries surgically or non-surgically is still a debatable issue. Implant option for surgical management is also in doubt. We would like to share our experience in treating a patient with bilateral clavicle fracture surgically. He had excellent outcomes in terms of function and radiology. Surgical option for bilateral clavicle fractures promises excellent outcome in terms of early rehabilitation and return in function.

This short report describes the care of an extensive wound in a terminally ill patient and specifically draws attention to the role of the Oasis Fluidized Bead Bed (Figure 1) (Huntleigh Healthcare) in promoting the healing process and patient comfort.

The need for wound care information and education has never been so acute with the national roll out of nurse prescribing and the increasing emphasis on evidence-based practice. The requirement to underpin practice with evidence means that nurses are increasingly seeking newer sources of information, including information technology and the Internet. Such sources have an advantage over more traditional sources because they: are able to overcome the barriers of geographical location; allow for flexible study; and allow users to practice their decision-making skills in a relatively risk-free environment. The development of an evidence-based web site presents many challenges not only in relation to ensuring the accuracy of the information provided but also in developing interactive sections. Following the development of a web site on tissue viability, an evaluation of its usefulness was undertaken. This showed that users felt that the site was useful, although problems with access restricted its use when seeking advice about patient management.