Basildon Hospitals Intrapartum Monitoring Strategy (BIMS) was introduced to address an increasing rate of babies diagnosed with hypoxic–ischaemic encephalopathy (HIE) and comprises intensive, physiology-based CTG training and a mandatory competency testing for all midwives and obstetricians. This combination aims to deepen the appreciation clinicians have for the intricacies of fetal monitoring and promotes consistency across the service. In our maternity unit, use of fetal ECG (STAN) was subsequently introduced to reduce the false-positive rate of CTG. The intensive training on physiological interpretation of CTG involves promoting a deeper understanding of fetal pathophysiology: instead of morphologically classifying decelerations as ‘early’, ‘variable’ and ‘late’, the underlying mechanism is explored as well as the fetal response to ongoing hypoxic or mechanical stresses. In addition, education focuses on the consideration of the features of type of intrapartum (acute, subacute or a gradually evolving) or chronic (long-standing) fetal hypoxia on the CTG trace and encourages differentiation of a compensatory fetal response from decompensation.

Intrauterine resuscitation refers to any intervention during labour carried out with the aim of increasing oxygen delivery to the fetus by improving fetoplacental circulation and thereby optimizing the intrauterine environment. The reversal of fetal hypoxia and acidosis may allow labour to continue safely, or optimize the fetal condition/well-being until urgent delivery is accomplished. If not corrected, continuation of fetal hypoxic stress may result in fetal decompensation leading to hypoxic–ischaemic injury. Prolonged decelerations occur due to an acute and profound fetal hypoxic stress secondary to reversible causes such as maternal hypotension, uterine hyperstimulation (hypertonus) often in response to oxytocin, sustained umbilical cord compression or due to irreversible causes such as cord prolapse, which may be amenable for intrauterine resuscitation. Rapid intravenous infusion of a crystalloid solution will help improve maternal venous return and cardiac output in the presence of maternal hypotension, and maternal repositioning may relieve aortocaval compression and improve maternal cardiac output, with resultant improvement in uteroplacental perfusion.

This chapter examines the ways in which the transmission of Chaucer’s Canterbury Tales in the fifteenth and sixteenth centuries, especially in manuscripts, reshaped the relationship between ‘Chaucer’ and ‘romance’, paving the way for Spenser’s own particular mode of romance in The Faerie Queene. Particular attention is given to the inclusion of The Tale of Gamelyn and The Tale of Beryn in early manuscripts of the Canterbury Tales, giving them ‘Chaucerian’ status, and to the manuscript context of genuinely Chaucerian works when excerpted and placed alongside non-Chaucerian texts, in so-called ‘miscellany’ manuscripts.

In the post-war period, neighbourliness seemed in some ways to become embedded in ideas of reconstruction and approaches towards aspects of social policy. In any consideration of the history of social democracy in Britain, the immediate aftermath of the Second World War seems to mark a key point in the national political culture. If social historians have sometimes been lured into mistaking the home front for a utopia of cooperation and community spirit, that is partly because such sentiments were being so actively propagated as part of the war effort. When neighbourliness was cited in wartime, it was usually freighted with notions about how it expressed inherent qualities in the British character and contributed to the public good. Neighbourliness in the post-war period has retained its prominence as a desirable feature of British society, albeit somewhat overwhelmed since the 1990s by evocations of 'community'.