Ice pack induced perineal analgesia after spontaneous vaginal birth: Randomized controlled trial

Background

Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy.

The Network Survival Method for Estimating Adult Mortality: Evidence From a Survey Experiment in Rwanda

Adult death rates are a critical indicator of population health and well-being. Wealthy countries have high-quality vital registration systems, but poor countries lack this infrastructure and must rely on estimates that are often problematic. In this article, we introduce the network survival method, a new approach for estimating adult death rates. We derive the precise conditions under which it produces consistent and unbiased estimates. Further, we develop an analytical framework for sensitivity analysis. To assess the performance of the network survival method in a realistic setting, we conducted a nationally representative survey experiment in Rwanda (n = 4,669). Network survival estimates were similar to estimates from other methods, even though the network survival estimates were made with substantially smaller samples and are based entirely on data from Rwanda, with no need for model life tables or pooling of data from other countries. Our analytic results demonstrate that the network survival method has attractive properties, and our empirical results show that this method can be used in countries where reliable estimates of adult death rates are sorely needed.     

Grow Old With Me! Future Directions of Race,Age, and Place Scholarship

This article reviews current theories of age and place to demonstrate a more inclusive perspective in sociology that considers race, age, and place. Scholars who study age have advanced our knowledge about what place means to old people or how environment operates in an oppressive way to aged bodies. Likewise, race scholars have advanced our knowledge about the ways oppression and White supremacy are rooted in place. Yet the two bodies of literature do not inform one another, and there are potentially dangerous gaps in our knowledge that contribute to oppression. The result is age scholarship about environment that lacks a critical race perspective and race scholarship on place that ignores the oppressive conditions of age. By reviewing these pieces, I argue that scholars must inform themselves of the ways in which we overlook important analyses and may potentially contribute to our own ageism.     

An Empowerment Approach in Teaching a Class about Autism for Social Work Students

Social workers are being asked to respond to the rapidly increasing number of individuals and families affected by Autism Spectrum Disorders (ASD). However, the curricula in schools of social work have limited content on disabilities. This article describes a course which prepares social work students for work with individuals with ASD through an empowerment approach in an ever-changing socio-cultural and political environment. This approach changes the focus of disabilities from a narrow perspective on particular services and rehabilitation to a broader concern with human rights, social inclusion and quality of life. The article describes the development of the course in collaboration with a university disability program, the areas of emphasis for the course (family focused, interdisciplinary, lifespan) and the multiple modes of delivery. The implications of teaching the course as an elective or as integrating it further into the curriculum are discussed.     

How the Right Usurped the Queer Agenda: Frame Co‐optation in Political Discourse

This article draws on a case study of lesbian, gay, bisexual, and transgender (LGBT) and queer politics in Vermont to explain the conditions under which radical discourse gains and loses a public voice. In contrast to claims that the marginalization of queer discourse is due to silencing by LGBT rights activists or to litigation strategies, we argue that variation in queer discourse over time is the result of the co‐optation of queer discourse and goals by opponents. Extending the social movement literature on frame variation, we argue that opponents co‐opt discourse when they adopt aspects of the content of a movement's discourse, while subverting its intent. We show that conservative LGBT rights opponents co‐opted queer discourse. As a result, queer positions lost their viability as the discursive field in which those arguments were made was fundamentally altered. Because queer positions became less tenable, we see the withdrawal of queer discourse from the mainstream and alternative LGBT media. Our work both supports and builds on research on frame variation by demonstrating how discourse can change over time in response to the interplay between changing aspects of the political and cultural landscape and the discourse of opponents.     

Lessons learned about collaborative evaluation using the Capacity for Applying Project Evaluation (CAPE) framework with school and district leaders

Schools, districts, and state-level educational organizations are experiencing a great shift in the way they do the business of education. This shift focuses on accountability, specifically through the expectation of the effective utilization of evaluative-focused efforts to guide and support decisions about educational program implementation. In as much, education leaders need specific guidance and training on how to plan, implement, and use evaluation to critically examine district and school-level initiatives. One specific effort intended to address this need is through the Capacity for Applying Project Evaluation (CAPE) framework. The CAPE framework is composed of three crucial components: a collection of evaluation resources; a professional development model; and a conceptual framework that guides the work to support evaluation planning and implementation in schools and districts. School and district teams serve as active participants in the professional development and ultimately as formative evaluators of their own school or district-level programs by working collaboratively with evaluation experts. The CAPE framework involves the school and district staff in planning and implementing their evaluation. They are the ones deciding what evaluation questions to ask, which instruments to use, what data to collect, and how and to whom results should be reported. Initially this work is done through careful scaffolding by evaluation experts, where supports are slowly pulled away as the educators gain experience and confidence in their knowledge and skills as evaluators. Since CAPE engages all stakeholders in all stages of the evaluation, the philosophical intentions of these efforts to build capacity for formative evaluation strictly aligns with the collaborative evaluation approach.     

Process evaluation of an environmental walking and healthy eating pilot in small rural worksites

Small Steps are Easier Together (SS) was a pilot environmental intervention in small rural worksites in Upstate New York in collaboration with Extension educators. Worksite leaders teamed with co-workers to select and implement environmental changes to increase walking steps over individual baseline and to choose healthy eating options over 10 weeks. Participants were 226 primarily white, women employees in 5 sites. A mixed methods process evaluation, conducted to identify determinants of intervention effectiveness and to explain differences in outcomes across worksites, included surveys, self-reports of walking and eating, interviews, focus groups, and an intervention log. The evaluation assessed reach, characteristics of recruited participants, dose delivered, dose received, and context and compared sites on walking and eating outcomes. Emergent elements of participant-reported dose received included: active leadership, visible environmental changes, critical mass of participants, public display of accomplishments, accountability to co-workers, and group decision making. Participants at sites with high reach and dose were significantly more likely than sites with low reach and dose to achieve intervention goals. Although this small pilot needs replication, these findings describe how these evaluation methods can be applied and analyzed in an environmental intervention and provide information on trends in the data.     

Linking Local Food Systems and the Social Economy? Future Roles for Farmers' Markets in Alberta and British Columbia*

Often organized as grassroots, nonprofit organizations, many farmers' markets serve as strategic venues linking producers and consumers of local food while fulfilling multiple social, economic, and environmental objectives. This article examines the potential of farmers' markets to play a catalyst role in linking local food systems to the social economy in western Canada. We used the Delphi method of inquiry to solicit and synthesize perspectives on the future role of farmers' markets within local food systems and the social economy from farmers' market vendors, market managers, and policy and government representatives in each province. We found that negotiations over the definition of local food systems, the dynamics of supply and demand relationships, and perceptions of “authenticity” affect the positionality of farmers' markets in relation to other marketing channels within regional food systems. Stakeholders engaged in this Delphi inquiry strategized ways to scale up local food systems beyond current limits while also maintaining the “authentic experience” offered by farmers' markets that has helped to fuel increased consumer interest, demand, and growth. Results confirm the need for further investigation of the relationship between the social economy, infrastructure, and authenticity in the development of local food systems.