Curved versus straight scissors to avoid 3rd and 4th degree perineal tears: A randomised feasibility study

BackgroundSevere perineal tears sustained during childbirth cause significant distress and morbidity amongst women. The objective of this study was to compare the use of straight scissors for cutting an episiotomy with the use of curved scissors, which are designed to curve away from the anal sphincter.MethodsWe used a single-centre, randomised feasibility trial. The intervention was the use of curved scissors. Women were recruited during a prenatal visit and randomised in the delivery suite, when it became clear that an episiotomy was required. The feasibility outcomes were the proportion of women able to be recruited, randomised and followed up. We also calculated the incidence of obstetric anal sphincter injury when either straight or curved scissors were used to cut an episiotomy. Other outcomes assessed were pain, length of hospital stay, perineal infection and perineal dehiscence.ResultsOf the 155 patients recruited in the prenatal period, only 20 (12.9%) were eventually randomised at birth. The main reasons for the high loss were that women either did not have a vaginal delivery (38, 24.5%), or they did not need an episiotomy (72, 46.5%). Rates of obstetric anal sphincter injury and other outcomes were similar between groups.DiscussionAnal sphincter injury during childbirth remains an important problem. Although the use of curved scissors provides a theoretical solution, we found that the high attrition rate made feasibility of conducting a suitably powered, randomised trial using the current design untenable. Alternative strategies have been suggested to make any future study more viable.     

'Clinton faces nation': a case study in the construction of focus group data as public opinion

This paper analyses the way in which a particular newspaper report constructs ‘public opinion’ based on data from small‐scale qualitative research. Using as a case study a report of a focus group discussion of Clinton's grand jury testimony, we show how these data are ‘worked up’ as representative, generalisable, and valid. By capitalising on the advantages of focus group data, while attending to and countering their disadvantages, the newspaper report is able to suggest that the views of ten people in San Francisco offer an authoritative indication of public opinion about Clinton across the USA. Finally, we sketch out some of the implications of this case study in relation to the construction of facticity more generally.     

Producing and Using Video Data in the Early Years: Ethical Questions and Practical Consequences in Research with Young Children

This article considers ethical questions and practical challenges arising from the production of video data with young children, and suggests that such considerations are reciprocal and that video data should be seen as constructed collaboratively by all participants. Video data can be a valuable means of eliciting children’s perspectives, but it raises particular issues of consent and confidentiality. Opportunities for young children to use video cameras are helpful in supporting informed consent and active participation, whilst the visual nature of video renders anonymity and confidentiality more difficult, and anonymisation of images may impact upon data quality. Video, like all research data, is influenced by the actions and biases of participants, and young children’s experiences as consumers of television will influence their reading of, and responses to, video data. An advantage of video is that it can provide participants with feedback about their participation. Challenges remain with regard to ownership.     

An Evaluation of Caller Satisfaction with Solution-Focused Telephone Counselling

Abstract

‘Practice Forum’ is intended to provide a forum for social work practitioners to share their practice with others; to describe what they are doing and assess its effectiveness.

We extend an invitation to all social work practitioners to submit articles for ‘Practice Forum’ and we look forward to receiving your contribution.

The telephone is a potentially valuable intervention tool in family counselling. The Child, Adolescent & Family Health Service has been experimenting with a response which combines the traditional advantages of telephone counselling with aspects of Steve deShazer's solution-focused approach (deShazer 1985). In 1990 a study was conducted to evaluate caller satisfaction with this approach. Results indicate a high level of satisfaction with the counselling. At a time of increasing funding cuts and lengthening waiting lists, it is important that as many options as possible remain available to our clients. An expansion in effective telephone counselling services may well be one way of achieving this.     

Aerodynamic roughness variation with vegetation: analysis in a suburban neighbourhood and a city park

Urban Ecosystems - Local aerodynamic roughness parameters (zero-plane displacement, z d , and aerodynamic roughness length, z 0 ) are determined for an urban park and a suburban neighbourhood with...