What are the views of midwives in relation to perineal repair?

PURPOSE: To determine the views of midwives towards perineal repair and the most effective way to teach and support midwives in developing this skill. PROCEDURE: A questionnaire was distributed to 111 midwives who attended a 1-day seminar. Information was sought on a range of views relating to perineal repair, including experience, confidence, education and accreditation, attitudes and trends. FINDINGS: One hundred and six (96%) questionnaires were returned. All respondents (100%) believed midwives should be taught to undertake perineal repair. The most important reason was to provide continuity of care for women. Experience increased confidence and enjoyment in undertaking perineal repair as well as lessening fears over the impact of suturing on women. Experience did not significantly impact on concerns regarding legal implications associated with perineal repair. Three quarters of respondents reported that midwifery students should have practical experience of perineal repair. There was strong support for doctors and midwives to undertake perineal repair education together (96%), preferably in a 1-day workshop format (56%); for standards to be set by the professional colleges (midwifery and obstetrics) (66%); for midwives and doctors to be accredited as competent before performing perineal repair independently (>90%) and for regular updates in perineal repair (93%). The majority of midwives (73%) felt that they were more likely to suture than 5 years ago, due mainly to a greater appreciation of woman centred care (35%). Over 60% of midwives said they would not suture a first-degree tear more than half of the time and 13% would not suture a second-degree tear more than half of the time. PRINCIPLE CONCLUSION: A desire to provide continuity of care appears to be a major motivator for midwives to learn to undertake perineal repair. There is need for standards to be set for perineal repair to encourage consistency in education. Perineal repair programs that involve midwives and doctors training together have strong support from midwives but it is unclear if doctors would also support this. Further research is needed to support or refute the trend for midwives to not suture some perineal trauma.     

Measurement and structural invariance of the US version of the Birth Satisfaction Scale-Revised (BSS-R) in a large sample

Background

The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally. The use of the measure and the concept has gathered traction in the United States following the development of a US version of the tool. A limitation of previous studies of the measurement characteristics of the BSS-R is modest sample size. Unplanned pregnancy is recognised as being associated with a range of negative birth outcomes, but the relationship to birth satisfaction has received little attention, despite the importance of birth satisfaction to a range of postnatal outcomes.

Volunteering in a School Kitchen Garden Program: Cooking Up Confidence,Capabilities, and Connections!

This paper reports on the evaluation of a kitchen garden program in primary schools in Victoria, Australia. It focuses on the motivations, impacts, and issues associated with volunteering in the program. The study revealed that volunteers are drawn from a range of sources, including: families of current and former students, former teachers, local residents, clients of aged care and/or disability services, other schools and communities, local universities, community organizations, the community services sector, and the corporate sector. Benefits to volunteers included: opportunities to use time productively, an increased sense of belonging, learning opportunities, and an increased sense of self-worth and enjoyment. For schools, volunteers enhanced engagement between the school and the local community, enabled them to engage more effectively with hard to reach groups, and increased student engagement. In addition, the involvement of volunteers improved the sustainability of the program, improved communication between teachers and families of students from minority ethnic groups, and gave students the chance to relate to new people, to learn from their experience and to have fun in working with the volunteers. Perhaps the most telling benefits to flow both to students and to volunteers were not the “three Rs—reading, w’riting and a’rithmetic” but the three Cs—confidence, capabilities, and connections. However, a clearly identified issue was the importance of matching volunteers’ motivations and needs with the roles they play to sustain current levels of volunteering and, therefore, the program itself.     

‘A Hidden Group of Children’: Support in Schools for Children who Experience Parental Imprisonment

Schools have been identified as playing a key role in supporting the children of prisoners. This paper reports on a study, which explored the support provision offered in schools to children who experience parental imprisonment. By interviewing school representatives, stakeholders, parents and children, we illustrate the support available in schools, the issues that arise and ways in which support provision can be strengthened. Our findings indicate that children of prisoners often constitute a ‘forgotten’ group in schools, and we suggest that an awareness of these children and the challenges they face needs to be raised amongst education practitioners and policy‐makers.     

Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria

The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item’s diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation (“Have there been periods in the past year where you spent a lot of time thinking about gambling?”) was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.     

Missing the Boat: Australia and Asylum Seeker Deterrence Messaging

Many of Australia's border protection policies have focused on attempts to deter the arrival of asylum seekers by boat. These include government ‘messaging’ in the hope this will influence the decision‐making of would‐be boat arrivals. This article outlines the findings of an exploratory study on the sources of information accessed by asylum seekers, prior to and during their boat journeys to Australia, about their destination country. The findings suggest that government media and Internet strategies focused on deterring asylum seekers are adopted without full regard to how information is sourced before and during these boat journeys.     

Living on the edge? Professional anxieties at work in academia and veterinary practice

ABSTRACT

Through empirical research on academics and veterinary surgeons, this article focuses on identity and how it is reflected in, and reproduced by, anxiety and insecurity at work. Three analytical themes – perfection, performativity and commodified service – each of which generates anxiety indicates a loss of autonomy as academics and vets are subjected to competitive market forces as well as an intensification of masculine managerial controls of assessment, audit and accountability. We see these pressures and their effects as reflecting a commodification of service provision where the consumer (student or client) begins to redefine the relationship between those offering some expertise and those who are its recipients, partly achieved through the performative gaze of constant and visible rating mechanisms. Our empirical research also identifies sources of anxiety concerns in their attempts to achieve perfection against this background of uncertain knowledge and precarious contexts of the performative nature of professional expertise.