Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature

ObjectiveTo undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth.MethodOvid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) ‘making sense of evidence’ tools.FindingsAsian ethnicity does not appear to be a risk factor for severe perineal trauma for women living in Asia. In contrast, studies conducted in some Western countries have identified Asian ethnicity as a risk factor for severe perineal trauma. It is unknown why (in some situations) Asian women are more vulnerable to this birth complication. The lack of an international standard definition for the term Asian further undermines clarification of this issue. Nevertheless, there is an urgent need to explore why Asian women are reported to be significantly at risk for severe perineal trauma in some Western countries.ConclusionCurrent research on this topic is confusing and conflicting. Further research is urgently required to explore why Asian women are at risk for severe perineal trauma in some birth settings.     

Children as Witnesses: Understanding Their Capacities,Needs, and Experiences

Historically the law regarded children as inherently unreliable and made it difficult for them to testify. Since 1975 awareness of child abuse has increased and research has established that children can be reliable witnesses. Governments began to recognize the needs and capacities of children and enacted legal reforms to facilitate prosecutions for child abuse. This paper reports on a survey of victim witness workers and other justice system professionals which reveals some of the continuedfailings of that system in dealing with children. Althoughrelatively rare, there are cases of false allegations of abuse, usually a result of investigations by poorly trained professionals. Further legal reforms and better human supports are required to ensure that the needs of children are met and their capacities as witnesses are fully appreciated.     

Editorial

The UK Government agencies have an interest in making greater use of administrative data. This paper discusses the methodological challenges of using administrative data held by the Department for Work and Pensions (DWP) for constructing an alternative sampling frame for the Family Resources Survey (FRS) and for replacing income data collected in the FRS. The analysis shows that administrative data would provide a good basis for sampling the FRS by linking to socio-demographic data held administratively, which would be advantageous for sampling specific sub-populations (e.g. types of benefit recipients or households with children). Sampling using administrative data also potentially offers more representative population sampling by including some addresses currently excluded from the small users Postcode Address File (PAF) but which are important to DWP, such as people living in care homes. However, comparing FRS questions and income data held administratively, suggests little overlap. Therefore, limited gains may be realised from shortening the length of the FRS by using income data from administrative sources.     

Book reviews

New scholarship on rape in American history

Sex Without Consent: Rape and Sexual Coercion in America. Edited by Merril D. Smith. New York: New York University Press, 2001, 308 pages. Cloth, $60.00; paper, $19.50.

The enigma of sexual desire

Sexual Appetite, Desire and Motivation: Energetics of the Sexual System. Edited by Walter Everaerd, Ellen Laan, and Stephanie Both. Amsterdam, Netherlands: Knaw Edita, 2001, 156 pages. Paper, NLG 80.00, Euro 36.30.

American sex in the private and public sectors

Sex, Love, and Health in America: Private Choices and Public Policies. Edited by Edward O. Laumann and Robert T. Michael. Chicago, IL: The University of Chicago Press, 2000, 535 pages. Hardcover, $48.

Enlarging the landscape of sexual pleasure

Good Sex: Feminist Perspectives from the World's Religions. Edited by Patricia Beattie Jung, Mary E. Hunt, and Radhika Balakrishnan. New Brunswick, NJ: Rutgers University Press, 2001, 220 pages. Cloth, $50.00; paper, $20.00.

Another stab at sexual theory

The Role of Theory in Sex Research. Edited by John Bancroft. Bloomington, IN: Indiana University Press, 2000, 366 pages. Cloth, $49.95.     

“A Fear Like I've Never Felt”: Experiences of Parents Whose Adult Children Deployed to Combat Zones

Despite the increase of research with military families, less is known about the experiences of those parents who have adult children deployed overseas for military operations. This article presents parents’ experiences of having adult children deployed to combat zones. Qualitative data were gathered through an Internet-based survey during 2010. Analyses revealed important themes within the parents’ portrayals expressing strong reactions of fear, worry and concern for their children's safety and well being throughout their experiences. Parents also described frustrations communicating with their deployed children. Support from formal and informal sources was important to their coping, as was assistance from religious and military organizations. Finally, parents reported varied impacts of the adult children's deployment on the parents’ marriages. Implications for future military family research and family life education are provided.     

Parental spanking and subsequent risk for child aggression in father-involved families of young children

This study examined separate and combined maternal and paternal use of spanking with children at age 3 and children's subsequent aggressive behavior at age 5. The sample was derived from a birth cohort study and included families (n = 923) in which both parents lived with the child at age 3. In this sample, 44% of 3-year-olds were spanked 2 times or more in the past month by either parent or both parents. In separate analyses, being spanked more than twice in the prior month at age 3, by either mother or father, was associated with increased child aggression at 5 years. In combined analyses, there was a dose–response association; the greatest risk for child aggression was reported when both parents spanked more than twice in the prior month (adjusted odds ratio: 2.01; [confidence interval: 1.03–3.94]). Violence prevention initiatives should target and engage mothers and fathers in anticipatory guidance efforts aimed at increasing the use of effective and non-aggressive child discipline techniques and reducing the use of spanking.     

Mortality decline in the people's Republic of China and the United States

From mortality levels in 1949 similar to those in the United States during the nineteenth century, China claims to have reduced mortality to levels comparable to those in the United States 30 years ago. The rapidity of this recent transition and its fragmentary statistical verification have made analysts doubt these claims. The purpose of this paper is to assess medical evidence which indicates that the rate of mortality decline has been rapid indeed, primarily due to the unique social organization of Chinese public health practices.     

Expanding the Role of Long-Term Care Social Workers: Assessment and Intervention Related to Urinary Incontinence

Urinary incontinence (UI) is a common and stigmatizing problem faced by long-term care (LTC) residents. It is typically addressed by medical professionals, with social work rarely involved. The purpose of this article is to illustrate how social workers can address the psychosocial implications of UI while working with residents and their family members as part of an interdisciplinary team. Using a case example and the NASW objectives for LTC, recommendations on how the role of the LTC social workers can be expanded to better address both the needs of residents, families, and the larger LTC system are provided.     

To Tell or Not to Tell? The Ethical Dilemma of the Would-Be Whistleblower

Despite the growing emphasis placed on the responsible conduct of research, little attention has been devoted to the question of what an individual should do upon discovering research misconduct. This article takes seriously the dilemma of a would-be whistleblower. It identifies ethical considerations that can be taken into account in moral decision-making about reporting research misconduct. It also offers rough guidelines about the moral significance of each consideration in the decision-making process based on the facts of the case in question. The article, therefore, offers tools for a would-be whistleblower to use to arrive at a defensible resolution to a difficult dilemma.     

Research ethics and clinical trials: Fostering collaboration with research participants

Accountability in research is a concept that applies to researchers and study participants alike. Human subjects play an active part in the success or failure of a clinical trial by virtue of their understanding of a study's goals expectations of personal gain, and adherence to study design. Trials must be designed to address patient concerns, offer an improved consent process, and move beyond our narrow conception of “patient rights.”; Problems with protocol adherence may be reduced by conceptualizing clinical research as an endeavor with mutual accountability within a relational ethic.