Vaginal lacerations from consensual intercourse in adolescents

Objective

(1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries.

Methods

We present a case series of 4 female adolescent patients seen at a children's hospital over a period of 6 months. Each patient developed significant vaginal bleeding after sexual intercourse, and 3 of the patients presented to the emergency department with vital signs consistent with compensated shock.

Results

Each patient was evaluated by pediatric surgery, and found to have a laceration of the vagina. Three of the patients described consensual intercourse prior to the onset of bleeding, and had lacerations of the vaginal fornices; these patients were determined to have injuries resulting from consensual sexual intercourse. The fourth patient reported sexual assault as the cause of her injuries, and was treated for longitudinal lacerations of the vaginal wall.

Conclusions

Lacerations of the upper vagina are not frequently reported in forced vaginal intercourse, but are occasionally reported as injuries sustained during consensual coitus. In the absence of reported sexual assault, a severe vaginal fornix laceration is consistent with the diagnosis of coital injury from consensual intercourse. Diagnosis and treatment of this injury can be delayed due to the sensitive nature of these injuries. Bleeding can be profuse, leading to hemorrhagic shock, and these injuries may require transfusion of blood products and surgical repair in some cases. Complications may include hemoperitoneum, pneumoperitoneum, or retroperitoneal hematoma, even in the absence of complete vaginal perforation.

Practice implications

Knowledge of the consensual sexual injuries that may occur in adolescent patients can guide diagnosis, treatment, and counseling for the patient and her family, preventing long-term medical complications and legal consequences.     

Striking the right note: the cultural preparedness approach to developing resonant career guidance programmes

Cultural preparedness is presented as a conceptual framework that could guide the development of culture-resonant interventions. The Jiva careers programme is presented as a case study to illustrate a method of career and livelihood planning based upon Indian epistemology and cultural practices. Social cognitive environments and career beliefs are discussed as key factors that characterise a group’s orientation to career development. An impact analysis is described. Traditional knowledge is highlighted as an important resource for constructing career guidance programmes to address the needs of clients from different cultural heritages.     

Emotion recognition in fathers and mothers at high-risk for child physical abuse

Objective

The present study was designed to determine whether parents at high risk for physical child abuse, in comparison with parents at low risk, show deficits in emotion recognition, as well as to examine the moderator effect of gender and stress on the relationship between risk for physical child abuse and emotion recognition.

Methods

Based on their scores on the Abuse Scale of the CAP Inventory (Milner, 1986), 64 parents at high risk (24 fathers and 40 mothers) and 80 parents at low risk (40 fathers and 40 mothers) for physical child abuse were selected. The Subtle Expression Training Tool/Micro Expression Training Tool ( [Ekman, 2004a] and [Ekman, 2004b]) and the Diagnostic Analysis of Nonverbal Accuracy II (Nowicki & Carton, 1993) were used to assess emotion recognition.

Results

As expected, parents at high risk, in contrast to parents at low risk, showed deficits in emotion recognition. However, differences between high- and low-risk participants were observed only for fathers, but not for mothers. Whereas fathers at high risk for physical child abuse made more errors than mothers at high risk, no differences between mothers at low risk and fathers at low risk were found. No interaction between stress, gender, and risk status was observed for errors in emotion recognition.

Conclusions and practice implications

The present findings, if confirmed with physical abusers, could be helpful to further our understanding of deficits in processing information of physically abusive parents and to develop treatment strategies specifically focused on emotion recognition. Moreover, if gender differences can be confirmed, the findings could be helpful to develop specific treatment programs for abusive fathers.     

Intrafamilial conflict and emotional well-being: a population based study among Icelandic adolescents

Objectives

During intrafamilial conflicts children are often innocent bystanders, caught in the crossfire. In such situations, they are at increased risk to become directly involved in abusive verbal behavior of the perpetrator, and exposed to being shouted or yelled at, threatened, rejected and even physically abused. The present study has two main objectives: (1) ascertain a national base rate of intrafamilial conflicts and physical violence at home among Icelandic adolescents; and (2) to investigate the association of witnessing and/or having been a part of intrafamilial conflict or physical violence at home with variables that relate to mental health and well-being.

Methods

The participants were 3,515 students, 14- and 15-year-old, in the national compulsory school system in Iceland. As a part of the 2003 ESPAD survey, each pupil was asked about experiences of severe verbal arguments and physical violence at home as well as their background, behaviors, and mental health assessed with the use of tested measurement scales such as the Symptom Distress Checklist 90 (SCL-90) and the Rosenberg Self-Esteem Scale.

Results

About 22% of the participants stated that they had witnessed a severe verbal argument between parents and 34% stated that they had been involved in a severe verbal argument with parents. This rate was slightly higher for girls compared to boys. All together 7% of adolescents had witnessed physical violence at home where an adult was involved and 6% of the participants stated that they had experiences of being involved in physical violence at home where an adult was involved. Witnessing or being involved in severe verbal arguments at home and/or witnessing or being involved in physical violence with an adult was significantly associated with greater levels of depression, anger, and anxiety, and negatively related with self-esteem (p < 0.01).

Conclusions

Many adolescents in Iceland witness severe parental verbal arguments or physical violence between adults in their homes and some are directly involved in such acts. It affects their long-term emotional and behavioral development and well-being.

Practice implications

Preventive measures have to be implemented at an early age and should include, but not be limited to, information on disciplining and upbringing of children and the negative impact of intrafamilial conflicts on the long-term health of their children. Due attention should be given to the health and well-being of children where such violence is known to occur.     

Experience of cooperative learning in engineering

The objective of this work is to share the authors’ experience towards a different mode of teaching/learning method. Cooperative learning (Jigsaw) was employed on the University of Vigo's fourth-year engineering students. The results of the experience show that cooperative learning is quite a viable alternative to the classical way of lecturing at the university when the number of students is not too high. The authors’ observation indicates that students did not show a lot of interest towards the new learning style but their resistance changed once they began the activity. The Jigsaw method has proved to be a useful tool for improving the learning process so that students have the opportunity to participate actively in the learning activities.     

Changes in instructors' assessment thinking related to experimentation with new strategies

Formative assessment has been recognised as a critical element in teaching for conceptual development. A case study research design was employed to: (1) characterise the assessment thinking of three science instructors at a research‐based university; and (2) examine the complex relationship between instructor thinking and practice by encouraging experimentation with alternative assessment strategies. Interviews, reflective journals, field notes and course documents were the data sources used to create a single case study that documented the development of these university instructors’ assessment thinking during their experimentation with formative assessment strategies. Throughout two semesters of experimentation, the instructors’ assessment thinking became more sophisticated; they grew to view the purpose of assessment less as a summative activity used for the assignment of marks and more as a tool for diagnosing student learning. However, more sophisticated thinking was not associated with revisions in teaching practice based on formative assessment data. Further investigations are needed to more completely understand the nature of assessment thinking and how assessment thinking influences assessment practices. Implications for professional development of university‐level science instructors include personalised experiences through which instructors can become active participants in gathering evidence of student learning that promotes growth in assessment thinking.     

Teaching practices prior and subsequent to 1998 in Turkey: Gazi University Vocational Education Faculty case

This study aimed to compare teaching practice before and after 1998 in Turkey. Participants were 10 academics from the Department of Educational Sciences, Vocational Education Faculty, Gazi University and nine vocational high school cooperating teachers. Semi‐structured interviews were analysed by using content analysis. The most significant findings were that the preparation, practice, observation, counselling and evaluation processes were more efficient before 1998 due to the smaller number of preservice teachers. After 1998, the cooperating teachers were legally included in the process and took more responsibility. A new model which combines the positive aspects of both practices is suggested in the article.     

Gender Gaps in Collegiate Teaching Style: Variations by Course Characteristics

Using data from over 9,000 faculty members that participated in the Faculty Survey of Student Engagement (FSSE), this study examined the moderating role a range of course characteristics played on the effects of gender on the percentage of class time spent on various activities, a measure of teaching style. Results revealed gender differences, but that the gaps between men and women in lecturing and active classroom practices varied by disciplinary area, course level, and the number of times a course had been taught by the same instructor. The results confirm that gender effects depend on context, which implies that efforts to improve teaching and learning must also adapt to the instructional context.     

Early career challenges in secondary school music teaching

The article reports an Economic and Social Research Council‐funded study of the early career experiences of secondary school music teachers in England, set within a wider national picture of decreasing age‐related pupil engagement with school music, career perceptions of music teaching, variable patterns of teacher recruitment and possible mismatches between the musical biographies of young people and intending music teachers. Qualitative and quantitative data were collected from a short‐term longitudinal survey (first questionnaire: n = 74, second questionnaire: n = 29), supplemented by case studies (n = 6) and open‐ended, written questions (n = 20). Analyses suggest that only a half of the newly qualified participants chose to teach full‐time in a mainstream, state‐funded school music classroom. Of these, the majority were faced with a range of early career challenges stemming from curricular, extra‐curricular and non‐curricular school expectations. These included the need to balance their existing musical performer identity with that of being a new teacher.