Asking about pain and pain scores after Caesarean section adversely affects patient reports of their postoperative experiences.

Objective Surgical Pain Scales (SPS) consist of 4 items that measure pain at rest, during normal activities, during work/exercise and quantify unpleasantness of worst pain, which are valid and responsive in men undergoing hernia repair. Our objective was to evaluate the psychometric properties of SPS in women undergoing vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Methods We modified SPS by converting original response scales from a visual analog scale (VAS) to Numerical Rating Scales (NRS). NRS have lower error rates and higher validity than VAS. The sample included 169 women with stage II–IV POP and SUI in a randomized trial comparing sacrospinous ligament fixation to uterosacral vault suspension with and without pelvic floor muscle training. Participants completed SPS and SF-36 at baseline, 2-weeks and 6-months after surgery. Construct validity and responsiveness were examined in cross-sectional and longitudinal data using Pearson’s correlation and ANOVA. Results Pain at rest, during normal activities and during work/exercise worsened at 2-weeks (p<0.05) and all measures of pain improved from baseline to 6 months (p<0.0001). Construct validity was demonstrated by correlations of .51–.74 between SPS and the SF-36 Bodily Pain Scale (p<0.0001). Pain worsened on SF-36 between baseline and 2-weeks in 63% of participants and this group demonstrated a mean increase in pain of 1.9 (SD 2.8) on the SPS (effect size 0.99) confirming responsiveness of the scale. Conclusions The modified Surgical Pain Scales are valid and responsive in women after pelvic reconstructive surgery.

A flash adjacent to the path of a moving object appears behind the moving object: the 'flash-lag effect'. We sought to test the flash-lag effect with a 'click' instead of a flash: a white triangle horizontally traversed the screen at a constant 12 degrees /s passing through a fixation cross in the presence of a quiet click. The subject judged whether the click occurred before or after the triangle passed through the cross. To be perceived as co-instantaneous events, the click had to be presented 127 ms after the moving triangle reached the cross (a 'click-lead' effect, providing falsification of predictive accounts of the flash-lag effect), as opposed to a standard flash-lag effect condition where a flashed triangle replaced the click and had to appear 60 ms before the moving triangle to appear aligned. With the auditory versus visual processing speed advantage considered, the neural time required to calculate a moving object's position is constant, independent of the modality of the flag.

Objective The Activities Assessment Scale (AAS) is a 13-item postoperative functional activity scale validated in men undergoing hernia surgery. We evaluated the psychometric characteristics of the AAS in women undergoing vaginal surgery for prolapse (POP) and stress incontinence (SUI). Methods Participants included 163 women with POP and SUI enrolled in a randomized trial comparing sacrospinous ligament fixation to uterosacral vault suspension with and without perioperative pelvic floor muscle training. Participants completed the AAS and SF-36 at baseline and 2-weeks and 6-months post-operatively. Internal reliability of the AAS was evaluated using Cronbach’s alpha. Construct validity and responsiveness were examined in cross-sectional and longitudinal data using Pearson’s correlation coefficient and ANOVA. The AAS is scored from 0–100 (higher scores = better function). Results Mean baseline AAS score was 87± 17.3 (range 25 to 100). Functional activity declined from baseline to 2-weeks post-operatively (mean change −4.5; 95% CI −7.6 to −1.42) but improved above baseline at 6-months (mean change +10.9; 95% CI 7.8 to 14.0). Internal reliability of the AAS was excellent (Cronbach’s Alpha = 0.93). Construct validity was demonstrated by a correlation of 0.59–0.60 between the AAS and SF-36 Physical Functioning Scale (p<0.0001) and lower correlations between the AAS and other SF-36 scales. Patients who improved in physical functioning based on the SF-36 between 2-weeks and 6-months postoperatively showed an effect size of 0.86 for change in the AAS over the same time period. Conclusions The AAS is a valid, reliable and responsive measure for evaluation of physical function in women after pelvic reconstructive surgery.

Growing tension within the early childhood education sector of Aotearoa New Zealand around the roles teachers and families might play in preparing children for success in school suggests that notions of readiness are gaining traction. In this paper, we draw on data from three empirical studies to position families as experts in the lives of their children, valuing the linguistically and culturally diverse literacies children carry from their whānau, homes, and communities in bicultural and superdiverse Aotearoa New Zealand. Exemplars of family pedagogies framed through a funds of knowledge theoretical lens, provide counternarratives to deficit discourses regarding children's language competencies, and challenge the encroaching reductionist notion of the 'language gap' and narrow views of early literacy promoted in the preparation of children for English-medium schooling. The data presented highlight family linguistic and cultural resources, the efforts of families to sustain home languages, and the critical role of early childhood teachers to engage in reciprocal partnerships with families. Affirmation of the complexities of children's language/s and literacies and the work of early childhood teachers are discussed in the implications for early childhood teacher education and professional development, centre leadership, and policy.