Corticosteroid injection is effective in improving shoulder-related disability, and physiotherapy is effective in improving the range of movement in external rotation 6 weeks after treatment.

African American adolescents and young adults disproportionately experience adverse sexual health outcomes, including HIV, other sexually transmitted infections, and unintended pregnancy. Despite the diversity of the African American population, many studies of sexual risk are limited to inner-city and clinic samples. The purpose was to examine the influence of parent-teen sexual risk communication on the sexual risk attitudes, beliefs, and behaviors of 488 African American college students from a historically Black university and document the psychometric properties of the Parent-Teen Sexual Risk Communication Scale (PTSRC-III) when used with this population. The PTSRC-III demonstrated excellent internal reliability and construct validity across all four parent-teen communication dyad categories (e.g., mother-son, mother-daughter, father-son, father-daughter). PTSRC was associated with students' reports of more conservative sexual attitudes and beliefs and greater perceived ease of sexual communication with partners. PTSRC with mothers was also associated with fewer sexual risk behaviors and pregnancies among the female students.

Objective To obtain the views of women on their experiences of decision making about the method of delivery following a previous caesarean section and the role of decision aids in this process.Design Qualitative study nested within a randomised controlled trial, using repeat semi-structured interviews conducted pre-and postnatally. Data were analysed using a framework approach.Setting Three maternity units in south-west England and Scotland.Sample Purposive sample of 30 women participating in a randomised controlled trial of two decision aids for women making a decision about mode of next delivery following a previous caesarean section (Decision Aids for Mode of next Delivery).Results Thirty women were interviewed during pregnancy about their experience of decision making about the mode of delivery and 22 were re-interviewed postnatally. Key themes were: role of decision aids in reducing decisional conflict and uncertainty during the pregnancy; impact of decision aids on knowledge and anxiety; the relationship between prior preferences, decisions and actual outcome; and the mediating role of decision aids.Conclusions Women making a decision about mode of delivery following previous caesarean section value some form of structured information to help reduce decisional conflict. Information provision for women making this decision needs to be relevant to their individual needs. Decision analysis may help reconcile prior preferences and the actual mode of delivery.Keywords Caesarean section, decision making, mode of delivery, qualitative research, VBAC.Please cite this paper as: Frost J, Shaw A, Montgomery A, Murphy D. Women's views on the use of decision aids for decision making about the method of delivery following a previous caesarean section: qualitative interview study . BJOG 2009;116:896-905.

Large sacrococcygeal tumours are rare and remain a difficult management problem. Chordomas are one of the most common tumours in this region and may account for 30-40 per cent of postrectal tumours. Four patients aged between 22 and 66 years, three with chordomas and one with a schwannoma, are described. Each was managed by a combined general and neurosurgical approach. Major radical excision of the tumour involving high amputation of the sacrum and lower sacral nerve root division was performed. These large lesions can be radically excised with limited postoperative morbidity and excellent preservation of neurological function, including sphincter control, provided that one S2 nerve root is left intact.

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