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Listening to children and young people is for social workers a legal requirement, it is also believed to lead to better outcomes and is increasingly promoted in policy. The practice of listening is, however, rarely straightforward, and this is particularly the case with socially excluded groups. As a result, the voices of the marginalized are less likely to be heard. In this paper the author draws on interview data from a research study into communication between social workers and looked-after children for the light it sheds on why effective dialogue with disaffected young people can be hard to achieve. It is argued that much that appears unsuccessful in an interaction can be understood in terms of power plays, with young people resisting the adult's agenda and trying to impose their own. True listening to disaffected young people requires time, so that a trusting relationship can be developed. It also demands an acceptance that the adult agenda may be flawed and a willingness to consider alternative possibilities. This can challenge the preconceptions, not just of individual workers, but of agencies and of national policy-makers. [ABSTRACT FROM AUTHOR]

Background: A model to study the effect of vasopressin V1a antagonist in dysmenorrhea.Methods: A double-blind, randomized, placebo-controlled, cross-over trial was performed. Eight patients with primary dysmenorrhea and eight tuballigated, healthy subjects participated on days 1-2 of two consecutive menstruations. At each menstruation a bolus injection of 10 pmol/kg of vasopressin was administered before and during infusion of either 300 microg/min of atosiban or placebo. Intrauterine pressure was measured as area under the curve throughout the experiments. Ischemia markers in plasma and pain recorded by a visual analog scale were measured before and after each vasopressin injection as well as before and after the start of either atosiban or placebo infusion.Results: Vasopressin injections elevated area under the curve in both healthy volunteers and dysmenorrhea subjects. The vasopressin-induced rise in area under the curve was lower during atosiban administration than during infusion of placebo in both groups. None of the ischemia markers differed between or within groups at vasopressin injections or atosiban/placebo infusions. In subjects with dysmenorrhea the increase in pain following the administration of vasopressin was significantly lower during atosiban than during placebo infusion. Healthy volunteers experienced only slight discomfort after the vasopressin injections.Conclusions: Atosiban reduces vasopressin-induced intrauterine pressure in both healthy volunteers and dysmenorrheics, and reported pain in subjects with dysmenorrhea. The ischemia markers are not a useful biomarker index in women with dysmenorrhea. The dysmenorrhea pain evoked by vasopressin correlated poorly with area under the curve, which may suggest that the effect is mediated by more than one V1a-like receptor. We conclude that this model with recordings in healthy women is useful in the evaluation of drug candidates for primary dysmenorrhea. [ABSTRACT FROM AUTHOR]