Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity

The current study examined the role of hypothalamic‐pituitary‐adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at‐risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers’ depression was measured five times during the infants’ first 18 months. Infant cortisol was collected during a social stressor (the still‐face paradigm) when infants were 6 months old, and mothers reported on toddlers’ internalizing and externalizing symptoms at 18 months. Among this sample of high‐risk mother–infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.     

Issues in applying recent CPMP ‘Points to Consider’ and FDA guidance documents with biostatistical implications

The International Conference on Harmonisation guideline ‘Statistical Principles for Clinical Trials’ was adopted by the Committee for Proprietary Medicinal Products (CPMP) in March 1998, and consequently is operational in Europe. Since then more detailed guidance on selected topics has been issued by the CPMP in the form of ‘Points to Consider’ documents. The intent of these was to give guidance particularly to non‐statistical reviewers within regulatory authorities, although of course they also provide a good source of information for pharmaceutical industry statisticians. In addition, the Food and Drug Administration has recently issued a draft guideline on data monitoring committees. In November 2002 a one‐day discussion forum was held in London by Statisticians in the Pharmaceutical Industry (PSI). The aim of the meeting was to discuss how statisticians were responding to some of the issues covered in these new guidelines, and to document consensus views where they existed. The forum was attended by industry, academic and regulatory statisticians. This paper outlines the questions raised, resulting discussions and consensus views reached. It is clear from the guidelines and discussions at the workshop that the statistical analysis strategy must be planned during the design phase of a clinical trial and carefully documented. Once the study is complete the analysis strategy should be thoughtfully executed and the findings reported. Copyright © 2003 John Wiley & Sons, Ltd.     

Society's search for a legal and ethical basis of physician-assisted suicide

A review of the way physician-assisted suicide (PAS) is being addressed in the United States reveals three models, each functioning out of distinctive concepts of autonomy: (1) litigation, which utilizes philosophical autonomy; (2) legislation, which utilizes political autonomy; and (3) act of conscience by a physician, which utilizes consumer autonomy. Each model raises a correspondingly distinct set of ethical questions and challenges centered around their point of reference-the judicial system, voters, or the doctor-patient relationship. In the end, however, efforts to resolve the challenge of PAS will falter if they do not go beyond these models of autonomy. Religious institutions offer a more constructive setting for facing the life and death decisionmaking of PAS. The challenge for religion is to address PAS in solidarity with sufferers, physicians, and the community, rather than retreating into iconoclastic dogmas.     

Late Adapters? How Social Workers Acquire Knowledge and Skills About Technology Tools

Little is understood about the scope of information and communication technology (ICT) use in practice for agency-based social work professionals, and still less is known about how such practitioners acquire and avail themselves of opportunities to learn about ICT tools. This study asked a sample of social work field supervisors (n?=?371) to describe their personal and professional ICT use, to rank the technological sophistication of their agency, to describe the barriers and facilitators to ICT use in their organizations and to operationalize environmental opportunities for acquiring new skills and knowledge. The authors examine factors that may influence technology use: asking if organizational culture is related to uptake in the professional context, and if self-reported individual resistance to innovation and change can explain voluntary adoption of ICT tools. The results offer a portrait of how agency-based social workers are using technology in personal and professional life, describe how these supervisors learn about developing technologies for practice, and highlight the gaps in technology infrastructures among agencies, pointing to directions for further exploration.     

Differentiated leader–member exchange,justice climate,and performance: Main and interactive effects

Leaders form different quality leader–member exchange (LMX) relationships with their subordinates. This variable treatment termed LMX differentiation can have negative effects on individuals' behavior and attitudes. In this study, we examined the cross-level main effect of justice climate on task performance and the moderating role of justice climate on the relationship between LMX differentiation and task performance. We tested these two hypotheses using a field study of 90 subordinates nested under 27 supervisors. Procedural justice climate, not distributive justice climate, was found to positively influence subordinate task performance. Further, distributive justice climate, not procedural justice climate, was found to moderate the LMX differentiation–task performance relationship; such that the relationship was positive when distributive justice climate was high and negative when distributive justice climate was low. Findings and future directions are discussed.     

Visualising the invisible: children on the streets of Lima,Peru, realise the self through photographs

This article presents findings from a photographic project conducted with six adolescent boys living and working on the streets of Lima, Peru. In this article, I examine how photographs provided the boys with a means by which to express themselves and served to humanise these participants who exist at the most extreme margins of society. Drawing parallels between the participants’ use of photographs and the roles that photographs play for families, I examine how the ability to record and document their childhood provided the boys in this study the opportunity for critical engagement in the creation of their own histories.     

Generating recognition,acceptance and social inclusion in marginalised youth populations: the potential of sports-based interventions

In recent years sport-based interventions have been implemented as a mechanism via which to target marginalised youth in relation to the development of social inclusion. Much of the political rhetoric surrounding social inclusion programmes highlights engagement with education, employment, or training, as key metrics. This has led some scholars to observe that conceptualising social inclusion in this way can act to further marginalise young people who fail to engage with these metrics. In contrast, this paper seeks to employ an alternative understanding of social inclusion, which uses the concepts of recognition and acceptance, to infer how participation in sports-based programmes may enable marginalised youth to meet mainstream societal expectations and aid with social assimilation. Drawing upon findings from two small-scale studies of sport-based interventions located in three UK cities, this paper places participant accounts at the centre of the analysis to explore broader notions of pro-social development in relation to recognition and interpersonal acceptance. The paper concludes by suggesting that within contexts in which young people are able to generate strong interpersonal relationships with key personnel (such as coaches), and which are built upon trust, recognition and developing self-worth, there is clear potential for sport-based programmes to incubate social assimilation.