Neoplasia masquerading as physical abuse

We describe three children with organic disease presenting as possible physical abuse. The first child was an infant with an ‘unexplained’ transverse fibular fracture, who was initially placed on the child protection register. Subsequent progress and investigation revealed that the fracture was caused by a haemangioma arising from the surrounding tissues. Two further children presented with bruising, in one case due to acute lymphoblastic leukaemia and in the other neuroblastoma. In both, the correct diagnosis became evident following assessment by an experienced paediatrician. These cases demonstrate the importance of obtaining an accurate history and of performing a careful examination when considering physical abuse, but also the need to review that diagnosis if subsequent contradictory evidence comes to light. Copyright © 2000 John Wiley & Sons, Ltd.     

Diagnosing physical abuse using Bayes' Theorem: a preliminary study

Objectives. To perform a preliminary study to compare the patterns of bruises in a physically abused group of children and a control group; to investigate whether these could be modelled statistically to enable probabilities of typical bruise patterns to be calculated; to apply Bayes' Theorem to find the probability that a child with a given bruise pattern has been the subject of physical abuse. Design. An observational study. Setting. Cardiff and Vale of Glamorgan. Subjects. Children who have suffered child physical abuse, 0–14 years. The diagnosis was confirmed at a case conference in all cases. A control group of 289 children who presented to the Accident and Emergency Department at the Cardiff Royal Infirmary after an accidental injury. Main outcome measures. The distribution bruise pattern in three regions of the body. The posterior probability of abuse for a given bruise pattern. Results. The bruise distribution in physically abused and control children was well described by a negative binomial distribution. There was a different distribution for the three different regions of the body in physically abused children. The bruising frequency and distribution for the physically abused group was very different from that of the controls. We were able to use parameters derived from these distributions to calculate posterior probabilities of physical abuse given a particular pattern of bruises using Bayes' Theorem. Conclusions. This preliminary study demonstrates that we can use Bayes' Theorem to combine prior probabilities of physical abuse with observed patterns of bruising in given children to obtain posterior probabilities of abuse. This principle has considerable potential for better diagnosis of the physically abused child. © 1998 John Wiley & Sons, Ltd.     

Developing a Model of Community Wellbeing and Resilience in Response to Change

This study examines the relationship between base of the pyramid (BoP) entrepreneurship success and wellbeing. The major contention is that the success of the BoP entrepreneurs is influenced by information and training support provided by large private organizations. A total of 134 BoP entrepreneurs, who run community information centres in remote areas of Bangladesh with the support of a leading private telecommunications company, participated in this research. The result revealed that support from a large private organization is important to ensure business success, and that this subsequently enhances the wellbeing of BoP entrepreneurs. Not only has this study empirically confirmed that assistance provided by large private organizations to BoP entrepreneurs influences business success, assistance also enhances the wellbeing of this vulnerable group and thus facilitate to reduce poverty within the local community. This study therefore can be a guideline for large private organizations that are willing to carry out pragmatic corporate social initiatives.     

Do Marriage and Cohabitation Provide Benefits to Health in Mid-Life? The Role of Childhood Selection Mechanisms and Partnership Characteristics Across Countries

Extensive research has found that marriage provides health benefits to individuals, particularly in the U.S. The rise of cohabitation, however, raises questions about whether simply being in an intimate co-residential partnership conveys the same health benefits as marriage. Here, we use OLS regression to compare differences between partnered and unpartnered, and cohabiting and married individuals with respect to self-rated health in mid-life, an understudied part of the lifecourse. We pay particular attention to selection mechanisms arising in childhood and characteristics of the partnership. We compare results in five countries with different social, economic, and policy contexts: the U.S. (NLSY), U.K. (UKHLS), Australia (HILDA), Germany (SOEP), and Norway (GGS). Results show that living with a partner is positively associated with self-rated health in mid-life in all countries, but that controlling for children, prior separation, and current socio-economic status eliminates differences in Germany and Norway. Significant differences between cohabitation and marriage are only evident in the U.S. and the U.K., but controlling for childhood background, union duration, and prior union dissolution eliminates partnership differentials. The findings suggest that cohabitation in the U.S. and U.K., both liberal welfare regimes, seems to be very different than in the other countries. The results challenge the assumption that only marriage is beneficial for health.     

INEQUALITY OF SUBJECTIVE WELL‐BEING AS A COMPREHENSIVE MEASURE OF INEQUALITY

The link between happiness and overall inequality is best studied using an index that incorporates different aspects of inequality, and is measured consistently in different countries. One such index is the degree to which happiness itself varies among individuals. Its correlation with both happiness levels and social trust is substantially stronger than the corresponding correlation for income inequality. This remains so after allowing for bounded scale reporting, including a purely ordinal measure of dispersion. Moreover, the correlation is stronger for individuals who profess to care most about inequality. The link between happiness and inequality may thus be stronger than previously appreciated. (JEL I31, D6, D63, D31)     

Transitioning from ‘outside observer’ to ‘inside player’ in social work: practitioner and student perspectives on developing expertise in decision-making

ABSTRACT

This paper reports on a six-year qualitative study of social workers’ perspectives on factors influencing decision-making in children and families social work in England. Data collected between 2010 and 2016 reflect frontline practice during a period of substantial change and reform in UK social work. This paper builds on an earlier analysis with data from all three stages of the study capturing the lived experiences of practitioners ranging from student social workers to qualified advanced practitioners in management roles. Data from 9 focus groups comprising 51 participants were analysed using grounded theory. Data analysis generated four representative categories: developing agency in the social work role; troubling emotions; transitions in the development of expertise and the impact of organisational cultures in children and families social work services. An emerging theoretical framework is presented. This identifies the significance of transitions and threshold concepts in the development of the social work professional from the role of students as ‘outside players looking in’ through to the expertise of qualified practitioners as ‘inside players’ within organisations. Recognising periods of liminality, transitional learning and uncertainties in developing decision-making expertise may be of significant benefit to social work education and the profession.     

Evidence of Skill and Strategy in Daily Fantasy Basketball

Using hand-collected data from DraftKings.com, a major daily fantasy sports website, we analyze draft selections of thousands of participants in daily fantasy basketball (DFB). In our study, the first thorough examination of DFB, we show that DFB is a game in which skill is necessary for success. Using econometric analysis, we find that winning participants utilize different strategies than losing participants; for example, winning participants more frequently select NBA rookies and international players. We also find that participants paying to enter more lineups in a given contest earn profits far more often than those entering few lineups, indicating that the number of lineups entered can serve as a proxy for skill. Additionally, we provide a thorough discussion of industry characteristics, prior literature, and gameplay, which should help readers familiarize themselves with this burgeoning fantasy sports variant. This study should further the literature on the contentious activity, which has been outlawed in many U.S. states and continues to elicit controversy.     

AGING OUT OF WOMEN INFANTS AND CHILDREN: AN INVESTIGATION OF THE COMPENSATION EFFECT OF PRIVATE NUTRITION ASSISTANCE PROGRAMS

This paper is the first to address the causal relationship between an abrupt change in the availability of public nutrition assistance and low-income households' private nutrition assistance utilization. In particular, we examined the way in which loss of Women Infants and Children (WIC) benefits impacted a household's utilization of private food assistance. Using a regression discontinuity analysis framework, we found that households significantly increased utilization of private nutrition assistance following an abrupt loss in public nutrition assistance. Estimates indicated that some households might have been able to compensate from about half to more than 90% of their loss in public WIC nutrition assistance. (JEL I38, C36, D12)