Sequential case series analysis for pharmacovigilance

Summary.  The self-controlled case series method is used to evaluate drug safety, particularly the safety of paediatric vaccines with respect to rare adverse reactions. We propose a group sequential version of the method for prospective surveillance of drug safety. We focus on the surveillance of new vaccines. We develop methods that are based on the sequential probability ratio test applied at predetermined surveillance intervals, using both simple and composite alternative hypotheses. We investigate the properties of the methods analytically in a simple setting and by simulations in more realistic scenarios. The methods are applied to data on influenza vaccine and Bell's palsy, and to data on measles, mumps and rubella vaccine and bleeding disorders.     

Adjustment strategies revisited: Agricultural change in the Welsh Marches

In the late 1980s and early 1990s, much attention was paid by British agricultural geographers to the restructuring of the farm sector under pressures of national, European and global change. The need to adopt a perspective capable of looking beyond the farm gate inspired the introduction of modified political economy approaches into agricultural research. One important cornerstone of the empirical application of this thesis was the concept of the ‘farm adjustment strategy’. This attempted to map out the responses, especially those of survival, made by farm family businesses to rapidly changing agrarian conditions. Subsequently, the farm adjustment strategy became remarkable for its popularity as a way to organise research into agricultural change in developed market economies. Following a retreat in the 1990s, there has been something of a recent revival in the use of the term ‘strategy’ relating to agricultural adjustment. Revisiting this concept is therefore timely. Using empirical evidence from studies of farming change in the Welsh Marches, this paper examines two issues. First, it makes a critical re-examination of the concept to resolve differences with interpretation linked to theoretical perspectives so that future misuse can be minimised. Second, an attempt is made to assess the relevance of defined elements of farm adjustment strategies to analyses of farm business change. In so doing, there is an attempt to recover our knowledge of agrarian restructuring and to help situate newly encultured investigations into the likely survival of family labour-based forms of production.     

A cost of living longer: Projections of the effects of prospective mortality improvement on economic support ratios for 14 advanced economies

The economic implications of increasing life expectancy are important concerns for governments in developed countries. The aims of this study were as follows: (i) to forecast mortality for 14 developed countries from 2010 to 2050, using the Poisson Common Factor Model; (ii) to project the effects of the forecast mortality patterns on support ratios; and (iii) to calculate labour force participation increases which could offset these effects. The forecast gains in life expectancy correlate negatively with current fertility. Pre-2050 support ratios are projected to fall most in Japan and east-central and southern Europe, and least in Sweden and Australia. A post-2050 recovery is projected for most east-central and southern European countries. The increases in labour force participation needed to counterbalance the effects of mortality improvement are greatest for Japan, Poland, and the Czech Republic, and least for the USA, Canada, Netherlands, and Sweden. The policy implications are discussed.     

The spaces and ethics of organic food

Initial assessments of the potential for organic food systems have offered an optimistic interpretation of the progressive political and ethical characteristics involved. This positive gloss has prompted a stream of critique emphasising the need to explore the ambiguities and disconnections inherent therein. In this paper, we consider the case of Riverford Organic Vegetables,¹ arguably the largest supplier of organic vegetables in the UK, and suggest that existing debates assume too much about the “goods” and “rights” of organic food and leave important questions about the spaces and ethics of organic food. We argue that, in the case of Riverford, the space of organic food production and distribution is neither the small, local, counter-cultural farm nor the large, transnational, corporate firm. Rather, simultaneously, the spaces of organic food production and distribution are the national network, the regional distribution system and the local farm. In addition, in the case of Riverford, the ethics of organic food exhibit few grand designs (of environmental sustainability, for example). Rather, the ethics of organic food are best characterised as: ordinary, since they relate to concerns about taste, value for money, care within the family and so on; diverse, since multiple practices steer the production and distribution of organic food; and graspable, in that both vegetables and box have material and symbolic presence for consumers.     

Joining up children's services: safeguarding children in multi‐disciplinary teams

In this article we reflect on the complexity and the contested nature of the roles of multi‐disciplinary teams working with children. This is an increasingly important issue in the current UK child welfare policy environment. The article uses the theories of Etienne Wenger to understand data gathered from five multi‐disciplinary teams working with children. We explore key issues relating to location; information sharing; models of understanding; and professional identities. We hope to demonstrate that the teams addressed tensions creatively through their engagement with diversity while at the same time developing common team values. We argue that effective strategies for making multi‐disciplinary teams work will combine inter‐agency issues with internal team‐specific aspects. Copyright © 2007 John Wiley & Sons, Ltd.     

No Fun Anymore: Leisure and Marital Quality Across the Transition to Parenthood

This study examines changes in leisure patterns across the transition to parenthood for dual‐earner, working‐class couples, as well as the relationship between leisure and marital quality. To this end, 147 heterosexual couples were interviewed across the transition to parenthood. Findings indicate that during the transition to parenthood, husbands and wives experience an initial decline in leisure, followed by a gradual incline after the wife’s return to work. Overall, wives who reported more shared leisure prenatally also reported more marital love and less conflict 1 year later. Husbands with more independent leisure prenatally reported less love and more conflict 1 year later. Conclusions suggest leisure time is integral to well‐functioning marriages, with effects lasting throughout the first year of parenthood.     

“Do We Have A Customer?” — A Team Approach To Intake

This article examines some of the ambiguities surrounding requests for assistance in the voluntary sector. The authors have developed a team approach at the ‘intake’ stage for clients whose requests often demand a well-thought-out response in order, as Haley suggests we must, “to start well”. Some of the literature about ‘beginning with families’ is examined, and the complex issues of ‘engaging’ and ‘joining’ are discussed. It is suggested that not every ‘shopper’ is necessarily a ‘customer’ for our wares, but that they are almost certainly shopping for something. ‘Emergency’ and ‘crisis’ calls are distinguished, and different responses to each are indicated. Finally, the procedures used are described, within the context of this particular voluntary agency, so that readers may distinguish what could be applicable in different contexts.