Removing gender barriers: Promoting inclusion for trans and non‐binary carers in fostering and adoption

This paper offers a conceptually informed analysis of fostering and adoption social work and argues for more consistent inclusion of trans and non‐binary people. The conceptual framework through which we explore current policy and practice is set out to provide clarity about the ways in which we employ the concepts of trans, gender diversity, and cisgenderism (a prejudicial ideology). We employ the notion of cisgenderism as a critical lens through which to overview fostering and adoption social work within the context of trans inclusion. Focus is turned to the existing literature relevant to trans parenting, trans‐headed families, and the field of fostering and adopting. We highlight significant knowledge gaps in this regard. We then argue that if fostering and adoption social work is to embody inclusive practice with trans people, a new culture must be embedded to promote collaborative working, enhance knowledge, and improve service provision. The paper concludes by asserting that such an approach must be underpinned by an understanding, acceptance, and appreciation of people who identify as trans and/or as non‐binary.     

A qualitative study of smoking cessation experiences and perceptions among homeless young adults

Up to 70% of homeless youth smoke, but there is little information available on their smoking cessation experiences and perceptions to guide cessation intervention efforts. This study examined reasons for quitting smoking, previous experiences quitting smoking, and preferences for smoking cessation programs among homeless young adults. Four focus groups (N?=?27) were conducted in centers serving homeless 18–25 year olds in Los Angeles. Sessions were audio recorded, transcribed, and analyzed by a systematic procedure for qualitative analysis to identify key themes on the topics of interest. The short-term health-related consequences of smoking and high cost of cigarettes were the main reasons participants indicated for quitting or wanting to quit. In terms of barriers to quitting, exposure to peers who smoke and smoking to cope with the daily stressors of homelessness were the two most salient themes. Suggested features of a smoking cessation program for homeless youth included having a group-based component to provide support, offering incentives to attend, and using “scare tactics” as a tool to increase motivation to quit. To increase acceptability and uptake, smoking cessation programs for homeless youth need to focus on the short-term consequences of smoking and harness of the power of peer influences.     

The definition of start time in cancer treatment studies analysed by non-mixture cure models

Non-mixture cure models are derived from a simplified representation of the biological process that takes place after treatment for cancer. These models are intended to represent the time from the end of treatment to the time of first recurrence of the cancer in studies when a proportion of those treated are completely cured. However, for many studies, other start times are more relevant. In a clinical trial, it may be more natural to model the time from randomisation rather than the time from the end of treatment and in an epidemiological study, the time from diagnosis might be more meaningful. Some simulations and two real studies of childhood cancer are presented to show that starting from time of diagnosis or randomisation can affect the estimates of the cure fraction. The susceptibility of different parametric kernels to errors caused by using start times other than the end of treatment is also assessed. Analysing failures on treatment and relapse after completing the treatment as two processes offers a simple way of overcoming many of these problems.     

Mind‐mindedness and self–other distinction: Contrasts between Japanese and British mothers’ speech samples

To elucidate cultural contrasts in children's family environments, we conducted in‐depth, direct comparisons of mind‐mindedness and self–other distinction from maternal speech. The study included 5‐min speech samples of 225 mothers from Japan (N = 111) and the U.K. (N = 114) talking about their 3‐ to 6‐year‐old children (including 11 sibling pairs, n = 236). Compared with Japanese mothers, British mothers spoke significantly more, gave a significantly higher proportion of child‐focused and mind‐related comments, and also showed a stronger self–other distinction. In addition, within each country, there was a positive relation between mothers’ references to children in the singular (as opposed to plural) form and their mind‐mindedness. Together, the current findings highlight cultural variations in maternal mind‐mindedness, explicit–implicit communication style, and self–other distinction, and also suggest further exploration of relations among them.     

Applications of Bayesian statistical methodology to clinical trial design: A case study of a phase 2 trial with an interim futility assessment in patients with knee osteoarthritis

Development of new pharmacological treatments for osteoarthritis that address unmet medical needs in a competitive market place is challenging. Bayesian approaches to trial design offer advantages in defining treatment benefits by addressing clinically relevant magnitude of effects relative to comparators and in optimizing efficiency in analysis. Such advantages are illustrated by a motivating case study, a proof of concept, and dose finding study in patients with osteoarthritis. Patients with osteoarthritis were randomized to receive placebo, celecoxib, or 1 of 4 doses of galcanezumab. Primary outcome measure was change from baseline WOMAC pain after 8 weeks of treatment. Literature review of clinical trials with targeted comparator therapies quantified treatment effects versus placebo. Two success criteria were defined: one to address superiority to placebo with adequate precision and another to ensure a clinically relevant treatment effect. Trial simulations used a Bayesian dose response and longitudinal model. An interim analysis for futility was incorporated. Simulations indicated the study had ≥85% power to detect a 14‐mm improvement and ≤1% risk for a placebo‐like drug to pass. The addition of the second success criterion substantially reduced the risk of an inadequate, weakly efficacious drug proceeding to future development. The study was terminated at the interim analysis due to inadequate analgesic efficacy. A Bayesian approach using probabilistic statements enables clear understanding of success criteria, leading to informed decisions for study conduct. Incorporating an interim analysis can effectively reduce sample size, save resources, and minimize exposure of patients to an inadequate treatment.     

The Influence of Feelings While Driving Regular Cars on the Perception and Acceptance of Self‐Driving Cars

Self‐driving vehicles will affect the future of transportation, but factors that underlie perception and acceptance of self‐driving cars are yet unclear. Research on feelings as information and the affect heuristic has suggested that feelings are an important source of information, especially in situations of complexity and uncertainty. In this study (N = 1,484), we investigated how feelings related to traditional driving affect risk perception, benefit perception, and trust related to self‐driving cars as well as people's acceptance of the technology. Due to limited experiences with and knowledge of self‐driving cars, we expected that feelings related to a similar experience, namely, driving regular cars, would influence judgments of self‐driving cars. Our results support this assumption. While positive feelings of enjoyment predicted higher benefit perception and trust, negative affect predicted higher risk and higher benefit perception of self‐driving cars. Feelings of control were inversely related to risk and benefit perception, which is in line with research on the affect heuristic. Furthermore, negative affect was an important source of information for judgments of use and acceptance. Interest in using a self‐driving car was also predicted by lower risk perception, higher benefit perception, and higher levels of trust in the technology. Although people's individual experiences with advanced vehicle technologies and knowledge were associated with perceptions and acceptance, many simply have never been exposed to the technology and know little about it. In the absence of this experience or knowledge, all that is left is the knowledge, experience, and feelings they have related to regular driving.     

Sex‐differentiated associations among negative parenting,emotion‐related brain function,and adolescent substance use and psychopathology symptoms

Parenting is a critical factor in adolescent social–emotional development, with maladaptive parenting leading to risk for the development of psychopathology. However, the emotion‐related brain mechanisms underlying the influence of parenting on psychopathology symptoms are unknown. The present study utilized functional magnetic resonance imaging and laboratory measures to examine sex‐differentiated associations among parenting, adolescent emotion‐related brain function, and substance use and psychopathology symptoms in 66 12–14‐year olds. Maternal parenting behaviors (warmth, negative parenting) were observed in a laboratory task. Adolescent brain responses to negative emotional stimuli were assessed in emotion processing regions of interest (left [L] and right [R] amygdala, anterior insula, and anterior cingulate cortex [ACC]). Adolescents reported on substance use and depressive, anxiety, and externalizing symptoms. Maternal negative parenting predicted adolescent brain activation differently by sex. For girls, negative parenting predicted heightened R ACC activation to negative emotional stimuli. For boys, negative parenting predicted blunted L and R anterior insula and L ACC activation. Furthermore, for girls, but not boys, heightened L anterior insula and heightened L and R ACC activation were associated with substance use and depressive symptoms, respectively. Findings suggest neural response to negative emotion as a possible sex‐specific pathway from negative parenting to psychopathology.