Evidence-based Medicine and Child Mental Health Services

There is increased focus on using research evidence to guide clinical practice in the provision of child mental health services, to allocate resources and to make policy decisions. Emphasis has been placed on randomised controlled trials, which are clearly vital. However, given the complexity of children's lives and the multiple systems relevant to their care, it is important to consider alternative research designs and to think creatively about outcomes. In the context of difficulties with random allocation a number of quasi-experimental designs are described that may more closely reflect actual clinical work. In the context of ecological theory, the importance of taking a systems level approach to evaluation is highlighted, with examples from the US. Finally, the ways in which qualitative outcomes measures can be used to sensitively describe the effects of treatment are outlined, and their potential for giving voice to children and families as consumers of mental health services. These suggestions aim to lessen the tension between the requirements of the scientific investigations of treatment effectiveness and the realities of clinicians' daily experiences.     

Overcoming Market Constraints on Pro‐Poor Agricultural Growth in Sub‐Saharan Africa

In sub‐Saharan Africa, there is fairly broad agreement that increased investment in key public goods such as roads and communications infrastructure, agricultural research and water control will be required if revitalised agricultural development is to take place. However, it has proved more difficult to reach agreement on what needs to be done to improve the performance of agricultural markets. In this article we set out an agenda for investment and policy reform in this area, providing a brief theoretical examination of the co‐ordination problems involved before examining in turn demand and supply constraints affecting smallholder farmers, and policies for price stabilisation and the co‐ordination of support services. We also argue that increased attention needs to be paid to governance issues.     

Never the Right Age? Gender and Age‐Based Discrimination in Employment

Although UK legislation against age discrimination is required by December 2006, little is yet known about how ageism affects different age categories of employees, and the gender dimensions of ageism have also been neglected. Both issues were investigated by questionnaire survey, producing responses from over 1000 employees of a major UK financial services enterprise. The extent and manifestations of ageism were found to vary across age categories and by sex, and evidence of gendered ageism emerged. Reported examples of ageism were highest among younger and older age categories, but all age groups were affected to some degree. Across all ages, women were more likely than men to experience ageist attitudes concerning appearance or sexuality. To be effective, legislation will need to cater for the complex nature and patterns of age discrimination revealed, though the comparator problem and other complexities are such that important aspects of age prejudice, including gender dimensions, risk being overlooked.     

Structure, Agency, and Context: The Contributions of Geography to World-Systems Analysis

The interaction of geography and world-systems theory has created two groups of work. The first body of work uses world-systems theory as its theoretical framework with minor levels of critique or change. The second body of work attempts to inform world- systems theory by explicitly including a geographical perspective. Human geographers attracted to world-systems theory provide a perspective that highlights the role of agency in what is widely perceived to be a rigid structuralist approach. Key geographical concepts of region and place are viewed as social constructs created within an overarching context of structural imperatives. By conceptualizing places, states, and the macroregions of core, semiperiphery, and periphery as geographical scales, the role of agency in creating and maintaining the important structures and institutions of the capitalist world-economy, such as hegemony, is illustrated. The geographer's interest in the creation of geographical scales results in analysis of the dynamism of the contemporary world-system.     

Gender Advertising: The Self- Fulfilling Prophecy?

The socialising role of advertising is discussed in the context of gender bias, and reference is made to studies analysing advertisements from various media. Policy considerations in regard to the regulation of gender advertising are discussed, with a review of the relevant Australian legislation. Alternative possibilities for reform in the area of sexist advertising are canvassed.