Childbearing and family in remarriage

Proportional hazards models are used to test hypotheses about the effect of women’s prior childbearing on the probability of having a birth in remarriage and to analyze the effects of other factors. Results indicate that the number of children at the time of remarriage has no effect on childbearing probabilities, but the age of the youngest child has a significant effect. These findings support the view that having a child is important to confirm the marriage, but that individual and family life course factors also affect the decision to have a child in a remarriage.     

Child Sexual Abuse and the Family Court

This paper examines judicial decision-making in the Family Court in custody and access disputes where allegations of child sexual abuse have been made. In seven cases examined judges took a sceptical view of such allegations and most commonly granted access in spite of strong evidence of abuse. The interpretation of the ‘best interests of the child’ often favoured continuing contact with both parents, and judges rarely denied access outright. Supervised access, the most common outcome, represents a compromise between familial ideology and child protection.     

Exact Bootstrap Variances of the Area Under ROC Curve

The area under the Receiver Operating Characteristic (ROC) curve (AUC) and related summary indices are widely used for assessment of accuracy of an individual and comparison of performances of several diagnostic systems in many areas including studies of human perception, decision making, and the regulatory approval process for new diagnostic technologies. Many investigators have suggested implementing the bootstrap approach to estimate variability of AUC-based indices. Corresponding bootstrap quantities are typically estimated by sampling a bootstrap distribution. Such a process, frequently termed Monte Carlo bootstrap, is often computationally burdensome and imposes an additional sampling error on the resulting estimates. In this article, we demonstrate that the exact or ideal (sampling error free) bootstrap variances of the nonparametric estimator of AUC can be computed directly, i.e., avoiding resampling of the original data, and we develop easy-to-use formulas to compute them. We derive the formulas for the variances of the AUC corresponding to a single given or random reader, and to the average over several given or randomly selected readers. The derived formulas provide an algorithm for computing the ideal bootstrap variances exactly and hence improve many bootstrap methods proposed earlier for analyzing AUCs by eliminating the sampling error and sometimes burdensome computations associated with a Monte Carlo (MC) approximation. In addition, the availability of closed-form solutions provides the potential for an analytical assessment of the properties of bootstrap variance estimators. Applications of the proposed method are shown on two experimentally ascertained datasets that illustrate settings commonly encountered in diagnostic imaging. In the context of the two examples we also demonstrate the magnitude of the effect of the sampling error of the MC estimators on the resulting inferences.     

‘It's those first few weeks’: Women's views about breastfeeding support in an Australian outer metropolitan region

ObjectiveTo examine factors that influence the establishment and continuation of breastfeeding among women living in a southern region of Victoria.MethodSequential mixed methods design including paper-based survey and focus group enquiry.FindingWomen who had breastfed their infants (n = 170) reported reliance on midwives, lactation consultants and maternal and child health nurses for breastfeeding advice and support in the immediate and medium postnatal periods. Women who chose a private hospital appeared to receive less immediate postnatal support than those in a public hospital. Access to individual guidance from midwives and MCH nurses was regarded as critical to overcoming breastfeeding difficulties, in the face of the alternative suggested by people to ‘give up’. They described themes of: ‘Women's experience of nurses/midwives’, ‘Expectations versus reality’, ‘Not giving up despite difficulties’, and ‘Breastfeeding support’. Sources of lay support were not universal.ConclusionThe duration of breastfeeding might be extended by early problem resolution. To enhance breastfeeding participation, further examination of the extent and timeliness of service provision by health service providers is necessary.     

“Chocolate city,vanilla suburbs:” Will the trend toward racially separate communities continue?

Almost a decade ago, the Kerner Commission warned that this country was moving toward two societies—one white and one black. Data on residential segregation indicate clear-cut boundaries for these two societies—large cities are becoming black but most suburban areas remain white. Detroit is a case in point and this led the 1976 Detroit Area Study to investigate the sources of racial residential segregation. Our approach was guided by three hypothesized causes of this segregation: (i) the economic status of blacks, (ii) the preference of blacks to be with their own kind, and (iii) the resistance of whites to residential integration. We developed several new measurement techniques and found that most evidence supported the third hypothesis. Blacks in the Detroit area can afford suburban housing and both blacks and whites are quite knowledgable about the housing market. Most black respondents expressed a preference for mixed neighborhoods and are willing to enter such areas. Whites, on the other hand, are reluctant to remain in neighborhoods where blacks are moving in and will not buy homes in already integrated areas. This last result has been overlooked by traditional measures of white attitudes toward residential integration but emerges clearly with the new measure.     

Free Personal Care in Scotland: A Narrative Review

The advent of free personal care for older people was a definingmoment in the development of UK political devolution. Afterall the controversy surrounding the 1999 Royal Commission onLong Term Care, Scotland’s decision to implement the mainrecommendations of the Sutherland Committee was a decisive breakfrom Whitehall’s approach and seemed to offer a key opportunityto learn from the implications of this policy for an Englishcontext. Against this background, this paper summarizes theorigins, nature and impact of free personal care, providinga narrative review of the policy to date.     

THE IMPACT ON FAMILIES OF REPORTED CHILD ABUSE OR NEGLECT

In order to evaluate the impact upon children and families of reported child abuse and neglect and the subsequent interventions, the casenotes of a random sample of substantiated cases (N=151) dealt with by the South Australian child protection agency were searched. The goal was to identify information concerning service delivery and changes for family members in the ensuing six months. Results relevant to both of these are presented and evaluated. An important corollary finding of this work was the absence of detailed information about outcome in the casenotes. We argue that this absence of feedback to child protection workers and policy-makers is likely to have detrimental effects on both worker morale and the quality of the services provided.     

Child Sexual Abuse Cases: Facilitating Their Detection and Reporting by General Practitioners

General Practitioners are frequently the first resource for families affected by child sexual abuse, and in many places are legally required to report suspected cases to the authorities. Based on a recent survey of GP experiences and attitudes concerning child sexual abuse, the issues relevant to GP's ability to respond appropriately are analysed in terms of (a) their ability to detect occurrence, and (b) their willingness to make official reports. As children are relatively powerless, child victims of sexual abuse may be particularly dependent on appropriate protective action by the GP, and suggestions are offered for reducing the identified obstacles to detection and reporting by GPs.