Stakeholder Perspectives on Children's Mental Health Needs and Supports in Six Low‐ and Middle‐Income Countries

Low‐ and middle‐income countries (LMIC) are faced with disproportionately high levels of unmet child mental health needs. This study explored through interviews the perspectives of 17 inter‐agency service stakeholders from Brazil, Indonesia, Kenya, Pakistan, Rwanda and Turkey on existing supports and challenges. Four themes emerged on the holistic nature of children's mental health needs linked with disadvantage; limited resources and skilled workforce; stigma; and strategies for future implementation, including awareness, parental engagement, skills‐based programmes and cultural adaptation. Stakeholder input is essential in conceptualising, developing and evaluating culturally appropriate interventions for vulnerable children in LMIC.     

Contrasting perspectives of parents and service providers on respite care in Queensland,Australia

Abstract

Parent-carers need support to continue to care for their child with significant disability in their home. There has, however, been little evidence that respite interventions have consistent or enduring beneficial effects on carer well-being. This article reports the findings of a qualitative study which adopted an Appreciative Inquiry philosophy to interview parent-carers of children with significant intellectual and/or developmental disabilities on how formal support services have helped them maintain their health and well-being, and disability support staff on how they help such parent-carers foster their health and well-being. We conclude that better communication and collaboration between service providers and users, more targeted training of workers, and embracing a person-centred and family-centred approach to respite services are needed. In addition, clearer definition and communication of the scope of respite services are required to best support families of children with significant disability in their home.     

A simple two-stage design for quantitative responses with application to a study in diabetic neuropathic pain

Two-stage designs offer substantial advantages for early phase II studies. The interim analysis following the first stage allows the study to be stopped for futility, or more positively, it might lead to early progression to the trials needed for late phase II and phase III. If the study is to continue to its second stage, then there is an opportunity for a revision of the total sample size. Two-stage designs have been implemented widely in oncology studies in which there is a single treatment arm and patient responses are binary. In this paper the case of two-arm comparative studies in which responses are quantitative is considered. This setting is common in therapeutic areas other than oncology. It will be assumed that observations are normally distributed, but that there is some doubt concerning their standard deviation, motivating the need for sample size review. The work reported has been motivated by a study in diabetic neuropathic pain, and the development of the design for that trial is described in detail.     

Measuring people's trust

Summary. We measure trust and trustworthiness in British society with a newly designed experiment using real monetary rewards and a sample of the British population. The study also asks the typical survey question that aims to measure trust, showing that it does not predict 'trust' as measured in the experiment. Overall, about 40% of people were willing to trust a stranger in our experiment, and their trust was rewarded half of the time. Analysis of variation in the trust behaviour in our survey suggests that trusting is more likely if people are older, their financial situation is either 'comfortable' or 'difficult' compared with 'doing alright' or 'just getting by', they are a homeowner or they are divorced, separated or never married compared with those who are married or cohabiting. Trustworthiness also is more likely among subjects who are divorced or separated relative to those who are married or cohabiting, and less likely among subjects who perceive their financial situation as 'just getting by' or 'difficult'. We also analyse the effect of attitudes towards risks on trust.     

Identifying the most successful dose (MSD) in dose-finding studies in cancer

For a dose finding study in cancer, the most successful dose (MSD), among a group of available doses, is that dose at which the overall success rate is the highest. This rate is the product of the rate of seeing non-toxicities together with the rate of tumor response. A successful dose finding trial in this context is one where we manage to identify the MSD in an efficient manner. In practice we may also need to consider algorithms for identifying the MSD which can incorporate certain restrictions, the most common restriction maintaining the estimated toxicity rate alone below some maximum rate. In this case the MSD may correspond to a different level than that for the unconstrained MSD and, in providing a final recommendation, it is important to underline that it is subject to the given constraint. We work with the approach described in O'Quigley et al. [Biometrics 2001; 57(4):1018-1029]. The focus of that work was dose finding in HIV where both information on toxicity and efficacy were almost immediately available. Recent cancer studies are beginning to fall under this same heading where, as before, toxicity can be quickly evaluated and, in addition, we can rely on biological markers or other measures of tumor response. Mindful of the particular context of cancer, our purpose here is to consider the methodology developed by O'Quigley et al. and its practical implementation. We also carry out a study on the doubly under-parameterized model, developed by O'Quigley et al. but not     

Child support and non-resident fathers’ contact with their children

The paper presents a model of a non-resident father’s child support and contact with his child, which combines the public good treatment of “child quality” with “trade” in father–child contact time in a setting of non-cooperative interaction. It predicts that father’s income and mother’s non-labour income should have exactly the same effect on the frequency of father–child contact if he chooses to make lump sum payments to the mother. If he does not or there is a binding child support payment order, they have effects opposite in direction. A higher binding support order reduces father–child contact but may well raise “child quality”.

Immigration: Not a Solution to Problems of Population Decline and Aging

Population and Environment - This article is a synopsis of a UN study, with emphasis on Italy and the United States. In March, 2000, the United Nations Population Division published a 143-page...     

Net migration and migration effectiveness: A comparison between Australia and the United Kingdom, 1976–96

This paper explores the impact of net migration in Australia and the United Kingdom using measures of migration effectiveness computed from period-age migration data for four consecutive five-year periods. Results reported in Part 1 of this paper (Stillwellet al. 2000) suggest that while the overall effectiveness of net migration at the scale of city regions has declined over the twenty-year period in both countries, important geographical variations are evident. Part 2 considers how patterns of migration effectiveness vary by age and presents a single classification of all the city regions on the basis of age-specific effectiveness. More detailed analysis includes spatial patterns for particular age groups and net migration profiles of selected regions. Cohort effects are shown to be important for explaining changes between time periods in these regions.     

Sociological Factors Affecting Agricultural Price Risk Management in Australia*

Abstract The highly volatile auction system in Australia accounts for 85 percent of ex‐farm wool sales, with the remainder sold by forward contract, futures, and other hedging methods. In this article, against the background of an extensive literature on price risk strategies, we investigate title behavioral factors associated with producers' adoption of price risk‐management strategies (specifically futures and forward contracts) for selling wool. This research presents a behavioral model based on Diffusion of Innovations, the Theory of Reasoned Action, and the Theory of Planned Behavior. We found that the auction system is used as a price risk‐management tool because other selling methods are considered more risky. We also report on a curious relationship between risk and complexity in terms of wool producers' intentions to use forward contracts. We explored sociological factors in conjunction with focus‐group data in an attempt to understand this relationship. This exercise yielded some interesting findings on the impact that trust, habit, social cohesion, and networks have on decision making in the rural community. The significance of this article lies in its application of core sociological theory in a new research context: the Australian wool industry.