Potential strategies to avoid progestogen-induced premenstrual disorders

Non-hormonal approaches to premenstrual syndrome (PMS) treatment such as selective serotonin reuptake inhibitors are by no means effective for all women and frequently we must resort to endocrine therapy. During many of the hormonal approaches, PMS-like symptoms can be introduced or re-introduced during the necessary cyclical or continuous progestogen component of the therapy. This is seen with combined oral contraception, progestogen only contraception, progestogen therapy for heavy menstrual bleeding and endometriosis, sequential hormone replacement therapy and any therapeutic strategy for premenstrual syndrome where it is necessary to provide endometrial protection, including estrogen suppression of ovulation or add-back during gonadotrophin releasing hormone suppression. The link to progestogen is very often missed by health professionals. When the pattern of symptoms mimics the cyclicity of PMS, it is termed progestogen-induced premenstrual disorder. The need to use progestogen to protect the endometrium from the proliferative actions of estrogen can pose insurmountable difficulties in managing premenstrual disorders. In the absence of any really useful evidence, nearly all practice in this area depends on clinician experience. We cannot afford to wait for adequate research evidence to be produced - it never will - and so we must rely on empirical findings, clinical experience, theoretical strategies and common sense.     

Unaccompanied migrant children and indebted relations: Weaponizing safeguarding

UK statutory guidance for practitioners suggests that indebtedness is an area where safeguarding red flags should be raised and action taken to minimize the risk of exploitation. Yet, our research shows that unaccompanied migrant children have complex indebted relationships, which can range from extractive to connective. Drawing on interviews with unaccompanied children, we show that these indebted relationships can include financial debt to smugglers, responsibilities to support transnational families, as well as social obligations to peers and others. Their accounts present a nuanced understanding of the taboo nature of indebted relationships, not to be shared with the practitioners in their lives. This is due, in part, to the potential threat of reporting to the Home Office, which might jeopardize their immigration status. In response to this weaponization of social care, we demonstrate how children turn to peer networks of support, creating their own alternative forms of social protection. In so doing, we complicate critiques of adultification, which traditionally highlight the ways that racially minoritized children may be treated as adults—to their detriment. In so doing, we show that because indebtedness is normatively linked to adulthood, unaccompanied children's hopes and fears may be rendered unsayable and therefore unsupportable in social care, all in the name of safeguarding.     

Inferactive data analysis

We describe inferactive data analysis, so-named to denote an interactive approach to data analysis with an emphasis on inference after data analysis. Our approach is a compromise between Tukey's exploratory and confirmatory data analysis allowing also for Bayesian data analysis. We see this as a useful step in concrete providing tools (with statistical guarantees) for current data scientists. The basis of inference we use is (a conditional approach to) selective inference, in particular its randomized form. The relevant reference distributions are constructed from what we call a DAG-DAG—a Data Analysis Generative DAG, and a selective change of variables formula is crucial to any practical implementation of inferactive data analysis via sampling these distributions. We discuss a canonical example of an incomplete cross-validation test statistic to discriminate between black box models, and a real HIV dataset example to illustrate inference after making multiple queries on data.     

The child welfare response to serious nonaccidental head trauma

Serious nonaccidental head trauma (NHT) can leave permanent neurological damage in children who survive abuse. This study reports on child welfare's handling of NHT cases compared with cases of physical abuse and head trauma due to neglect with regard to placement in foster care, reunification with family, and safety issues. The results show that workers placed children with NHT in foster care immediately after the abuse but treated them no differently than other physically abused children regarding reunification.     

Improving access to health care for foster children: the Illinois model

Children in foster care have lower health status than do their peers and limited access to health care. The Illinois Department of Children and Family Services developed HealthWorks, a separate primary care preferred provider system for children in foster care. This study compared claims data for children in HealthWorks with children not enrolled in HealthWorks and with children in Aid to Families with Dependent Children (AFDC) who had never entered foster care. Children enrolled in HealthWorks were more likely than were other children to receive all of the services except general inpatient hospitalizations. They had greater odds of receiving general exams and physicians' services and were more likely to visit the emergency room than children who were not enrolled. They were more likely to receive all of the measured services when compared with children receiving Medicaid through AFDC.     

Working artefacts: ethnomethods of the prototype

This paper follows recent science studies in theorizing information technologies as socio-material configurations, aligned into more and less durable forms. The study of how new technologies emerge shifts, on this view, from a focus on invention to an interest in ongoing practices of assembly, demonstration, and performance. This view is developed in relation to the case of the 'prototype', an exploratory technology designed to effect alignment between the multiple interests and working practices of technology research and development, and sites of technologies-in-use. In so far as it is successful, the prototype works as an exemplary artefact that is at once intelligibly familiar to the actors involved, and recognizably new.     

Environmental and social supply chain management sustainability practices: construct development and measurement

The purpose of this paper is to conceptualise and operationalise the concept of supply chain management sustainability practices. Based on a multi-stage procedure involving a literature review, expert Q-sort and pre-test process, pilot test and survey of 156 supply chain directors and managers in Ireland, we develop a multidimensional conceptualisation and measure of social and environmental supply chain management sustainability practices. The research findings show theoretically sound constructs based on four underlying sustainable supply chain management practices: monitoring, implementing systems, new product and process development and strategy redefinition. A two-factor model is then identified as the most reliable: comprising process-based and market-based practices.     

The Early Development Instrument: An Examination of Convergent and Discriminant Validity

The convergent and discriminant validity of the Early Development Instrument (EDI), a teacher-rated assessment of children’s “school readiness”, was investigated in a multicultural sample of 267 kindergarteners (53% male). Teachers evaluations on the EDI, both overall and in five domains (physical health/well-being, social competence, emotional maturity, language/cognition, communication/general knowledge), were related to direct, child-based assessments of performance on two standardized measures of school readiness, and measures of phonological awareness and early social competence. Regression analysis indicated that together the four comparison measures accounted for 36% of variance in overall EDI scores, each making a significant and unique contribution. Results supported the convergent validity of overall EDI scores but not the discriminant validity of EDI domain scores. Moreover, correlations between EDI scores and comparison measures varied widely across teachers, suggesting considerable individual differences in teacher’s ability to evaluate school readiness relative to direct, child-based assessments, and confirming that the EDI is more appropriate for deriving inferences at higher aggregated levels such as community or region. The validation of EDI domain scores remains an important challenge in future research.     

The ensemble Kalman filter is an ABC algorithm

The ensemble Kalman filter is the method of choice for many difficult high-dimensional filtering problems in meteorology, oceanography, hydrology and other fields. In this note we show that a common variant of the ensemble Kalman filter is an approximate Bayesian computation (ABC) algorithm. This is of interest for a number of reasons. First, the ensemble Kalman filter is an example of an ABC algorithm that predates the development of ABC algorithms. Second, the ensemble Kalman filter is used for very high-dimensional problems, whereas ABC methods are normally applied only in very low-dimensional problems. Third, recent state of the art extensions of the ensemble Kalman filter can also be understood within the ABC framework.     

Adoption and permanence planning in Scotland: Impact of the Adoption and Children (Scotland) Act 2007 on key processes and timescales

Adoption and permanence planning has been a key feature of Scotland's policy in relation to children and young people who are “looked after.” Although policy and law has significantly developed in recent years, there has been comparatively little research on permanence processes in Scotland. This paper outlines key findings from the first comprehensive study of permanence planning in Scotland. It examines the process for two cohorts of children where adoption or other types of permanence orders were made. The children were selected under the long standing Adoption (Scotland) Act 1978 and the more recent Adoption and Children (Scotland) Act 2007. In total, 300 cases were examined, analysing data from the children's first contact with services through to the order made by the Scottish Courts. This paper pays particular attention to the timescales found at key stages under the two sets of legislation and asks what difference the change in legislation has made.