What Policies Advance Infants and Toddlers? Evidence to Inform State and Federal Options

A variety of civic actors—government, associations, and local agencies—work to help parents advance the vitality of our youngest children. Empirical findings accumulating over the past half-century identify benefits for infants and toddlers stemming from three policy models: paid leave for parents after a newborn arrives; regular pediatric assessments, including home visiting; and quality caregivers situated in homes or centers. We review what is known about the effects of these policies, along with constituent elements of quality (mediators) that operate proximal to children's health, cognitive, and emotional growth. Much has been learned about how such collective action, carried out by local organizations, advance infant–toddler development. Methodological advances foster new knowledge: moving closer to causal inferences and pinpointing social mechanisms that enrich infant–toddler settings. Less well understood is how policy levers can move the malleable elements of program quality to raise the magnitude or sustainability of program effects. We note the benefits of income-support efforts for fragile families, while urging new work on how economic dynamics touch the capacity of parents and caregivers to better nurture infants and toddlers.     

Propensity‐score‐based priors for Bayesian augmented control design

Drug developers are required to demonstrate substantial evidence of effectiveness through the conduct of adequate and well‐controlled (A&WC) studies to obtain marketing approval of their medicine. What constitutes A&WC is interpreted as the conduct of randomized controlled trials (RCTs). However, these trials are sometimes unfeasible because of their size, duration, and cost. One way to reduce sample size is to leverage information on the control through a prior. One consideration when forming data‐driven prior is the consistency of the external and the current data. It is essential to make this process less susceptible to choosing information that only helps improve the chances toward making an effectiveness claim. For this purpose, propensity score methods are employed for two reasons: (1) it gives the probability of a patient to be in the trial, and (2) it minimizes selection bias by pairing together treatment and control within the trial and control subjects in the external data that are similar in terms of their pretreatment characteristics. Two matching schemes based on propensity scores, estimated through generalized boosted methods, are applied to a real example with the objective of using external data to perform Bayesian augmented control in a trial where the allocation is disproportionate. The simulation results show that the data augmentation process prevents prior and data conflict and improves the precision of the estimator of the average treatment effect.     

Sibling Incest Dynamics: Therapeutic Themes and Clinical Challenges

Increasing empirical evidence points to the prevalence and devastating effects of sibling incest. The dynamics of incestuous sibling relationships are complex and typically embedded in severely dysfunctional families. Often confused and/or distressed by their incestuous experiences, many victims fail to disclose the abuse. Left undisclosed and untreated, unresolved issues of mutuality and consequent shame and guilt can lead to life-long emotional problems and dysfunctional behavioral patterns that are difficult to repair. Two cases illustrate common therapeutic themes, the importance of timely disclosure and coordinated, multi-dimensional treatment approaches, as well as the therapeutic challenges of assisting sibling incest victims who present for treatment as adults.     

Intercultural consolidation: exploring the experiences of internationally qualified social workers and the English post-qualifying framework

The increasing movement of social workers from one country to another, especially with the expansion of the European Union, appears likely to pose a number of challenges to host countries in terms of receiving, supporting and developing social workers who trained in other countries. This paper explores the provision of a post-qualifying ‘consolidation’ module to a group of 15 internationally qualified social workers and evaluates both the student experience and the cultural challenges faced by individual social workers who came to practise in England after qualifying in their home countries. These social workers undertook the module at the University of Greenwich in London, England, and were selected for this as a part of a project with two London boroughs. Factors which have an important influence on successful ‘settlement’ into a new role and culture are discussed and analysed. It is argued that the provision of post-qualifying training can be a key part of the acculturation process but timing and other factors need to be considered. The paper explores what was learned from the project and its evaluation about the experiences and support needs of internationally qualified social workers. The project took place in 2007–2008 and was evaluated by students, the teaching team, stakeholders from services and service users.     

Waiting on Others: Gender in the Medical Waiting Room

In this article, I describe how gendered interactions and power dynamics play out in medical waiting rooms. While people are spending time idle, waiting for the next thing to happen (i.e., to check in, to see the doctor, to pay), social processes continue to occur and reinforce these gendered interactions and dynamics. Using data collected from ethnographic observations of medical waiting rooms in the Midwestern United States, this article illustrates that waiting offers another opportunity to understand the subtle ways that gendered expectations and hierarchies are perpetuated. Patients, their friends, and families do gender in medical waiting rooms through the amount of auditory and physical space they take up and the ways in which they behave and respond to the actors and expectations in this space.