Statistical modeling for Bayesian extrapolation of adult clinical trial information in pediatric drug evaluation

Children represent a large underserved population of “therapeutic orphans,” as an estimated 80% of children are treated off‐label. However, pediatric drug development often faces substantial challenges, including economic, logistical, technical, and ethical barriers, among others. Among many efforts trying to remove these barriers, increased recent attention has been paid to extrapolation; that is, the leveraging of available data from adults or older age groups to draw conclusions for the pediatric population. The Bayesian statistical paradigm is natural in this setting, as it permits the combining (or “borrowing”) of information across disparate sources, such as the adult and pediatric data. In this paper, authored by the pediatric subteam of the Drug Information Association Bayesian Scientific Working Group and Adaptive Design Working Group, we develop, illustrate, and provide suggestions on Bayesian statistical methods that could be used to design improved pediatric development programs that use all available information in the most efficient manner. A variety of relevant Bayesian approaches are described, several of which are illustrated through 2 case studies: extrapolating adult efficacy data to expand the labeling for Remicade to include pediatric ulcerative colitis and extrapolating adult exposure‐response information for antiepileptic drugs to pediatrics.     

Public Attitudes towards Income Redistribution: Evidence from Hong Kong

The drivers of public support for redistributive policy have stimulated academic debate around the world. The majority of studies use cross‐country surveys conducted in the Organisation for Economic Co‐operation and Development countries to contribute to the debate on whether self‐interest or social values have more influence on public attitudes towards redistribution. Drawing on a phone survey conducted in 2013, this study advances the discussion by investigating public attitudes towards redistribution and social policy changes against the backdrop of buoyant government revenues in Hong Kong. The Hong Kong welfare model, best seen as a parallel to the liberal welfare state, is selective and residual. Contrary to the usual assumption, the social values hypothesis, viewing poverty as societal problems instead of individual reasons, has been supported in the Hong Kong context. It lends support to greater redistribution in a residual welfare state. The policy implications of the findings are also discussed.     

Teacher,Researcher and … Policy Actor? Social Work Academics’ Involvement in Social Policy

This cross‐sectional quantitative study expands the knowledge on the level of involvement of social work academics (SWAs) in social policy formulation processes, and the factors associated with this. SWAs are an interesting case for exploring the academia–policy nexus because they are affiliated with a profession in which the discourse regards social policy as a target of intervention. The study took place in Israel, where social work is strongly embedded in academia and enjoys relatively high professional status. The study drew upon a sample, which consisted of 57 per cent of all SWAs in Israel, and employed questionnaires developed specifically for the study. The findings show that the highest levels of involvement were in activities characterized by more active, public sphere routes of influence within the policy arena that were undertaken in conjunction with traditional social work partners. Social work scholars engaged in these activities more during the initial stages of the policy process. These forms of policy involvement reflect the dual impact of academia and the social work profession upon SWAs. Associated with level of involvement were individual factors, which included academic rank, perception of the social role of academia, perceived individual policy role, and perceived policy competencies. By contrast, factors linked to institutional support for policy engagement were not found to be associated with policy involvement.     

The social security number: A small device underpinning big systems

The possession and use of a personal social security number helps to structure people's daily lives. However, despite its fundamental normative importance, the social security number remains a little‐known entity. Increasingly universal and yet diverse in form, it is a legal and technical norm which is as much a mechanism for surveillance and monitoring as it is a necessary instrument for giving effect to social rights. Analysis of this constituent element of social security systems permits as assessment of some of the technical difficulties presented by the ever‐increasing movement of people and data. Overcoming these technical difficulties should permit to envisage a first technical step towards realizing a universal and global social security system.     

Trajectory of problem behaviours of Korean adopted children: using piecewise hierarchical linear growth modelling

This study examined the trajectory of problem behaviours in domestically adopted children in South Korea as they aged. This study used the Panel Study on Korean Adopted Children's longitudinal, three‐wave data (2006, 2008 and 2010). Although data were collected at three time points, our data consisted of six time points, which covered the 5–10 years age range of the adopted children at the time of survey. One hundred sixty‐four children were included in the analysis, 75 of whom contributed to one time point, 74 to two time points and 15 to three time points. The trajectory of the problem behaviours of adopted children was examined using a piecewise hierarchical linear growth model. Because the initial exploration of the data suggested non‐linear changes in behaviour problems over time, we split the growth trajectory into two time periods: Time 1 (5–7 years) and Time 2 (7–10 years). A two‐rate model was used to estimate separate slopes for the two time periods. Results showed that the externalizing and internalizing problems of adopted children have different trajectories. Internalizing problems did not show significant changes after 5 years of age, while externalizing problems increased until 7 years of age and decreased significantly thereafter.     

Contact between birth parents and children in kinship care in a sample from Spain

Within the context of kinship care, the main objectives of this work are to study the characteristics of contact between foster children and their birth parents, and their relationship with key variables of fostering, the children and their kinship caregivers. The sample included 189 children from Spain and their kinship families. A semi‐structured placement interview and two scales relating to the child–caregiver relationship and child's psychological adjustment were used with the kinship families. The results revealed a significant percentage of foster children who had no family contact. Various visit types, frequencies and durations were described. Kinship care with contact, compared with placements without contact, was frequently characterized by the absence of professional supervision, and an affectionate child–caregiver relationship; moreover, children with contact were perceived to have fewer serious behaviour and socio‐emotional problems and a greater probability of family reunification. The regression analysis showed that the main predictors for how caregivers assessed contact were the children's emotional reaction during visits and the quality of the relationship between the kinship families and the birth parents. These results suggest the need for further research about contact, which will certainly have a major impact on professional intervention with these families.     

A social welfare perspective of market‐oriented social enterprises

The article analyses market‐oriented social enterprises from a social welfare perspective, within the context of the innate conflict between business and welfare orientations. After defining the concept of market‐oriented social enterprises and presenting some successful examples on such entities that employ different marginalised populations, particularly people with disabilities, the article asks three interrelated questions: (i) What policy environment is needed to encourage the development of social enterprises? (ii) Given the innate tension between the social and economic objectives in social enterprises, what structural principles are needed to enable them to meet those dual objectives? Lastly, (iii) What intervention modalities are best suited to help individual participants in those frameworks? Answers to these questions are discussed within conceptual frameworks from the worlds of welfare and business that jointly provide a base for a social welfare rationale for market‐oriented social enterprises.     

Demands and Devotion: Cultural Meanings of Work and Overload Among Women Researchers and Professionals in Science and Technology Industries

How do cultural meanings influence how people experience work‐life demands? Much research, especially quantitative research, on the effects of structural work and family conditions does not account for employees’ cultural beliefs about the meaning of work in their lives. This article uses unique survey data to investigate the effects of employee embrace of elements of the “work devotion schema”—a cultural model that valorizes intense career commitment and organizational dedication—on their sense of “overload,” an experience that includes feeling exhausted and overloaded by all one's roles, net of actual hours on the paid job and family responsibilities. We argue that by cognitively, morally, and emotionally framing work as a valued end, the work devotion schema reduces feelings of overload. Using a case of senior women researchers and professional service providers in science and technology industries, we find that those who embrace work devotion feel less overloaded than those who reject it, net of work and family conditions. However, this effect is curtailed for mothers of young and school‐aged children. We end by discussing implications for flexibility stigma and gender inequality.