Minimal Risk in Pediatric Research: A Philosophical Review and Reconsideration

Despite more than thirty years of debate, disagreement persists among research ethicists about the most appropriate way to interpret the U.S. regulations on pediatric research, specifically the categories of “minimal risk” and a “minor increase over minimal risk.” Focusing primarily on the definition of “minimal risk,” we argue in this article that the continued debate about the pediatric risk categories is at least partly because their conceptual status is seldom considered directly. Once this is done, it becomes clear that the most popular strategy for interpreting “minimal risk”—defining it as a specific set of risks—is indefensible and, from a pragmatic perspective, unlikely to resolve disagreement. Primarily this is because judgments about minimal risk are both normative and heavily intuitive in nature and thus cannot easily be captured by reductions to a given set of risks. We suggest instead that a more defensible approach to evaluating risk should incorporate room for reflection and deliberation. This dispositional, deliberative framework can nonetheless accommodate a number of intellectual resources for reducing reliance on sheer intuition and improving the quality of risk evaluations.     

On the margins of the child protection system: creating space for relational social work practice

In the UK, a threshold divides between two categories of children, child protection (CP) and child in need. Each category tends to be treated as a homogeneous entity, despite containing heterogeneous levels and forms of risk and need. CP practice, accompanied by regulation, protocols and procedures, aspires to achieve a coordinated multi‐agency response to identified concerns with available resources targeted towards this category. However, it is well known that those children assessed as falling just below the CP threshold can still have high levels of need and risk, requiring a level of social work involvement beyond the low‐resource and low‐oversight model that generally accompanies a child in need categorisation. This paper probes an approach to practice, which divides levels of risk within the child in need category enabling adequate, coordinated support and oversight to be provided for children and families with complex needs. Evidence from our study evaluating this approach suggests that a simple protocol provided a clear process within, which social workers and agency partners felt confident and safe to practice outside of the formal CP framework. The protocol prevented drift and helped to create a space within, which relational social work practice flourished.     

Labor Market Disparities Between African Americans and Afro Caribbeans: Reexamining the Role of Immigrant Selectivity

Black immigrants from the Caribbean have long attained greater labor market success than African Americans. The most recent studies show that Afro Caribbeans have earnings that are approximately 16% greater than African Americans and that Afro Caribbeans are as much as 21% more likely to be employed than African Americans. The most prominent explanation for greater Afro Caribbean success is that, because they have chosen to migrate, Afro Caribbeans are positively self‐selected on characteristics that are key for success in the U.S. labor market. Proponents of immigrant selectivity argue that migrants have greater levels of both hard and soft skills than nonmigrants. Using data from the National Survey of American Life—the first social survey to provide a nationally representative sample of both African Americans and Afro Caribbeans—this study finds that Afro Caribbeans have greater hard skills than African Americans but split the difference on two measures of soft skills: African Americans and Afro Caribbeans are matched on John Henryism, but African Americans have greater personal mastery than Afro Caribbeans. Contrary to expectations, controlling for differences in hard and soft skills does not provide for a meaningful reduction in labor market disparities between African Americans and Afro Caribbeans.     

‘Nothing about us without us’: the emerging disability movement and advocacy in China

The disability movement and disabled persons’ self-help organizations (DPOs) are emerging in China, some of which succeeded in promoting policy and social changes with special strategies. Based on an original survey and interview, this article explains the development and survival strategies of China’s DPOs, and especially interprets some successful cases of social advocacy and policy advocacy in the emerging disability movement. It is hoped that scholars will pay more attention to the advocacy and public engagement of the disability community in non-western settings in the future.     

The association between social support networks and maternal employment: a comparison of western German,eastern German,and migrant mothers of preschool-aged children

A lack of adequate childcare can delay mothers’ return to the labor market after childbirth. This paper examines whether social support with childcare by kin and friends facilitates maternal employment in the first 72 months after childbirth. Using data from the German Socio-Economic Panel (SOEP) 1993–2009, a comparison of natives (n?=?1409) and migrants (n?=?411) in corporative-conservative western Germany with mothers in former socialist eastern Germany (n?=?528) shows that kinship support is positively associated with maternal employment when public childcare is limited. Western German and migrant mothers return to work sooner if they are surrounded by kin. But kin do not provide support for maternal employment in eastern Germany, where public childcare is more easily accessible and continuous female employment is a prevalent social norm. Friendship networks, by contrast, are most valuable for maternal employment if they complement public childcare.     

Family support policies and child outcomes: a realist-scoping review*

Family support policies (FSP) refer to government policies that promote the well-being of families with children (e.g. job-protected paid leave, cash transfers, childcare). We developed an initial conceptual and theoretical framework of FSP and conducted a realist-scoping review to document the state of evidence regarding the influence of FSP on three child outcomes: poverty, development, and health. Based on the contexts and mechanisms through which FSP are hypothesized to affect child outcomes, we constructed a framework to guide a search of five electronic databases (OVID, ProQuest, PubMed, Scopus, and Web of Knowledge). We analysed articles meeting our inclusion criteria (i.e. conceptualized FSP as a function of the welfare state; conceptualized child poverty, development, and health as outcomes; and conducted empirical analyses) in relation to our mechanisms and thematic concerns (context, developmental periods, and differential impacts). A total of 22 studies met our inclusion criteria, which tested 25 independent child outcomes. Our findings identified initial mechanisms that explain the relationship between FSP and child outcomes through (1) increasing parents’ basic capabilities, (2) shaping parents’ childcare options, and (3) influencing parental leave-taking and shifting beliefs about gender relationships in the home and workplace. Future work will be to test these mechanisms and framework through a realist synthesis.     

‘I couldn’t just entirely be her sister’: the relational and social policy implications of care between young adult siblings with and without disabilities

Research has commonly explored siblings of people with disabilities’ roles in care for their brothers or sisters with disabilities. Social policy has also commonly framed young adult siblings of people with disabilities as ‘young carers’. However, there has been less consideration of the implications of care for the relationship shared between young adult siblings with and without disabilities and of what this may mean for social policy. What do different types of care mean for sibling relationships? What are the relational and social policy implications of care between siblings? Drawing on a qualitative study of 25 siblings with disabilities and 21 siblings without disabilities aged 15–29, this article explores how young adult siblings perceive, talk and act with regard to the different types of care enacted between them. The article identifies how, during young adulthood, some types of care can endanger siblings’ capacity to feel like siblings and discusses ways that young adult siblings talk and act in order to – as best they can – keep their role within the bounds of a normative sibling relationship. The findings are discussed in light of implications for social policy, particularly with regard to seeing siblings of people with disabilities as ‘young carers’.     

Cambodian Refugee Families: Impacts of Immigration-Related Stressors on Intergenerational Relationships

The purpose of this study was to elucidate Cambodian refugees’ perceptions of immigration-related stressors and their impacts on intergenerational relations during the processes of immigration and settlement. We used narrative analysis to evoke older immigrants’ voices as they transitioned to the United States. Thirty-one Cambodian immigrants were interviewed using open-ended interview guides informed by ethnographic tenets of data collection. Participants expressed (a) changes in family structure and elder isolation and (b) intergenerational ambivalence and elder’s dependence on adult children as products of immigration-related stressors. Implications of these results for refugee and immigrant mental health research are discussed.