Fathering With Multiple Partners: Links to Children's Well‐Being in Early Childhood

The claim that multiple partner fertility may pose a risk of adverse outcomes for children has not been tested. We test this argument using a sample of 4,027 resident fathers and children from the Fragile Families and Child Well‐being Survey by examining the pathways through which fathers' multipartnered fertility is associated with children's externalizing behaviors and physical health status at 36 months. Path analyses indicate that multiple partner fertility exerted both a significant direct and indirect effect through paternal depression to influence children's externalizing behaviors. Fathers' multiple partner fertility also exerted a significant indirect effect through one mediator—father involvement—to influence children's physical health. This evidence suggests that the disruptions brought about by multipartnered fertility are important for understanding child well‐being.     

Ethnic‐Controlled Economy or Segregation? Exploring Inequality in Latina/o Co‐Ethnic Jobsites1

Recent research has increasingly focused on how ethnicity operates within labor markets. Due to perceptions of intragroup homogeneity and assumptions that inequality only occurs between majority whites and people of color, most research has neglected intragroup economic inequality. This study examines how skin color, immigration/nativity status, and gender influence wage differentials in Latina/o co‐ethnic jobsites (where workers are the same ethnicity). Using data from the Los Angeles Study of Urban Inequality (LASUI), it is found that there are skin color, immigration/nativity status, and sex wage gaps among Latina/os working in co‐ethnic jobsites. Moreover, illustrating intersectionality, immigrant women and dark‐skinned immigrants suffer from wage gaps in co‐ethnic jobsites. Unexpectedly, some Latinas experience a wage advantage, in comparison with Latinos, which is associated with lighter skin. The author suggests that Latinas are subjected to multiple‐jeopardy situations in which they experience an intersection of inequalities in jobsites saturated by co‐ethnics but that lightness of skin color functions as a form of social capital. Thus, research on the benefits or costs associated with working with co‐ethnics cannot be extended to the entire ethnic group. The conclusion is that for Central Americans and Mexicans, co‐ethnic jobsites are generally forms of segregated employment with limited protection from discrimination.     

Report on the implementation and evaluation of an interprofessional learning programme for inter‐agency child protection teams

Effective collaborative working between the different professions and agencies working to safeguard children is essential. Lack of knowledge of others' roles, perceived differences in status and expertise, and negative stereotypes are examples of why this can be difficult to achieve. A facilitated interprofessional learning (IPL) programme was implemented to assess if such an intervention could overcome some of the barriers to effective interprofessional and inter‐agency team working. Six teams based in primary and secondary care trusts took part with participants from health, education, police and social services. Quantitative and qualitative data were collected from individual participants using a pre‐validated team climate inventory and reflective statements. Findings from this study demonstrate statistically significant changes in five out of six categories in the inventory. Reflective statements suggested that overall the programme offered a positive learning experience at both an individual and team level. The importance of outside facilitation to maintain the team's momentum was acknowledged, as was the difficulty of maintaining a good level of activity once the programme had ended. Nevertheless, the IPL programme provided a timely opportunity to reflect upon the interprofessional and inter‐agency team working needed within Children's Trusts and the implications for staff involved with regard to skills development. Copyright © 2009 John Wiley & Sons, Ltd.     

Non‐accidental injury and bone fragility disorders: the need for a multidisciplinary perspective

A case is presented of a child who was initially diagnosed with osteogenesis imperfecta following a skull fracture. However, she later presented with multiple fractures and soft tissue injuries which were considered to be due to non‐accidental injury. It can be perplexing distinguishing accidental and non‐accidental injury in children where a bone fragility disorder has been suspected. A combination of a careful review of the history, a thorough examination and expert review of the radiology is imperative. DNA testing can be helpful. Multidisciplinary case review, taking into account the social history and any concerns professionals have about the family, is invaluable in informing a difficult diagnosis. In this context, there is a definite role for other agencies in challenging the diagnosis or exclusion of non‐accidental injury. Professionals should be willing to challenge the exclusion of non‐accidental injury when such exclusion is not evidence based. Copyright © 2009 John Wiley & Sons, Ltd.     

Family Therapy for Kids Without Families: Working Systemically With Children and Young People in Residential Care

A significant proportion (4%, Australian Institute of Health and Welfare, 2008) of children and young people in Australia live in some form of residential care, usually in small group‐homes staffed by residential care workers in shifts. However, as Hawkins‐Rodgers (2007) points out, these placements are often not resourced to heal the effects of trauma and multiple attachment disruptions in their residents. The lack of an archetypal ‘family’ has led in the past to family therapists considering that there is little work to be done with such clients. This leaves such placements to be supported most frequently by clinicians who specialise in behaviour management and other linearly founded models of practice. The Alternate Care Clinic (ACC) is the first mental health service in New South Wales dedicated entirely to children and young people in out of home care with a high level of complex needs. This article examines the systemic therapeutic model the clinic has developed in the last two years. In particular, the article seeks to explore the importance of ‘meaning making’ in a diffuse parental system, particularly with regards to the term ‘family’. The complexities of working in this area and possible ways forward are illustrated with a closely worked case study.     

‘Allowed into a Man's World’ Meanings of Work–Life Balance: Perspectives of Women Civil Engineers as ‘Minority’ Workers in Construction

This article discusses how women working as civil engineers within the UK construction industry perceive work–life balance and considers strategies they use to achieve this. The findings are presented of a qualitative research project that explored the experiences of women in this role, focusing on the subcultural context of a profession that is dominated by the values of presenteeism and infinite availability. A feminist post‐structuralist framework is used to analyse how women negotiate their personal and professional time and the extent to which their other roles as carers and nurturers unsettle male work practices in this highly gendered profession. There are gradually increasing numbers of women in professional construction roles and their success appears to depend on being able to fit in to the dominant masculine culture of long working hours and the male pub gathering. Despite an increased presence, women's minority status in construction continues to challenge their professional identity and this is central to the conflict many face between the dual roles of corporate worker and private non‐work person.     

Parental involvement in the development of a culture‐based school curriculum

This study focuses on parental involvement in Sámi schools when developing a culturally sensitive school curriculum. The research recognizes a number of competing and complementary interests that play a role when constructing structures and policies in curriculum development. Two Sámi schools in Sweden with 115 pupils, their parents and 27 teachers were included in a longitudinal three‐year study. Interviews, school visits, videotapes and document analysis were used to gather information. The results indicate the invisible existence of culture‐based school practice and curriculum texts. The lack of contact among homes, schools and community culture was obvious. Parents and teachers expressed an interest in developing a culture‐based local curriculum through a process of reflecting on and creating an education incorporating the past, the present and the future. The study showed that parents, pupils and teachers experienced increased awareness in culture‐based schoolwork. The study pointed to a desire for cooperation between home and school in the development of a culture‐based school curriculum and a school practice supported by a culturally responsible teacher.     

Active‐controlled,non‐inferiority trials in oncology: arbitrary limits,infeasible sample sizes and uninformative data analysis. Is there another way?

In oncology, it may not always be possible to evaluate the efficacy of new medicines in placebo-controlled trials. Furthermore, while some newer, biologically targeted anti-cancer treatments may be expected to deliver therapeutic benefit in terms of better tolerability or improved symptom control, they may not always be expected to provide increased efficacy relative to existing therapies. This naturally leads to the use of active-control, non-inferiority trials to evaluate such treatments. In recent evaluations of anti-cancer treatments, the non-inferiority margin has often been defined in terms of demonstrating that at least 50% of the active control effect has been retained by the new drug using methods such as those described by Rothmann et al., Statistics in Medicine 2003; 22:239-264 and Wang and Hung Controlled Clinical Trials 2003; 24:147-155. However, this approach can lead to prohibitively large clinical trials and results in a tendency to dichotomize trial outcome as either 'success' or 'failure' and thus oversimplifies interpretation. With relatively modest modification, these methods can be used to define a stepwise approach to design and analysis. In the first design step, the trial is sized to show indirectly that the new drug would have beaten placebo; in the second analysis step, the probability that the new drug is superior to placebo is assessed and, if sufficiently high in the third and final step, the relative efficacy of the new drug to control is assessed on a continuum of effect retention via an 'effect retention likelihood plot'. This stepwise approach is likely to provide a more complete assessment of relative efficacy so that the value of new treatments can be better judged.     

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