A review of the epidentiological research on child sexual abuse. Community and college student samples

This article is the first of two consecutive reviews on the major empirical studies which have been carried out in an attempt to estimate the prevalence of child sexual abuse among females. The research is structured in terms of three sample categories: (a) probability and non-probability samples of the general population; (b) college student samples; and (c) clinical inpatient and outpatient samples. This part of the review deals with (a) and (b) and highlights a number of unresolved methodological issues which may contribute to the variance in reported prevalence rates. These include a myriad of definitions of child sexual abuse and different methods of eliciting information on possible histories of abuse. Despite these problems. taken as a whole the prevalence studies indicate the significant numbers of people who have experienced abuse and who are willing to disclose aspects of these abusive experiences.     

Working children: the health and safety issue

Recent evidence has emerged that in Britain, like the US, many children below the official minimum school leaving age, are working. In many cases, the work is illegal. Research in the US suggests that many working children risk accidents and other hazards to health. Evidence from Britain on the health and safety aspects of child labour is of a more fragmentary nature, but enough exists to suggest a need for greater vigilance.     

Making the journey into the networked enterprise, Part 2

In the May issue of Physician Executive, the authors described the difficulties other industries have had with vertical integration and why so many corporations have abandoned it for other organizational structures. In this second part of the series, they explore the ways health care organizations can make the shift into integrated delivery systems, avoiding the trap of the hierarchical, vertically integrated monolithic structures that will become the dinosaurs of the future.     

An Assessment of Change in Risk Perception and Optimistic Bias for Hurricanes Among Gulf Coast Residents

This study focuses on levels of concern for hurricanes among individuals living along the Gulf Coast during the quiescent two‐year period following the exceptionally destructive 2005 hurricane season. A small study of risk perception and optimistic bias was conducted immediately following Hurricanes Katrina and Rita. Two years later, a follow‐up was done in which respondents were recontacted. This provided an opportunity to examine changes, and potential causal ordering, in risk perception and optimistic bias. The analysis uses 201 panel respondents who were matched across the two mail surveys. Measures included hurricane risk perception, optimistic bias for hurricane evacuation, past hurricane experience, and a small set of demographic variables (age, sex, income, and education). Paired t‐tests were used to compare scores across time. Hurricane risk perception declined and optimistic bias increased. Cross‐lagged correlations were used to test the potential causal ordering between risk perception and optimistic bias, with a weak effect suggesting the former affects the latter. Additional cross‐lagged analysis using structural equation modeling was used to look more closely at the components of optimistic bias (risk to self vs. risk to others). A significant and stronger potentially causal effect from risk perception to optimistic bias was found. Analysis of the experience and demographic variables’ effects on risk perception and optimistic bias, and their change, provided mixed results. The lessening of risk perception and increase in optimistic bias over the period of quiescence suggest that risk communicators and emergency managers should direct attention toward reversing these trends to increase disaster preparedness.     

Grandparental childcare in Australia: gender differences in the correlates of providing regular grandparental care while parents work

Grandparents’ regular care for children while parents work has been mostly studied from the parental perspective. This paper focuses on the grandparents. Using the Australian Bureau of Statistics Time Use Survey 2006 (N = 7672) we investigate regular-caring grandparents’ demographic characteristics, which childcare activities they undertake, and how regular childcare provision relates to their time in other activities, subjective time pressure and satisfaction. Results indicate the correlates and nature of regular care differ by gender. Regular and non-regular-caring grandmothers’ relative time allocation to different childcare tasks barely differs, while regular-caring grandfathers’ care includes a much higher proportion of active care and travel than non-regular-caring grandfathers’. Regular care provision is associated with less leisure than non-regular-caring counterparts for both genders, but with only grandmothers’ housework, personal care and sleep time. Providing regular care doubles the likelihood of grandmothers reporting high subjective time pressure compared to non-regular-caring grandmothers; there is no association between regular care and time pressure for grandfathers. We conclude that in taking on regular care, grandparents echo the gender patterns found among parents, namely that it is women who are disproportionately impacted by meeting family care needs.     

Heterogeneity in treatment effects across diverse populations

Differences in patient characteristics, including age, sex, and race influence the safety and effectiveness of drugs, biologic products, and medical devices. Here we provide a summary of the topics discussed during the opening panel at the 2018 Johns Hopkins Center for Excellence in Regulatory Science and Innovation symposium on Assessing and Communicating Heterogeneity of Treatment Effects for Patient Subpopulations: Challenges and Opportunities. The goal of this session was to provide a brief overview of FDA-regulated therapeutics, including drugs, biologics and medical devices, and some of the major sources of heterogeneity of treatment effects (HTE) related to patient demographics, such as age, sex and race. The panel discussed the US Food and Drug Administration's role in reviewing and regulating drugs, devices, and biologic products and the challenges associated with ensuring that diverse patient populations benefit from these therapeutics. Ultimately, ensuring diverse demographic inclusion in clinical trials, and designing basic and clinical research studies to account for the intended patient population's age, sex, race, and genetic factors among other characteristics, will lead to better, safer therapies for diverse patient populations.