Can Psychosocial Intervention Improve Peer and Sibling Relations Among War‐affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial

Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war‐affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)‐year‐old girls (49.4 percent) and boys (50.6 percent)], who were cluster‐randomized into the TRT and wait‐list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well‐being at baseline (T1), postintervention (T2), and six month follow‐up (T3). Results showed gender‐specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.     

Infant Sex Moderates the Effects of Maternal Pre‐ and Postnatal Stress on Executive Functioning at 8 Months of Age

Previous studies report that early life stress, including maternal pre‐ and postnatal stress, has adverse effects on cognitive development and that these associations might be sex‐specific. However, no studies exist on early life stress and infant executive functioning (EF). The aim of this study was to examine the relationship between maternal pre‐ and postnatal stress and infant EF, and whether these associations are moderated by infant sex. Maternal prenatal depressive, general anxiety, and pregnancy‐specific anxiety symptoms were measured three times, and postnatal depressive and general anxiety symptoms were measured 6 months postpartum. Infant EF was assessed with a modified A‐not‐B task 8 months postpartum (N = 214). Maternal postnatal general anxiety predicted poorer EF in girls in comparison with boys. Moreover, there was a trend toward an interaction between prenatal anxiety and infant sex such that prenatal anxiety predicted infant EF differently in girls and in boys. No association was found between depressive symptoms or pregnancy‐specific anxiety symptoms and infant EF. These findings suggest that maternal anxiety may have sex‐specific effects on early EF and that pre‐ and postnatal stress may differently affect infant EF/cognitive development. The implications of these findings and important future directions are discussed.     

Country-Level Investment in Cultural Opportunity Structures. A Potential Source of Health Differences Between 21 European Countries

Individual’s participation in cultural activities may positively affect health through a pathway mediated by social capital. We examine whether country-level investment in cultural opportunity structures was associated with between-country differences in self-rated health and, if so, whether these associations were mediated by citizens’ confidence in societal institutions, i.e., by institutional trust, regarded as a dimension of social capital. For 24,887 respondents in the European Social Survey, 2006, data on self-rated health, institutional trust (individual-level and country-level), and sociodemographic variables were linked with statistics-based country-level data on 10 indicators of cultural opportunity structures and mediator variables (gross domestic product (GDP), Gini index, and welfare state regime). Over and above the sociodemographics, six cultural indicators contributed to between-country health differences in logistic multilevel regression analysis: the percentage of arts students, the RC index, the percentage of writers and creative artists of total employment, exports of cultural goods, imports of cultural goods, and the number of feature films produced per capita. Controlling, furthermore, for trust, and country-level mediators, only imports of cultural goods contributed to between-country differences in health. No associations with other cultural indicators remained after controlling for GDP or welfare state regime. Institutional trust may partially mediate the significance of cultural investments for self-rated health. However, both cultural investment and trust may be concomitants of general prosperity and welfare policies. Future studies should investigate whether the countries’ welfare policies influence the transformation of cultural investment into institutional trust and which types of indicators best depict associations between investments and health.     

Making Sense of After‐School Care Dilemmas in Mothers' Stories of After‐School Care in Finland and Sweden

The study focuses on dilemmas in storied experiences of everyday after‐school care arrangements among Swedish and Finnish mothers. Finland and Sweden, which share a history of strong labour market attachment among women, arrange institutional after‐school care in similar ways. The data consist of interviews with three Swedish and six Finnish mothers. A positioning analysis of four stories shows how decisions related to children's after‐school hours were allocated among different actors. Two reoccurring dilemmas, Competent‐dependent child stories and Unburdened‐deficient mother stories, emerged from the data analysis as related to prevailing moral discourses on childhood and motherhood.     

Likelihood approach for evaluating bioequivalence of highly variable drugs

Bioequivalence (BE) is required for approving a generic drug. The two one‐sided tests procedure (TOST, or the 90% confidence interval approach) has been used as the mainstream methodology to test average BE (ABE) on pharmacokinetic parameters such as the area under the blood concentration‐time curve and the peak concentration. However, for highly variable drugs (%CV > 30%), it is difficult to demonstrate ABE in a standard cross‐over study with the typical number of subjects using the TOST because of lack of power. Recently, the US Food and Drug Administration and the European Medicines Agency recommended similar but not identical reference‐scaled average BE (RSABE) approaches to address this issue. Although the power is improved, the new approaches may not guarantee a high level of confidence for the true difference between two drugs at the ABE boundaries. It is also difficult for these approaches to address the issues of population BE (PBE) and individual BE (IBE). We advocate the use of a likelihood approach for representing and interpreting BE data as evidence. Using example data from a full replicate 2 × 4 cross‐over study, we demonstrate how to present evidence using the profile likelihoods for the mean difference and standard deviation ratios of the two drugs for the pharmacokinetic parameters. With this approach, we present evidence for PBE and IBE as well as ABE within a unified framework. Our simulations show that the operating characteristics of the proposed likelihood approach are comparable with the RSABE approaches when the same criteria are applied. Copyright © 2014 John Wiley & Sons, Ltd.     

Sleep and Its Association With Socioeconomic Status,Health, and Risky Behaviors Among Ghanaian School Children

Socioeconomic differences in sleep and how sleep relates to health and risky behaviors among 12‐ to 18‐year‐old Ghanaians (N = 1,195) were investigated. Overall, 49.2% of boys and 60.8% of girls had inadequate sleep. Girls (OR = 1.6, 95% CI = 1.3–2.0) and older (16‐ to 18‐year‐olds) adolescents (OR = 1.6, 95% CI = 1.3–2.1) had higher probability of inadequate sleep than boys and younger (12‐ to 15‐year‐old) adolescents, respectively. High material affluence, low parental education, low parental occupational grade, drunkenness, marijuana use, drug use, and not having plans to continue schooling after graduation decreased the chances of inadequate sleep, while low school performance, low fruit and vegetable intake, and tiredness during daytime increased the probability of inadequate sleep. Promotion of adequate sleep and gender equality should be taken into consideration in adolescent health promotion programs.     

Data on survival of recent births as a source of child mortality estimates in the developing world: An assessment of census data

In many less developed countries, household surveys collect full and summary birth histories to provide estimates of child mortality. However, full birth histories are expensive to collect and cannot provide precise estimates for small areas, and summary birth histories only provide past child mortality trends. A simple method that provides estimates for the most recent past uses questions about the survival of recent births in censuses or large household surveys. This study examines such data collected by 45 censuses and shows that on average they tend to underestimate under-5 mortality in comparison with alternative estimates, albeit with wide variations. In addition, the high non-sampling uncertainty in this approach precludes its use in providing robust estimates of child mortality at the country level. Given these findings, we suggest that questions about the survival of recent births to collect data on child mortality not be included in census questionnaires.     

Responsibility in Home–School Relations — Finnish Parents' Views

Finnish parents' views on responsibility in the home–school relations were explored. Responsibility was here understood as responsibility over education and upbringing. The data consist of semi‐structured interviews with 24 mothers and four fathers. In the home–school discourses, parents and teachers were often referred to as partners, and active parental involvement in school life was seen as a key to children's success. However, in some discourses teachers and parents were seen as polar opposites, e.g. teachers as experts — parents as laymen. Few references were made to children's responsibility.