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Abstract: Given the raised profile that parenting support and education is currently receiving on government family policy agendas in many nations, this paper reviews the ways in which parenting support and education policies are embedded within eight OECD countries. Drawing out the similarities and differences of policy and practice, and comparing the financial support each country affords to parenting support, it assesses the effectiveness of parenting support programmes in relation to national expenditure and links parenting policy to child outcomes. The paper concludes with some recommendations for policy makers and programme developers. The countries reviewed are: The UK, Netherlands, Canada, Ireland, the US, Finland, Australia and New Zealand. [Copyright &y& Elsevier]

The neoliberal restructuring of government policies in developed nations since the 1970s has stimulated many observers to observe the “roll back” of the state from social assistance, including housing. Some suggest that the “roll out” of new forms of state activity are occurring. This paper argues that perceptions of “roll back” and “roll out” arise from a particular conception of the capacity of the state that focuses on apparent state action over discursive production. A modified version of governmentality theory is deployed to demonstrate that despite perceptions of a weakening state housing assistance presence in Australia, the UK, the Netherlands and New Zealand, the conceptive and discursive role of the state has remained strong. The paper concludes by arguing that greater appreciation of the persistent pragmatic capacity of the state to define the objects, subjects and relationships of housing policy fruitfully illuminates the condition of the state under neoliberalism. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

The Australian government has announced major reforms with the move to a primary maternity care model. The direction of the reforms remains contentious; with the Australian Medical Association warning that the introduction of non-medically led services will compromise current high standards in maternity services and threaten the safety of mothers and babies. The purpose of this paper is to conduct a critical review of the literature to determine whether there is convincing evidence to support the safety of non-medically led models of primary maternity care. Twenty-two non-randomised international studies were included representing midwifery-led care, birth centre care and home birth. Comparative outcome measurements included: perinatal mortality; perinatal morbidity; rates of medical intervention in labour; and antenatal and intrapartum referral and transfer rates. Findings support those of the three Cochrane reviews, that there is sufficient international evidence to support the conclusion of no difference in outcomes associated with low risk women in midwifery-led, birth centre and home birth models compared with standard hospital or obstetric care. These findings are limited to services involving qualified midwives working within rigorous exclusion, assessment and referral guidelines, limiting the number of urgent intrapartum transfers that come with increased risk of perinatal mortality. What is known about the topic? Systematic reviews of maternal and perinatal outcomes associated with midwifery-led care when compared to conventional intrapartum hospital care concluded that these non-medically led models of care are associated with several benefits for low risk women and their babies with no identified adverse effects. What does this paper add? The finding of no difference in outcomes associated with midwifery-led, birth centre and home birth compared with standard hospital or obstetric care is limited to international studies involving women in the care of qualified midwives working within rigorous guidelines for practice involving inter-professionally agreed exclusion, assessment and referral criteria. What are the implications for practitioners? Midwives caring for women in non-medically led models are urged to be vigilant to the need for early detection and prompt action in the event of unforseen complications to avoid an over emphasis on normality. This decreases the likelihood of urgent intrapartum transfers that come with an increased risk of perinatal mortality. [ABSTRACT FROM AUTHOR]