A COMPARISON OF THE IMPRECISE BETA CLASS, THE RANDOMIZED PLAY-THE-WINNER RULE AND THE TRIANGULAR TEST FOR CLINICAL TRIALS WITH BINARY RESPONSES

This paper develops clinical trial designs that compare two treatments with a binary outcome. The imprecise beta class (IBC), a class of beta probability distributions, is used in a robust Bayesian framework to calculate posterior upper and lower expectations for treatment success rates using accumulating data. The posterior expectation for the difference in success rates can be used to decide when there is sufficient evidence for randomized treatment allocation to cease. This design is formally related to the randomized play‐the‐winner (RPW) design, an adaptive allocation scheme where randomization probabilities are updated sequentially to favour the treatment with the higher observed success rate. A connection is also made between the IBC and the sequential clinical trial design based on the triangular test. Theoretical and simulation results are presented to show that the expected sample sizes on the truly inferior arm are lower using the IBC compared with either the triangular test or the RPW design, and that the IBC performs well against established criteria involving error rates and the expected number of treatment failures.     

Gay, lesbian, and bisexual youth and young adults: social support in their own words

Perceived social support was explored in a qualitative study of 17 gay, lesbian, and bisexual youth and young adults from a Seattle-based sexual minority youth drop-in center. The participants were interviewed in person with an open-ended question format to describe, in their own words, perceived social support they received as sexual minorities. Support was organized into four types, those fulfilling concrete, emotional, financial, or informational needs. Content analysis revealed several themes of support tailored to the specialized needs participants had as sexual minorities: locating parental figures among other gays and lesbians, parental reactions to learning of the youths' sexual orientation, the ability to reciprocate support, and finding supporters who introduced the youth to the gay, lesbian, and bisexual community. Non-family members were found to be more supportive than family members, particularly regarding informational support. Sexual minorities were perceived as more supportive than non-sexual minorities. Understanding the process and significance of acquiring a sense of community from which youth may garner continued support may present an avenue for intervention among social service providers. Additional implications for practice and research are also discussed.     

The continuing quest for excellence in health care delivery

At the recent Perspectives in Medical Management conference in New Orleans, more than a dozen sessions focused on issues of medical quality management. Speakers discussed total quality management, explaining its features and how physician executives can implement strategies in their organizations. Others talked abut the benefits and applications of clinical benchmarking and clinical guidelines, while still others described how their organizations custom-tailored quality programs to meet their needs. Some of the highlights of the meeting are summarized on the following pages.     

INFORMATION CHANNEL DISPOSITION AND USE*

The use of information channels by individuals in organizations is substantially discretionary. Although much studied, variation in patterns of discretionary use has yet to be explained adequately in terms of an accepted integrative theory validated across varieties of channel types and organizational settings. In a step toward the development of such a theory, the present paper proposes a basic channel-disposition model that relates an individual's attitude or disposition toward a channel to his/her actual use of the channel in the context of information and channel supply-and-demand structures in the organization. An exploratory study of the dispositions of 186 users of ten management information system (MIS) reports in four organizational settings provides limited evidence in support of the model proposed.     

Children with disabilities and chronic conditions and longer-term parental health

This paper uses panel data from the Statistics Canada National Longitudinal Survey of Children and Youth (1994–2000) to study the implications of parenting a child with a disability or chronic condition for subjective assessments of parental health. We find mother's health to be negatively affected, particularly if the disability is longer-term. Within families, the wife's health deteriorates relative to her husband's when they are parenting a child with a disability. These results are consistent with Akerlof and Kranton's [Akerlof, G., Kranton, R., 2000. Economics and identity. The Quarterly Journal of Economics 105(3), 715–753] arguments that ‘identity’ is an important determinant of both behaviour and well-being. For parents of children with disabilities, the behaviour associated with a traditional ‘good mother’ identity (e.g., care-giving) appears to have more adverse health consequences than the behaviour associated with a ‘good father’ identity (e.g., breadwinning).     

Race differences in the effects of multiple roles on health: longitudinal evidence from a national sample of older men.

This paper examines race differences in the effects of social roles on physical health. Using data from the older men cohort of the National Longitudinal Surveys of Labor Market Experience, we examine the impact of employment, marriage, and being a supporter on health limitations and mortality. Employment has the most consistent health-protective effect, and the benefits of employment are more pronounced for Blacks than for Whites. Marriage affects health in conjunction with employment. These findings lend further support to the growing literature on the effects of roles on health. The results further illustrate the importance of ascribed statuses as structural determinants of the relationship between roles and health, highlighting the very real differences in the meanings and expectations of social roles for Blacks and Whites.     

In the Mix,Yet on the Margins: The Place of Families in Urban Neighborhood and Child Development Research

In the 1990s, the most popular theoretical and empirical research issue concerning the local ecologies of families focused on the impact of family structures (e.g., household composition) and processes (e.g., child management strategies) on the relationship between urban neighborhoods and child and adolescent development. In this article, we synthesize and critically examine the decade's prevailing literature on the topic, organizing this review into three areas: (a) the research designs of quantitative and ethnographic studies of urban neighborhoods, families, and child outcomes; (b) the conceptual approaches used in these studies; and (c) the role of structural and behavioral features of family and parenting as factors that influence the relationship between urban neighborhoods and child development in ethnically and racially diverse populations. Results suggest that although family has been center stage in the neighborhood effects research question of the decade, it has remained on the margins in terms of theoretical and methodological specificity. Recommendations for future research are also offered.     

Reflections on the academic job search in sociology

Although a variety of resources exist to aid social scientists, in general, in their aca-demic job pursuits, almost no resources detail this process specifically for sociolo-gists. This research aims to provide a review of the literature on the academic job market and to provide a sociological analysis of the job searching process in sociology. We report and analyze the experiences of five sociologists as they moved from graduate school, post-doctoral fellowships, an applied research position, and a non-tenure track teaching position to assistant professor positions. We detail the importance of impression management and self-presentation throughout this process (by job candidates, departments, and administrators), the resources provided by the American Sociological Association that exist to aid job candidates, and we suggest implications of the current organization of the sociology job market.     

Roles,race and subjective well-being: A longitudinal analysis of elderly men

The basic contention of this paper is that research on subjective well-being would benefit from an integration of theory and research from other studies of subjective states, such as mental and physical health. Toward that end, we present results of an analysis of the impact of race and social roles on subjective well-being in a nationally representative sample of elderly men. The findings demonstrate that particular role configurations have an effect on happiness and that these effects are different for blacks and whites. Theoretical implications of these findings for subjective well-being research and role accumulation theory are discussed.