Utilizing Bayesian predictive power in clinical trial design

The Bayesian paradigm provides an ideal platform to update uncertainties and carry them over into the future in the presence of data. Bayesian predictive power (BPP) reflects our belief in the eventual success of a clinical trial to meet its goals. In this paper we derive mathematical expressions for the most common types of outcomes, to make the BPP accessible to practitioners, facilitate fast computations in adaptive trial design simulations that use interim futility monitoring, and propose an organized BPP-based phase II-to-phase III design framework.     

Theory and Validity of Life Satisfaction Scales

National accounts of subjective well-being are being considered and adopted by nations. In order to be useful for policy deliberations, the measures of life satisfaction must be psychometrically sound. The reliability, validity, and sensitivity to change of life satisfaction measures are reviewed. The scales are stable under unchanging conditions, but are sensitive to changes in circumstances in people’s lives. Several types of data indicate that the scales validly reflect the quality of respondents’ lives: (1) Differences between nations in life satisfaction associated with differences in objective conditions, (2) Differences between groups who live in different circumstances, (3) Correlations with nonself-report measures of life satisfaction, (4) Genetic and physiological associations with life satisfaction, (5) Systematic patterns of change in the scales before, during, and after significant life events, and (6) Prediction by life satisfaction scores of future behaviors such as suicide. The life satisfaction scales can be influenced by factors such as question order, current mood, and mode of presentation, but in most cases these can be controlled. Our model of life satisfaction judgments points to the importance of attention, values, standards, and top-down effects. Although the scales are useful in research on individual well-being, there are policy questions that need more analysis and research, such as which types of subjective well-being measures are most relevant to which types of policies, how standards influence scores, and how best to associate the scores with current policy deliberations.     

Human Health Risk Assessment of Penicillin/Aminopenicillin Resistance in Enterococci Due to Penicillin Use in Food Animals

Penicillin and ampicillin drugs are approved for use in food animals in the United States to treat, control, and prevent diseases, and penicillin is approved for use to improve growth rates in pigs and poultry. This article considers the possibility that such uses might increase the incidence of ampicillin-resistant Enterococcus faecium (AREF) of animal origin in human infections, leading to increased hospitalization and mortality due to reduced response to ampicillin or penicillin. We assess the risks from continued use of penicillin-based drugs in food animals in the United States, using several assumptions to overcome current scientific uncertainties and data gaps. Multiplying the total at-risk population of intensive care unit (ICU) patients by a series of estimated factors suggests that not more than 0.04 excess mortalities per year (under conservative assumptions) to 0.14 excess mortalities per year (under very conservative assumptions) might be prevented in the whole U.S. population if current use of penicillin drugs in food animals were discontinued and if this successfully reduced the prevalence of AREF infections among ICU patients. These calculations suggest that current penicillin usage in food animals in the United States presents very low (possibly zero) human health risks.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.

Some implications of common consequences in lotteries

This work studies the implications of some aspects of preferences toward risk in the choice between two binary lotteries exhibiting a common consequence. The results obtained are then applied to two different problems: the choice between two risky challenges characterized by different rewards in the case of success and different probabilities of success and the choice between self-protection and self-insurance in the presence of the risk of incurring financial loss.

     

The Effect of Social Responsiveness on Infants' Object‐Directed Imitation

Previous research has demonstrated that social interactions underlie the development of object‐directed imitation. For example, infants differentially learn object action sequences from a live social partner compared to a social partner over a video monitor; however, what is not well understood is what aspects of social interactions influence social learning. Previous studies have found variable influences of different types of caregiver responsiveness on attention, language, and cognitive development. Therefore, the purpose of this study was to examine how the responsive style of a social partner influenced the learning of object‐directed action sequences. Infants interacted with either a sensitive or redirective experimenter before the learning trial. Results revealed infants changed their patterns of engagement; infants interacting with a sensitive experimenter had longer periods of attentional engagement than infants interacting with a redirective experimenter. Furthermore, during the learning trial, the amount of sensitivity during interaction with the social partner predicted learning scores. These findings suggest that infants' attention is influenced by social partners' interactive style during ongoing interaction, which subsequently affects how infants learn from these social partners.     

Using institutional ethnography's ideological circle to portray how textually mediated disability discourse paralysed a Supreme Court of Canada ruling

Persons with disabilities created through texts as damaged goods are being ‘cured’ by workplace accommodation, a textually mediated work process. Prior to 1999, workplace accommodation in the Canadian federal public service signified the adjustments necessary to enable a disabled worker to fit into a workplace designed for able-bodied workers. In 1999, a Supreme Court of Canada (SCC) ruling known as Meiorin turned this accommodation provision on its head. Instead of being focused on individual-level fixes so that a disabled worker could be accommodated in an existing workplace, this legislation required employers to transform their workplaces so as to make them ready to receive as many different types of workers as reasonably possible from the outset. Using Dorothy E. Smith's institutional ethnography, I use my experiences as a disability rights activist employed in the Canadian federal public service to explicate how textually mediated disability discourse paralysed this groundbreaking SCC ruling.     

Predicting engagement in a transition to parenthood program for couples

Fostering participant engagement is a challenging but essential component of effective prevention programs. To better understand which factors influence engagement, this study examines several predictors of couple engagement in Family Foundations (FF), a preventive intervention for first-time parents shown to enhance parent mental health, couple relations, parenting quality, and child adjustment through age 3 years. FF consists of a series of classes delivered through childbirth education departments at local hospitals. Baseline data on socio-demographics, parent mental health, and couple relationship quality were examined as predictors of participants’ level of engagement in FF (n = 89 couples, 178 individuals). Sociodemographic variables such as parent gender, socioeconomic status, and age predicted program engagement to a limited extent. However, findings indicated that marital status was the best predictor of engagement. Discussion focuses on how findings can inform the development of practices that promote engagement, such as the use of targeted outreach efforts for individuals most at risk of disengagement.