Decision‐making in a phase II clinical trial: a new approach combining Bayesian and frequentist concepts

The aim of a phase II clinical trial is to decide whether or not to develop an experimental therapy further through phase III clinical evaluation. In this paper, we present a Bayesian approach to the phase II trial, although we assume that subsequent phase III clinical trials will have standard frequentist analyses. The decision whether to conduct the phase III trial is based on the posterior predictive probability of a significant result being obtained. This fusion of Bayesian and frequentist techniques accepts the current paradigm for expressing objective evidence of therapeutic value, while optimizing the form of the phase II investigation that leads to it. By using prior information, we can assess whether a phase II study is needed at all, and how much or what sort of evidence is required. The proposed approach is illustrated by the design of a phase II clinical trial of a multi‐drug resistance modulator used in combination with standard chemotherapy in the treatment of metastatic breast cancer. Copyright © 2005 John Wiley & Sons, Ltd     

Television Viewing Patterns in 6‐ to 18‐Month‐Olds: The Role of Caregiver–Infant Interactional Quality

The present study examines coviewing of Baby Mozart by 6‐ to 18‐month‐old infants and their caregivers under naturalistic conditions. We had two questions. First, extending the method of Barr, Zack, Garcia, and Muentener ( Infancy, 13 [2008], 30–56 ) to a younger population, we asked if age, prior exposure, and caregiver verbal input would predict infant looking to a Baby Mozart video from 6 to 18 months. Second, we asked if caregiver–infant interactional quality, defined as the amount of shared focus and turn taking between infant and caregiver, would be associated with infant looking time. We found that, in addition to the anticipated effect of prior exposure and caregiver verbal input, interactional quality measures were related to infant media‐directed looking. Infants who engaged in more shared focus and turn taking looked more to the program than infants who interacted less with their caregivers. These results are discussed in terms of social mediation of coviewing during early infancy.     

Who's calling the shots? Decision-makers and the adoption of effective school-based substance use prevention curricula

This study investigates the relative roles of school district and school-level decision-makers in the implementation of effective substance use prevention curricula. Drawing on a "Site-Based Management" approach to effective decision-making, we hypothesized that schools whose personnel played active decision-making roles would be more likely to implement effective curricula than those in which decision-making was the prerogative of school district personnel. Study data comprised 1369 questionnaires completed by a representative national sample of both district-level prevention coordinators and middle school-based lead prevention teachers. From the perspective of the lead prevention teachers, the school district-level prevention coordinator was more influential than school staff in selecting effective prevention curricula. However, we did find some support for our hypothesis from our district-level informants, who indicated that community groups and advisory committees also play a modest role in the selection of such curricula.     

Negotiating for more than a slice of the pie

Negotiation is an important way for physician executives to manage conflict and to accomplish new projects. Because of the rapidly changing nature of the health care environment, as well as conflicts and politics within their organizations, managers need to effectively negotiate with a wide range of other parties. Managers should consider the relative importance of both the substantive and relationship outcomes of any potential negotiation. These two factors may guide the executive's selection of initial negotiation strategies.     

Unbuckling the Bible Belt: A State-Level Analysis of Religious Factors and Google Searches for Porn

While the link between individual religious characteristics and pornography consumption is well established, relatively little research has considered how the wider religious context may influence pornography use. Exceptions in the literature to date have relied on relatively broad, subjective measures of religious commitment, largely ignoring issues of religious belonging, belief, or practice. This study moves the conversation forward by examining how a variety of state-level religious factors predict Google searches for the term porn, net of relevant sociodemog raphic and ideological controls. Our multivariate findings indicate that higher percentages of Evangelical Protestants, theists, and biblical literalists in a state predict higher frequencies of searching for porn, as do higher church attendance rates. Conversely, higher percentages of religiously unaffiliated persons in a state predict lower frequencies of searching for porn. Higher percentages of total religious adherents, Catholics, or mainline Protestants in a state are unrelated to searching for porn with controls in place. Contrary to recent research, our analyses also show that higher percentages of political conservatives in a state predicted lower frequencies of porn searches. Our findings support theories that more salient, traditional religious influences in a state may influence residents—whether religious or not—toward more covert sexual experiences.     

Can Stress Build Relationships? Predictors of Increased Marital Commitment Resulting from the 2007–2009 Recession

Although some studies have examined factors that can help married couples maintain their relationship quality during financial stress, few have examined factors that might actually help marriages flourish during financial stress. This study examined participants’ reports of their commitment increasing because of the 2007–2009 Recession using dyadic data from a national sample of married couples. We found that religious marital sanctification, relationship maintenance behaviors, and social and financial support from family and friends were all related to both wives’ and husbands’ reports that their commitment had increased during the Recession. Wives who faced employment- or housing-related problems reported increased commitment. Finally, the more economic pressure participants felt during the Recession, the more their relationship commitment increased.     

Family Structure and Child Well-Being in a Non-western Context: The Role of Parent–Child Relations and Parental Conflict in South Korea

Population Research and Policy Review - Research suggests that children who live with two biological married parents are less likely to exhibit behavioral problems than children who do not. While...