Quantification of follow-up time in oncology clinical trials with a time-to-event endpoint: Asking the right questions

For the analysis of a time-to-event endpoint in a single-arm or randomized clinical trial it is generally perceived that interpretation of a given estimate of the survival function, or the comparison between two groups, hinges on some quantification of the amount of follow-up. Typically, a median of some loosely defined quantity is reported. However, whatever median is reported, is typically not answering the question(s) trialists actually have in terms of follow-up quantification. In this paper, inspired by the estimand framework, we formulate a comprehensive list of relevant scientific questions that trialists have when reporting time-to-event data. We illustrate how these questions should be answered, and that reference to an unclearly defined follow-up quantity is not needed at all. In drug development, key decisions are made based on randomized controlled trials, and we therefore also discuss relevant scientific questions not only when looking at a time-to-event endpoint in one group, but also for comparisons. We find that different thinking about some of the relevant scientific questions around follow-up is required depending on whether a proportional hazards assumption can be made or other patterns of survival functions are anticipated, for example, delayed separation, crossing survival functions, or the potential for cure. We conclude the paper with practical recommendations.     

How Believing in Ourselves Increases Risk Taking: Perceived Self-Efficacy and Opportunity Recognition

What effect does positive and negative feedback about past risk taking have on the future risk taking of decision makers? The results of an experimental study show that subjects who are led to believe they are very competent at decision making see more opportunities in a risky choice and take more risks. Those who are led to believe they are not very competent see more threats and take fewer risks. The feelings of self-competence and self-confidence on one task did not generalize to a similar task. Perception of opportunities was unexpectedly not related to the perception of threats. As executives bring their personal perceptual biases to firm decision making, our results identify a serious built-in bias in SWOT analysis (the analysis of firms' strengths and weaknesses as related to potential opportunities and threats). Executives who believe that they and their firm are very competent will take more risks and vice versa. Our results also provide evidence that the perceived likelihood of an event depends on whether the event is a loss or a gain. Human decision making is subject to the general bias that outcome expectations are not independent of outcome valuations.     

Social process theory of emotion: A dynamic systems approach

In this paper we apply a dynamic systems perspective to infant emotional development. We propose that emotions are not states but self-organizing dynamic processes intimately tied to the flow of an individual's activity in a context. We review data on the relationship between emotional actions and the social context, in particular the development of smiling and laughter. These data are more adequately explained by our perspective than by other theories of emotional development. We provide a model for how emotional processes in early infancy become embedded into sociocultural systems, and suggest new avenues of research on emotional development.     

An outbreak of cryptosporidiosis among veterinary science students who work with calves

The authors describe an outbreak of cryptosporidiosis among students working with calves as part of their veterinary science technology program. After an off-campus provider identified an index case, school authorities requested cryptosporidium (crypto) as part of the stool ova and parasite examination of all students presenting to the college health center with significant gastroenteritis. Thirteen students submitted stool specimens that were examined for crypto; 7 were positive, and all were from veterinary science students. One of the calves used in the program also tested positive for crypto. All of the students were immunocompetent and recovered uneventfully. The outbreak was contained by strictly enforcing infectious-disease precautions in the calf barn. The authors recommend considering crypto as a cause of gastroenteritis, especially among farm-animal workers, and urge strict infectious disease precautions for those who attend to livestock.     

Stigma of ink: Tattoo attitudes among college students

We test a structural equations model of stigma against tattooed persons and attitudes toward future tattoos among 195 tattooed and 257 non-tattooed college students. Having tattooed friends and family members undermines stigma against tattooed persons while beliefs about negative side effects of tattooing reinforces stigma assignment. The variables above and the respondent having a tattoo predict attitude toward future tattoos. We test a second model, stigma victimization, drawing on data from the 195 tattooed respondents. While greater tattoo abundance results in greater stigma victimization, respondents with more tattoos also report a greater commitment to their current tattoos and less desire for removal. We discuss results using attitude theory, stigma theory, and the contact theory of prejudice.     

Analysis of Maslow's Need Hierarchy with three social class groups

Maslow's Hierarchy of Needs is often cited as a possible basis for a fuller understanding of the individual's needs, particularly with regard to Quality of Life. The reluctance to use these concepts is based primarily on lack of empirical evidence in this field. To rectify this situation, a new methodology based on Q sorting was developed to measure the individual's need importance for each of the five needs Maslow proposes. After an estimation of reliability, the test was administered to 240 adults, made up of three social groups, lower class, working class and middle class, balanced for age and sex. The results provided evidence that individuals of a similar social class share similar notions of which needs are most important to them, and these notions differ across social class. It appeared the majority of the middle class sample were esteem, self-actualization orientated, while the majority of the working class were esteem, belonging orientated. Conversely, the majority of the lower class sample were physiology and belonging orientated. However, a cluster analysis of the need items revealed that the items representative of a need were not necessarily assigned similar importance by any one group. It would appear that each need can not be viewed as a unitary whole of equal importance, but rather must be seen as a conglomerate. Methodologically, the article illustrates the feasibility of directly measuring need importance and the use of cluster analysis to group both need items and individuals. Further, the assessment of group differences allows a fuller understanding of needs and the importance the individual assigns to their satisfaction.     

Why Parents Pay for College: The Good Parent,Perceptions of Advantage,and the Intergenerational Transfer of Opportunity

This article asks how parents think about the cost of a college education for their children. Based on data from more than ninety in‐depth interviews with upper‐middle‐class parents and children, it is clear that grooming children for college and then paying for their education is intimately linked with ideas about being a “good parent.” We present data on three related aspects of parents' consciousness about paying for college. First, data are presented on how parents view the benefits of college for their children. Second, data illustrate how parents think about the obligations associated with paying. Third, we report on what parents expect in return for their efforts and expenditures. Data also indicate that parents' views are contingent on their perceived ability to pay for the increasing costs of higher education. We conclude by considering how the implicit contract between upper‐middle‐class parents and children may change as new economic and structural uncertainties increase parents' anxieties and challenge their abilities to see themselves as good parents.