Issues in the design and analysis of therapeutic trials in human immunodeficiency virus infection

The first randomized trial of antiviral therapy in human immunodeficiency virus (HIV) disease included 282 patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex and was stopped in 1986 after an average follow-up of 4 months because of a substantial reduction in mortality in the group who received zidovudine (AZT). The era of anti-HIV treatment had begun. This paper discusses some of the difficulties which have emerged over the subsequent 10 years as new anti-HIV drugs have been developed requiring evaluation in clinical trials. The trials in which the British Medical Research Council has played a major role (the Concorde, Alpha and Delta trials) and some of the key trials conducted by the AIDS Clinical Trials Group (ACTG) (the ACTG 019 and ACTG 175 trials) and the Community Programs for Clinical Research on AIDS (CPCRA) (the CPCRA 007 trial) in the US will be used to illustrate some of the issues faced by clinical trialists and governmental regulatory agencies in the evaluation of therapies for a disease which, in spite of advances in therapy, still has a high mortality.     

When disaster strikes. The concerns of staff nurses

1. This study determined how involvement with an earthquake affected patient care delivery and ascertained what nurses need to continue providing safe and efficient care in future disasters. 2. Although 60% of the staff had experienced a previous disaster, the literature described that learned coping does not automatically "transfer" to present loss experiences. 3. Providing staff with debriefing sessions and other support groups is helpful in the post-trauma period. At all levels, there is a need to communicate concerns and to be involved in disaster drills and other disaster preparedness sessions.     

What Influences Business Academics’ Use of the Association of Business Schools (ABS) List? Evidence From a Survey of UK Academics

The development of the Association of Business Schools (ABS) list in 2007 and its rapid adoption by UK business schools has had a profound effect on the nature of business and management academics’ ways of working. Using a large‐scale survey of UK business academics, we assess the extent to which individuals use the Academic Journal Guide (AJG/ABS) list in their day‐to‐day professional activities. In particular, we explore how their perceptions of the list, the academic influence of their research, academic rank and organizational context drive the varied use. Building on prior research on the importance of univalent attitudes in predicting behaviour, we find those who have either strong positive or negative views of the list are more extensive users than those who are ambivalent. We also find that the extent of use of the AJG/ABS list is greatest among those academics who have lower academic influence, in the middle or junior ranks within business schools and in middle and low‐status universities. We explore the implications of these findings for the value of journal rankings and for the management of business schools.     

Psychometric Properties of the Family Inventory of Resources and Stressors in Families of Children with Emotional/Behavior Disorders: Ethnic/Racial and Developmental Differences

The Family Inventory of Resources and Stressors (FIRST) has been shown to have adequate psychometric properties in the assessment of families of children with emotional and behavior disorders (EBD). However, the extent to which ethnic/racial and developmental differences moderate the psychometric properties of this instrument is unknown. The study sample consisted of 150 families with an EBD child consecutively admitted to the Astor Transitions Program. This study seeks (1) to conduct a psychometric analysis of the FIRST subscales among African American and Hispanic/Latino families with older students versus early childhood students with EBD, and (2) to determine whether profiles will show greater stress for families of older students due to longer exposure to their EBD. Alpha coefficients were computed with a cutoff of 0.70 (or higher) indicating acceptable internal consistency reliability. Criterion variables reflecting family environment, mental health, and level of service correlated with relevant FIRST subscales assessed validity. Ethnic/racial and developmental effects were found to moderate the psychometric properties of the FIRST. No statistically significant between-group mean differences on the FIRST were found for families of early childhood versus older EBD students. Despite evidence of response bias on the part of families and lack of standardization during test administration by caseworkers, the current findings still reveal adequate reliability and limited validity of FIRST subscales.     

Parent–child joint media engagement in infancy

Early conversations are an important source in shaping children's cognitive and emotional development, and it is vital to understand how parents use media as a platform to engage in conversations with their young children and what might predict the quality of these interactions. Thus, in the current study we explored the nature of parent–child discourse while engaging in media (i.e., joint media engagement) with infants, and how parent (empathic concern and responsiveness) and child (negative emotionality and regulatory capacity) variables might be associated with the quality of engagement. The current study consisted of 269 infants (50% female, M_age = 17.09 months, SD = 3.93; 59% White) and their primary caregiver (98% mothers) who engaged in a variety of in‐home tasks and parental questionnaires. Results established three meaningful codes for both parent and child that assessed positive and negative joint media engagement. Further, results suggested that parental empathic concern was associated with positive parent and child media engagement, while child negative emotionality was associated with lower levels of distraction. Discussion focuses on the importance of studying parent–child discourse in the context of joint media engagement and recommends limiting media exposure before 18 months of age.     

Welfare measurement in labour supply models with nonlinear budget constraints

This paper is concerned with the measurement of individual welfare in labour supply models which allow for the impact of income taxation and income support schemes on labour supply decisions. The paper is motivated by the concern over the need to have measures which can be interpreted easily, which can be compared with net income, and which can be meaningfully aggregated. To illustrate the issues we use estimates of a discrete choice model of labour supply for United Kingdom lone mothers to compute alternative welfare measures which might be considered as having intuitive appeal to policy-makers. We compute welfare change based on these measures arising from a recent reform of the child support payments system. Received: 25 February 1997/Accepted: 12 March 1998     

Photo albums: Images of time and reflections of self

The advent of popular photography has allowed ordinary people to visually record their view of themselves and the passage of their lives. Photographs not only record events but also allow the maker to group them for presentation in a structured manner comparable to verbal narratives, most commonly in photo albums. We examined more than forty albums created by amateur photographers in order to investigate the psychological and social functions of photo albums and their value to scholars as documentations of social life. Albums are intensely personal; they create a relationship between the presenter and the viewer; the audience is small; the possessor plays an active role in the album's presentation; and there is an accompanying verbal narrative. This narrative is crucial to the understanding of the album. This paper explores the structure of these narratives and their role in creating the meaning of the album. In the absence of a possessor/presenter, a narrative can be constructed by determining the type of album being examined and establishing the personal relationships and themes within the album. We suggest devices and procedures for reconstruction of such a narrative in the absence of a presenter.