The importance of preservation of the ethical principle of equipoise in the design of clinical trials: relative impact of the methodological quality domains on the treatment effect in randomized controlled trials

Previous research has identified methodological problems in the design and conduct of randomized trials that could, if left unaddressed, lead to biased results. In this report we discuss one such problem, inadequate control intervention, and argue that it can be by far the most important design characteristic of randomized trials in overestimating the effect of new treatments. Current guidelines for the design and reporting of randomized trials, such as the Consolidated Standards of Reporting Trials (CONSORT) statement, do not address the choice of the comparator intervention. We argue that an adequate control intervention can be selected if people designing a trial explicitly take into consideration the ethical principle of equipoise, also known as "the uncertainty principle."     

A Probabilistic Framework for Risk Analysis of Widespread Flood Events: A Proof‐of‐Concept Study

This article presents a flood risk analysis model that considers the spatially heterogeneous nature of flood events. The basic concept of this approach is to generate a large sample of flood events that can be regarded as temporal extrapolation of flood events. These are combined with cumulative flood impact indicators, such as building damages, to finally derive time series of damages for risk estimation. Therefore, a multivariate modeling procedure that is able to take into account the spatial characteristics of flooding, the regionalization method top‐kriging, and three different impact indicators are combined in a model chain. Eventually, the expected annual flood impact (e.g., expected annual damages) and the flood impact associated with a low probability of occurrence are determined for a study area. The risk model has the potential to augment the understanding of flood risk in a region and thereby contribute to enhanced risk management of, for example, risk analysts and policymakers or insurance companies. The modeling framework was successfully applied in a proof‐of‐concept exercise in Vorarlberg (Austria). The results of the case study show that risk analysis has to be based on spatially heterogeneous flood events in order to estimate flood risk adequately.     

ASYMMETRIC INFORMATION AND THE EXCESS VOLATILITY OF STOCK PRICES

Evidence suggests the volatility of stock prices cannot be accounted for by information about future dividends. We argue that some of the volatility of stock prices in excess of fundamentals results from fluctuations in the amount of public information over time. Our model assumes that dividends and consumption are constant in the aggregate but that there are good firms and bad firms whose identity may be unknown to the public, as in Akerlof's "lemons" problem. In that case, the collective valuation of the constant dividend stream depends on the degree of informational asymmetry.     

Estimation of Error and Bias in Bayesian Monte Carlo Decision Analysis Using the Bootstrap

Bayesian Monte Carlo (BMC) decision analysis adopts a sampling procedure to estimate likelihoods and distributions of outcomes, and then uses that information to calculate the expected performance of alternative strategies, the value of information, and the value of including uncertainty. These decision analysis outputs are therefore subject to sample error. The standard error of each estimate and its bias, if any, can be estimated by the bootstrap procedure. The bootstrap operates by resampling (with replacement) from the original BMC sample, and redoing the decision analysis. Repeating this procedure yields a distribution of decision analysis outputs. The bootstrap approach to estimating the effect of sample error upon BMC analysis is illustrated with a simple value-of-information calculation along with an analysis of a proposed control structure for Lake Erie. The examples show that the outputs of BMC decision analysis can have high levels of sample error and bias.     

An Empirical Investigation of Terrorism-induced Stress on Expatriate Attitudes and Performance

Despite international terrorism's increasing relevance for international business, the effects of terrorism that confront employees during assignments abroad have hardly been investigated. Applying a stress perspective, this article analyzes the impact of terrorism-induced stress on attitudes and the performance of expatriates. Employing data from 143 expatriate managers in high-risk countries, the study shows that several terrorism-related stressors create a significant stress level for the individual, causing negative work attitudes and attitudes towards host country nationals (disaffection). This eventually leads to worse performance. We applied partial least squares (PLS) structural equation modeling (SEM) to analyze the entire impact path and found substantial support for our hypotheses. Of all the relevant stressors, intra-family conflicts due to terrorism have the greatest impact.     

Understanding How Case Managers Use ‘Sabotage’ as a Frame for Clinically Difficult Situations

Case managers are among the direct service providers responsible for engaging people with severe mental illnesses. Understanding how they interpret and respond to clinically difficult situations can inform ways to intervene and reduce service disengagement. This qualitative study explored clinically difficult situations when case managers invoked the term ??sabotage??. Interviews were conducted with 21 case managers and analyzed by co-coders focusing on how case managers used the term sabotage to describe service user behavior. Themes that emerged were attributing sabotage to; fear of success, fear of attaining what you desire, avoidance of responsibility and change, and a lack of structured support. Drawing on the concepts of clinical case management and mental health recovery, we consider implications for the training and supervision of case managers and how services are structured.     

Toward a model of changing disability identities: a proposed typology and research agenda

In light of recent developments in the field of disability studies, this article is an attempt to update a typology of orientations to disability developed over 20 years ago. The proposed revised typology represents a synthesis of two theoretical strands in sociology: opportunity structure theory and identity theory. The author provides examples from the literature, by and about people with disabilities, to illustrate each proposed type of disability identity. These types include normalisation, crusadership, affirmation, situational identification, resignation, apathy and isolated affirmation. The article suggests that individuals with disabilities may move along a 'career path' from one type to another over time, as they encounter new opportunities and interaction situations. The author proposes a research agenda to refine and establish the validity of the typology, and to determine its applicability to diverse populations of disabled people in the world today.