Development of predictive signatures for treatment selection in precision medicine with survival outcomes

For survival endpoints in subgroup selection, a score conversion model is often used to convert the set of biomarkers for each patient into a univariate score and using the median of the univariate scores to divide the patients into biomarker‐positive and biomarker‐negative subgroups. However, this may lead to bias in patient subgroup identification regarding the 2 issues: (1) treatment is equally effective for all patients and/or there is no subgroup difference; (2) the median value of the univariate scores as a cutoff may be inappropriate if the sizes of the 2 subgroups are differ substantially. We utilize a univariate composite score method to convert the set of patient's candidate biomarkers to a univariate response score. We propose applying the likelihood ratio test (LRT) to assess homogeneity of the sampled patients to address the first issue. In the context of identification of the subgroup of responders in adaptive design to demonstrate improvement of treatment efficacy (adaptive power), we suggest that subgroup selection is carried out if the LRT is significant. For the second issue, we utilize a likelihood‐based change‐point algorithm to find an optimal cutoff. Our simulation study shows that type I error generally is controlled, while the overall adaptive power to detect treatment effects sacrifices approximately 4.5% for the simulation designs considered by performing the LRT; furthermore, the change‐point algorithm outperforms the median cutoff considerably when the subgroup sizes differ substantially.     

Response‐adaptive designs for binary responses: How to offer patient benefit while being robust to time trends?

Response‐adaptive randomisation (RAR) can considerably improve the chances of a successful treatment outcome for patients in a clinical trial by skewing the allocation probability towards better performing treatments as data accumulates. There is considerable interest in using RAR designs in drug development for rare diseases, where traditional designs are not either feasible or ethically questionable. In this paper, we discuss and address a major criticism levelled at RAR: namely, type I error inflation due to an unknown time trend over the course of the trial. The most common cause of this phenomenon is changes in the characteristics of recruited patients—referred to as patient drift. This is a realistic concern for clinical trials in rare diseases due to their lengthly accrual rate. We compute the type I error inflation as a function of the time trend magnitude to determine in which contexts the problem is most exacerbated. We then assess the ability of different correction methods to preserve type I error in these contexts and their performance in terms of other operating characteristics, including patient benefit and power. We make recommendations as to which correction methods are most suitable in the rare disease context for several RAR rules, differentiating between the 2‐armed and the multi‐armed case. We further propose a RAR design for multi‐armed clinical trials, which is computationally efficient and robust to several time trends considered.     

Coercive controlling behaviors in intimate partner violence in male same-sex relationships:A mixed-methods study

Using mixed methods, we explored the role of coercive controlling behaviors in a high-risk sample of 126 men in violent same-sex relationships. Contrary to a prediction that separate factors of physical violence and coercive control might emerge, a simple principle components analysis supported that male same-sex relationship intimate partner violence (IPV) is essentially unidimensional. Qualitative narratives supported a single latent factor solution of violence, and that coercive controlling behaviors better detect IPV dynamics within the same violent encounters (i.e., weapon use), even when compared to profiles defined by physical violence. Narratives also highlighted gender-different tactics of coercion used, underscoring importance of context-based assessments.     

Testing the Effectiveness of Fundraiser Job Titles in Charitable Bequest and Complex Gift Planning

Traditional fundraiser job titles are often institution centered, focusing on the benefits of fundraising as “institutional advancement” or “institutional development.” Such institution‐centered job titles may not be as effective with donors given the modern shift toward donor‐centered philanthropy. Alternative job titles can be gift centered (for example, “major gifts”) or donor centered (for example, “donor advising”). A survey of 3,188 respondents tested sixty‐three job titles in four charitable scenarios: a charitable bequest gift, a gift of stock, a gift of real estate, and a charitable gift annuity. Measured by which person donors would be more likely to contact to discuss each donation, the worst‐performing titles were the traditional institution‐focused fundraiser job titles, in particular those using “advancement,” “institutional advancement,” or “development.” This was also true when examining only respondents who had made large gifts ($500+) to a charity. Traditional institution‐focused job titles are both the most commonly used and the worst performing. Nonprofit managers may do well to consider the donor's perspective when selecting job titles for fundraisers rather than following traditional industry practices.     

A population sample registry for public health survey investigations: methods,lessons, and successes

Public health relies on sample surveys to monitor the health of populations and investigate factors that contribute to population health and illness. Such investigations require surveying individuals who are selected in ways that support statistical inference to the population. Faced with rising costs and declining participation, survey researchers are exploring economical ways to recruit samples that validly represent larger populations. The current report describes an innovative resource, the Colorado Adult Population Sample–Survey Research Registry, which maintains survey access to respondents from a probability-based state health survey. We describe recruitment and retention strategies, explore representativeness, report several studies that used the registry, and discuss future directions.     

Social-ecological innovation: adaptive responses to urban environmental conditions

Novel approaches to natural resource management, particularly those which promote stakeholder participation, have been put forward as fundamental ingredients for establishing resilient, polycentric forms of environmental governance. This is nowhere more pertinent than in the case of the complex adaptive systems associated with urban areas. Decentralisation of urban green space management has been posited as an element thereof which, according to resilience thinking, should contribute to the adaptive capacity of cities and the ecosystem services upon which they rely. Implicit in this move towards increased adaptive capacity is the ability to manage through innovation. Although the importance of innovation towards system adaptability has been acknowledged, little work has thus far been carried out which demonstrates that innovative use of urban green space represents a form of adaptive response to environmental conditions. The current paper reports on research which maps examples of organised social-ecological innovation (OSEI) in an urban study area and evaluates them as adaptive responses to local environmental conditions which may contribute to system resilience. The results present OSEI as a coherent body of responses to local social and environmental deprivation, exhibiting diversity and adaptability according to individual contexts. The study therefore provides evidence for the importance of local stakeholder-led innovation as in the building of adaptive capacity in urban social-ecological systems.     

Therapeutic Responses to Domestic Violence in Australia: A History of Controversies

This paper reviews controversies about domestic violence occurring in heterosexual relationships discussed in the Australian context by practitioners and academics and published in the Australian & New Zealand Journal of Family Therapy over the past three decades. Controversies arose in relation to the provision of therapeutic interventions for domestic violence, primarily in individual and couple counselling and group programs. After a literature review, the following controversial issues are identified: (1) the role of patriarchy: Is a patriarchal culture the main cause of domestic violence? (2) Systemic family therapy and gendered violence: Does systemic family therapy hide men's responsibility for domestic violence? (3) Therapeutic and educational interventions for domestic violence: Does therapy turn a ‘crime’ into a ‘psychological problem’? (4) Men as victims: Do both men and women perpetrate domestic violence in equal measure? (5) It takes two to tango: What part do women play in eliciting men's violence?