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     

New Zealand Vietnam Veterans’ Family Programme,Nga Whanau a Tu (Families of War): Development and Outcome

This article reviews recent research concerned with the association between combat-related posttraumatic stress disorder (PTSD) and interpersonal functioning, before describing the development of a pilot program established to provide mental health services for Vietnam veteran family members. The results of a brief program evaluation are also presented. Sixty clients provided posttreatment and six-month follow-up data on a variety of outcome measures which were compared with independent ratings returned by 33 therapists. On average, clients reported that counselling had been beneficial and indicated satisfaction with services received. However, at posttest, therapists indicated that approximately 50% of clients were in need of continued treatment. There was a decrease in satisfaction with services over the posttest-follow-up period, but no change on most measures of psychotherapy outcome.     

Doubling vs. Constant Bets as Strategies for Gambling

Some gamblers use a doubling strategy as a way of improving their chances of coming home a winner. This paper reports on the results of a computer simulation study of the doubling strategy and compares the short term and long term results of doubling to gambling with a constant sized bet. In the short term players using a doubling strategy were more likely to win, then lose, however in the long term, the losses suffered by doublers were much greater than that suffered by constant bettors. It is argued that the use of a doubling strategy is related to an incomplete conceptualization of random events sometimes known as the law of averages. A second simulation examined the fate of doubling in an ideal world in which the law of averages was actually true. In this ideal world, doublers were much better off than constant bettors. The relationship of the results to a naive conceptualization of random events is discussed.     

Most valuable stakeholders: The impact of employee orientation on corporate financial performance

In sports, the most valuable player award goes to the individual or group of players who have contributed most to the success of the team. This paper presents the results of two Australian empirical studies conducted six years apart, which suggest that, in business, employees are the most valuable stakeholder group. In particular, we find evidence to support the proposition that employee orientation contributes more to corporate financial performance (CFP) than orientation towards any other individual primary stakeholder group, including customers, communities, suppliers and shareholders. These findings have practical implications for corporate level strategy and the prioritization of budgetary resources by communication managers. From a theoretical perspective, the paper contributes to the debate on the best way to conceptualize employee orientation.     

The state of Australian public relations: Professionalisation and paradox

It is almost a decade since the last empirical study of Australian public relations appeared in the academic literature. This paper reports on a survey conducted immediately prior to the onset of the global financial crisis aimed at revealing the state of public relations in Australia. In particular, the study investigated levels of professionalisation in terms of such criteria as the strategic orientation of public relations, its position within organisational hierarchies, and the importance placed on ethics and professional development. The findings show Australian PR professionals to be highly educated, comparatively well paid and frequently in positions of influence with their CEOs. Paradoxically despite these strengths, the profession in Australia does not seem to have outgrown public relations’ pervasive identity crisis.     

Personal resilience and identity capital among young people leaving care: enhancing identity formation and life chances through involvement in volunteering and social action

This study explored identity capital and personal resilience among care leavers and young people in care engaging in social activities through volunteering. Care leavers and young people in care are disadvantaged developmentally by lack of identity resources and an accelerated transition to independence. This study analysed material from semi-structured interviews to explore the Identity Capital Model and theories of individualisation, agentic identity development and resilience in explaining the identity resources of young people transitioning out of care. The analysis identified links between the exploration opportunities of volunteering with the development of agentic individualisation and enhanced identity capital. The findings indicate that developmental processes may be enhanced through supported and personalised volunteering opportunities to aid vulnerable young people transitioning out of care. Young people leaving care can make substantial gains particularly in social capital, personal resilience and identity capital. This study indicates that volunteering opportunities for this group of vulnerable young people may assist in compensating for the lack of resources often experienced by care leavers when transitioning to adulthood.     

Developing family-based care: complexities in implementing the UN Guidelines for the Alternative Care of Children

In response to immense challenges facing children in out-of-home care in all parts of the world, there is a growing international trend towards the development of family-based placements for children in out-of-home care, away from large-scale institutions. This development of family-based care within a range of care options is recommended within the international Guidelines for the Alternative Care of Children (the Guidelines), which were welcomed unanimously by the United Nations General Assembly in 2009. This paper offers an overview of these guidelines’ key principles, and considers the complexities that arise in efforts towards their implementation. Drawing on the literature, supported by research that informed Moving forward (the implementation handbook on the Guidelines) and illustrated by practice examples from across global regions, the authors examine three fundamental challenges in States’ efforts to implement the Guidelines’ ‘suitability’ principle, namely: de-institutionalising the care system; financing suitable family-based care and supporting the suitability of kinship care. The paper critically reflects on de-institutionalised systems and practices, and the cross-cultural assumptions about suitable foster and kinship care that emerge in efforts towards de-institutionalisation; it aims to spark new thinking on strategic ways in which alternative care is planned and delivered, to impact on future practice.