An adaptive seamless phase II/III design for oncology trials with subpopulation selection using correlated survival endpoints

Although the statistical methods enabling efficient adaptive seamless designs are increasingly well established, it is important to continue to use the endpoints and specifications that best suit the therapy area and stage of development concerned when conducting such a trial. Approaches exist that allow adaptive designs to continue seamlessly either in a subpopulation of patients or in the whole population on the basis of data obtained from the first stage of a phase II/III design: our proposed design adds extra flexibility by also allowing the trial to continue in all patients but with both the subgroup and the full population as co-primary populations. Further, methodology is presented which controls the Type-I error rate at less than 2.5% when the phase II and III endpoints are different but correlated time-to-event endpoints. The operating characteristics of the design are described along with a discussion of the practical aspects in an oncology setting.     

Humility: Our Current Understanding of the Construct and its Role in Organizations

Since 2000, researchers and practitioners have shown increased interest in humility. This construct has been studied in disciplines ranging from organizational behaviour to positive psychology, culminating in a wealth of information that can now be analysed and reviewed through the lens of humility in organizations. This review begins by reflecting on existing conceptualizations of humility and presenting a summary of findings that reflects a greater consensus in definitional work than some researchers may realize. It then considers the progress that has been made in measuring humility by specifying key measurement strategies. It next synthesizes existing empirical findings on humility to illuminate the uniqueness of the construct. It also shows that researchers have focused on studying dependent variables that exist at multiple organizational levels and that largely comprise pro‐social and relational variables, emotional well‐being, and learning and performance outcomes. The paper concludes with recommendations for future research.     

Screening for recommended antenatal risk factors: How long does it take?

Background

Detection and management of antenatal risk factors is critical for quality care.

A Cross-National Analysis of Lifespan Inequality, 1950–2015: Examining the Distribution of Mortality Within Countries

Cross-national health research devotes considerable attention to lifespan and survival rate disparities that are found between countries. However, the distribution of mortality across the world is shaped mostly by what happens within countries. We address this striking gap in the literature by modeling length-of-life inequality for individual nation-states. We use life tables from the United Nation’s (2015) World Population Prospects to estimate inequality levels for 200 countries across 13 waves between 1950 and 2015. We find that lifespan inequality is steadily declining across the world, but that each country’s level of inequality, and the rate at which it declines, vary considerably. Our models account for more than 90% of the longitudinal and cross-sectional variation in country-level lifespan inequality during the 1990–2015 period. Maternal mortality is the strongest predictor in our model, while disease prevalence, access to safe water, and health interventions figure prominently, as well. Gross domestic product per capita shows the expected curvilinear association with lifespan inequality, while primary education (both overall enrollment and gender equity in enrollment), external debt, and migration also play critical roles in shaping health outcomes. By contrast, the distribution of political and economic resources (i.e., democracy and income inequality) is less important.

     

Older lesbian sexuality: identity, sexual behavior, and the impact of aging

In response to the very limited and mostly outdated literature on older lesbian sexuality, this exploratory study examined older lesbian sexual identity, romantic relationships, the impact of aging, and experiences of discrimination within these contexts. Utilizing an online survey that recruited via numerous online lesbian communities and snowball sampling, 456 lesbians over the age of 50 responded to closed, Likert scale, and open-ended questions that provided a preliminary understanding of older lesbian sexuality. The results indicated that older lesbians have experienced fluidity in past romantic and sexual relationships, as well as in erotic fantasies, despite strong identification with being lesbian. The findings also indicate a decreased focus on sexuality in the context of relationships, with more focus on stability and continuity. Future research is needed that provides greater specificity and detail about older lesbian conceptions of sexual behavior and sexual identity labels, as well as specific sexual behaviors.     

Childhood family structure and schooling outcomes: evidence for Germany

We analyze the impact on schooling outcomes of growing up in a non-intact family in Germany. We find that this experience is associated with worse outcomes according to estimates from models that do not control for possible correlations between common unobserved determinants of family structure and educational performance. Evidence of adverse effects emerges also when endogeneity is accounted for. In such cases, however, the point estimates are typically smaller, and their confidence intervals are large enough to include zero, particularly for individuals who grew up in Western Germany.     

Gympie’s country music Muster: Creating a cultural economy from a local tradition

This paper provides an historical analysis of the National Country Music Muster, a country music festival held in a forest outside of Gympie, a town in rural southeast Queensland, Australia, between the period 1982 and 2006 (the first twenty-five years of the event). This article analyses the origins of the Muster, demonstrating how local events are often developed as a result of regional traditions and assets, or ‘countryside capital’ (Garrod et al., 2006). While this countryside capital was used to develop the Muster, this paper will demonstrate the event created its own capital, which the Gympie community has then utilised. The Muster has enabled the development of community capacity in three key ways: community not-for-profit groups have received increased income through participation as volunteers at the Muster; collaborative efforts between groups have developed senses of community on site; and the Muster has fostered social capital development by encouraging volunteer groups to work on site, all of which, of course, ensures the Muster continues to operate. Additionally, the Muster has provided the impetus for the creation of two country music focused cultural institutions in Gympie, as well as several spin-off events, which seek to capitalise on the increased traffic through town during the Muster period. Each of these institutions and spin off events has helped embed country music within Gympie’s cultural economy. Further, they provide a clear demonstration of a rural community actively and creatively deploying its cultural capital in order both to buttress itself against fluctuations in the town’s fortunes and to assert a locally relevant country identity.     

Towards Sustainability in Australian Social Work Field Education

The educational framework of Australian social work field education has remained static over the past few decades. Emerging challenges are creating a compelling case for change. These include increasing demand for placements, declining capacity of organisations to provide placement requirements, reduction in practitioners’ incentives and capacity to support student placements and to facilitate a work integrated learning context, and an interrelated web of policies and regulations that constrain adaptation to these changes. In a critical exploration of multiple levels of regulation and policy contexts, we argue that conventional approaches to social work field education are not sustainable given significant changes to the funding arrangements for universities and within the welfare service system. To futureproof integrative learning in social work, we advocate transformation of educational culture, policies, and design toward sustainability.

IMPLICATIONS

• Supervised placements are designed to integrate practice and academic learning but their future use as the single means for achieving this integration will be unsustainable.

• Drawing on an ecological orientation enables social work educators to position sustainability as a key consideration and response to current constraints in higher education and the field.

• Focusing on sustainability across policy, practice, and regulation contexts has potential to generate transformative change that enhances our effectiveness in futureproofing the design of integrative learning in social work.