An application of a multi‐stage strategy involving confidence intervals to evaluate whether a response rate is favourable or not

In early clinical development of new medicines, a single‐arm study with a limited number of patients is often used to provide a preliminary assessment of a response rate. A multi‐stage design may be indicated, especially when the first stage should only include very few patients so as to enable rapid identification of an ineffective drug. We used decision rules based on several types of nominal confidence intervals to evaluate a three‐stage design for a study that includes at most 30 patients. For each decision rule, we used exact binomial calculations to determine the probability of continuing to further stages as well as to evaluate Type I and Type II error rates. Examples are provided to illustrate the methods for evaluating alternative decision rules and to provide guidance on how to extend the methods to situations with modifications to the number of stages or number of patients per stage in the study design. Copyright © 2004 John Wiley & Sons, Ltd.     

Majority Rules? The Effects of School Ethnic Composition on Substance Use by Mexican Heritage Adolescents

This article examines key aspects of the school environment - its composition by ethnicity and acculturation - as important social contexts for understanding Mexican immigrant and Mexican American adolescents' drug use norms and behaviors. Results are presented based on surveys completed by Mexican-background students from 35 Phoenix. Arizona middle schools, whose enrollment ranged from a numerical minority to an overwhelming majority. Multivariate mixed models tested for the influence of school ethnic composition measures on substance use outcomes, while accounting for individual level predictors and for the nesting of data at the school level. The proportional representation of Latinos in the school was not a factor in an individual's drug use norms or drug use for the sample overall. Once students were broken down by acculturation status, however, ethnic composition had an effect. Less acculturated Mexican heritage students in schools with higher proportions of Latino students reported less substance use and less adherence to pro-drug norms. Further investigation using other measures of ethnic composition suggested that these effects were attributable to the larger presence of less acculturated Latinos in the school rather than more acculturated Latino students. These school-level effects support the individual-level results indicating that less acculturated Mexican American students face less daunting substance use risks. The results suggest that ethnic group size, but not necessarily numerical predominance, matters and that within-group differences influence the effect of a particular ethnic group's presence in the school. In other words, the majority does not always rule. These findings are interpreted using the concepts of segmented assimilation and school level social capital.     

Dignified Joking: Humor and Demeanor in a Public Speaking Club*

An investigation was made of the joking that occurs during meetings of a club which gathers weekly to practice public speaking. In this setting, humor is expected as part of a good speaking performance. It is assumed that the use of humor can establish rapport with an audience and aid in persuasion. This paper describes how such joking must be managed to avoid both a potential disintegration of the club's focused gathering and an undermining of the face-work involved in doing public speaking.     

Social and psychological exclusion

The New Deal for Lone Parents is one policy in the UK which aims to reduce benefit dependency and enable lone parents to opt into a scheme which offers help and advice on jobs, benefits, training and childcare with the hope of improving job readiness. In tandem with this scheme there exists a myriad of community intervention initiatives whose aim may not be as explicit, but whose value can be equally empowering in raising self-awareness and self-esteem. This study examines the experiences of lone parents who participate in such schemes and contrasts this with the experiences of those who do not. The study shows that community-based schemes may not offer the best option for all lone mothers, but can provide an effective staging post for some towards a position of job readiness.

Poverty and social exclusion affect many different aspects of people's lives. They exist when people are denied opportunities to work, to learn, to live healthy, active and fulfilling lives …

Department of Social Security, September 1999, p. 3     

Beliefs, death, anxiety, denial, and treatment preferences in end-of-life care: a comparison of social work students, community residents, and medical students

This study examined cultural and religious beliefs, death anxiety, denial, and medical treatment preferences in end-of-life care in a sample of social work students, community residents, and medical students in a mid-western city of 49,000. Results indicated that most social work students, community residents, and medical students preferred palliative as opposed to life-prolonging care during terminal illness. The three groups differed in cultural and religious beliefs and all three reported a moderate amount of death anxiety. Students reported less denial of terminality than community residents. Implications for personal and professional preparation to provide end-of-life care are discussed.     

A study of coping: Successful recovery from severe burnout and other reactions to severe work-related stress

This is a qualitative study of the situational determinants of coping with severe reactions to work-related stress, including burnout. The successful resolution of the crisis caused by an incapacity to work due to physical and emotional exhaustion is documented in an exploratory study of broad coping processes and specific strategies involved. Subjects were recruited from a large territory (the province of Quebec in Canada). Comparative analysis of the accounts of the 20 human service workers and 16 other professionals led to the identification of a common process typified by six consecutive stages: admitting the problem, distancing from work, restoring health, questioning values, exploring work possibilities and making objective changes. The recovery process is long and takes from 1 to 3 years. The ultimate strategy utilized by most of the subjects was to change their objectivc working conditions. Various strategies for identity reinforcement (seeking reassurance, understanding causes, seeking support) were observed in addition to the stages. Three-fifths of the subjects resorted to formal psychotherapy in the first sample. The recovery process appears to be of a psychosocial nature. This characteristic may render it sensitive to social context; although it has been observed in two samples, it would require testing in different working conditions and different countries.     

Home-based workers: Worker and work characteristics

The purpose of the study reported here is to describe the worker and work characteristics of 899 home-based business owners and wage earners, using a definition that excludes farmers, hobbyists, and persons taking work home from a job located elsewhere. Contrary to predictions by futurists of an influx of white-collar workers from the office to home, the home-based workers in this research are more likely to be marketing and sales persons, contractors, or mechanical and transportation workers. Full- or part-time employment status, home tenure, seasonality of work, and occupation are significantly associated with ownership status. Findings show significant group differences on age, education, years in the community, household size, and net annual home-based income. Business owners, on average, are older, have less education, come from larger households, have lived in their communities more years, and have lower net annual home-based incomes than their wage earner counterparts.This article reports results from the Cooperative Regional Research Project, NE-167, entitled, At-Home Income Generation: Impact on Management, Productivity and Stability in Rural and Urban Families, partially supported by Cooperative States Research Service, U.S. Department of Agriculture and the Experiment Stations at the University of Hawaii, Iowa State University, Lincoln University (Missouri), Michigan State University, Cornell University (New York), The Ohio State University, The Pennsylvania State University, Utah State University, and University of Vermont. Appreciation is expressed to Ana Marie Vargas and Johnny M. H. On for their assistance with the computer analyses, and to Florence Abe, Laraine Hoffman, and Meesok Lee for their help in the final preparation of this article. The authors acknowledge the patience and helpful suggestions of two anonymous reviewers.Her current research interests include home-based employment, multiple farm income families, and computer-based education. She received her Ph.D. from Oregon State University.Her current research interests include home-based employment, economic adjustments of farm families, and the interrelationship of management to an individual's quality of life. She received her Ph.D. from Purdue University.Her primary areas of research are rural households, the impact of employment on a family, learning theories as applied to financial education, retirement, and home-based employment. She received her Ph.D. from The Pennsylvania State University.     

Complex demoeconomic dynamics

We show how various kinds of qualitative long run demoeconomic behavior depend on household preferences, productivity and the cost of childrearing. In particular, a dominant trend in growth can be interspersed with periods of fluctuation as slowly moving changes in productivity, preference and child care costs push nonlinearities past crucial bifurcation points. Moreover, nonperiodic, essentially unpredictable demoeconomic behavior is robust, thus suggesting a possible explanation for persistent and substantial errors in population forecasts.[/p]A partial draft of the present paper was first presented at the annual meetings of the Population Association of America, San Francisco, April 3, 1986. The computer experiments were performed by Changseob Kim and Weihong Huang.