Early stopping in seamless phase I/II clinical trials

In recent years, seamless phase I/II clinical trials have drawn much attention, as they consider both toxicity and efficacy endpoints in finding an optimal dose (OD). Engaging an appropriate number of patients in a trial is a challenging task. This paper attempts a dynamic stopping rule to save resources in phase I/II trials. That is, the stopping rule aims to save patients from unnecessary toxic or subtherapeutic doses. We allow a trial to stop early when widths of the confidence intervals for the dose-response parameters become narrower or when the sample size is equal to a predefined size, whichever comes first. The simulation study of dose-response scenarios in various settings demonstrates that the proposed stopping rule can engage an appropriate number of patients. Therefore, we suggest its use in clinical trials.     

Deterred by debt? Young people,schools and the escalating cost of UK higher education

Popular commentaries lament that reforms to the financing of Higher Education (HE) in the UK will operate as a significant deterrent to HE participation amongst students from less advantaged backgrounds. This view of debt as a deterrent is powerful and exists not only at a societal level, but also, as we show, is present in schools. Our data reveal, however, that these ‘debt commentaries’ play out very differently across schools according to the nature of their catchment and the sorts of views staff hold about pupils in relation to their fear of debt. Furthermore, students’ views on debt largely contradict these popular ‘debt-as-deterrent’ narratives and instead are often characterised by acceptance, ambivalence and at times positive orientations towards the prospect of debt. These findings vividly illuminate both the regional and institutional specificity of staff and student decision making in relation to ‘debt’, hence they have substantial implications for HE funding policy specifically and debates about widening participation in HE more generally, where ensuring greater equity in the scope of choices young people have when it comes to choosing a university is a pressing concern.     

Promoting sustainable development through civil society: A case study of the EU’s NSA/LA thematic programme in Kyrgyzstan

The article focuses on the contribution of the European Union (EU) in promoting sustainable development through the involvement of civil society in partner countries. More specifically, it analyses the main features and outcomes of the projects implemented by civil society organizations (CSOs) in Kyrgyzstan under the EU thematic programme Non‐State Actors and Local Authorities in Development (NSA/LA). Despite its importance—this is the only EU programme providing direct support to non‐state actors and local authorities engaged in poverty reduction—to date, there has been very little research on the functioning of this instrument on the ground. This article seeks to fill this gap in the literature by examining the EU’s contribution to sustainable development through a case study on Kyrgyzstan. The study is based on primary data: 10 semi‐structured interviews conducted with the EU‐funded organizations implementing the NSA/LA programme. The NSA/LA projects were analysed by considering two major fields of engagement of non‐state actors in the development process: as service providers and as advocates (Banks & Hulme, 2012). Overall, the organizations awarded EU support were not only focused on fulfilling short‐term needs but also sought to introduce new ways of dealing with poverty and inequality, positioning themselves between the “Big‐D” and the “little‐d” approaches to development (Bebbington, Hickey, & Mitlin, 2008). Nonetheless, the EU‐funded projects were too limited and fragmented to be able to sustain long‐term structural change. Therefore, the EU should place new emphasis on creating synergies between new and old structures at the grassroots level and establishing mechanisms and bodies that could merge and co‐ordinate their efforts. In addition, the calls for proposals could highlight the need to share the lessons learnt by “obliging” the beneficiaries to act as multipliers and to pass on their positive experience to neighbouring communities. Finally, the EU could stimulate the funded organizations to experiment with innovative mechanisms of involvement in the policy‐making process, by making this aspect a mandatory requirement of the projects implemented with its support.     

American Indian/Alaska Native Elders: A Growing Demographic that Is Changing How We View Aging

Today, AIAN Elders are more actively engaged in their families and communities, encouraging the development of intergenerational programs, language and cultural revitalization, being stewards in research conducted in their communities, as well passing on their knowledge and experiences on how to live as healthy Native people. Elders have traditionally been quiet and observant of their environment, but the current and future cohorts of Elders are advocates, leaders, and culture bearers for their families and communities and they are now in positions of leadership. Western society acknowledges the value of traditional knowledge and AIAN Elders are viewed as exemplars of healthy aging and their lessons and experiences can be attributed to our own lives. This commentary highlights the paradigm shift in how society views older adults, specifically AIAN Elders and their role in health and wellbeing.     

Demographic and Social Factors Associated with Homophobia and Fear of AIDS in a Community Sample

Examinations of demographic and social factors associated with homophobia and fear of AIDS are limited by the frequent use of homogeneous, college student samples and limited examination of interrelationships among variables. The present study examined community attitudes toward homosexuality and fear of HIV/AIDS as a function of age, education, race/ethnicity, religious affiliation, political party affiliation, and personal contact with homosexual individuals and persons living with HIV/AIDS. A community sample of 463 adults completed standardized measures of homophobia and fear of AIDS as well as demographic and social background items. When examined separately, each demographic and social factor assessed, with the exception of race/ethnicity, was associated with homophobia and all but race/ethnicity and political party affiliation were associated with fear of AIDS. However, when entered into multiple regression analyses, 24% of the variance in homophobia was predicted by a single variable, including only personal contact with homosexual individuals, while 18% of the variance in fear of AIDS was accounted for by five variables, including personal contact with homosexual individuals, religious affiliation, political affiliation, education, and personal contact with someone living with HIV/AIDS. Findings suggest that it is important to consider intercorrelations among social and demographic factors, particularly when considering homophobia.     

Family Background and the Process of Ability Formation*

This paper takes a sociometric approach to the process of skills formation in children as they mature into adults. Honda suggests that meaningful communication with family as a child is the determining factor that raises those abilities (ability β ¹ ) that fall outside of scholastic aptitude – motivation, personal relations skills, personality, and emotions. Along with considering the results of Honda's thesis, I have constructed an operating hypothetic model that includes two additional factors: the financial state of the family during childhood, and the transition of the communication target from within the family to a target outside the family. The data for this investigation were then verified. From the results, the direct effect of the observed family communication, when isolated from other influencing variables in the formation of abilities β, is not as decisive a factor as Honda emphasized. It was clear that the financial status of the family played a role, as did the indirect results of the intermediary shift from communication within the family to outside the family (the process of children becoming socially independent). The results of this analysis show that we should not necessarily be looking for the decisive factors of abilities β within the family; if anything, it reflects the existence of a formative route for abilities β that capitalizes on the resources outside the family. Based on the above, the results also show the potential for the introduction of social intervention to address the disparity and inequality in skills formation, and the possible anticipation of more rationality in the overblown discourse surrounding the role of the family in facilitating educational ability.     

The cost‐effectiveness of UK parenting programmes for preventing children's behaviour problems – a review of the evidence

Parenting programmes are widely used in the UK, promoted in policy documents as a cost‐effective way for children's services to address behaviour problems and thereby the longer‐term costs associated with conduct disorders, particularly antisocial behaviour and criminality. To explore whether these programmes are a cost‐effective component of family intervention, this paper examines evidence from cost‐effectiveness studies based on randomized controlled trials, modelling studies estimating longer‐term costs and outcomes, and studies estimating costs of UK parenting programmes, including evidence from routine practice. Findings indicate that parenting programmes have the potential to be cost‐saving in the long term; however, gaps in the evidence include: lack of follow‐up of families who drop out of programmes, absence of control groups in longer‐term follow‐ups, and little information about costs and effects of programmes in routine practice. The size of savings resulting from implementation of effective parenting programmes will depend on the extent to which families likely to be most costly to society attend and experience lasting benefit.     

赫斯和青年马克思的人道思想对比

赫斯和马克思是生长在同一个时代和社会背景下有着相近思想兴趣的两个人,因为都有着对当时社会中人类苦难的特别关注与极度怜悯,而有了寻找苦难根源及寻求改变当时人类苦难之良方的志向,他们一生都在为人类的解放而奋斗;可以说"人道问题意识"是他们心头共同的用一生的行动探寻和思索的问题意识。如果再追问他们是如何探寻"人道问题"的,则发现他们一直在试图克服"受苦者的目光",即试图解决人的个体存在与类存在之间的矛盾。     

Thinking about biology and culture: can the natural and human sciences be integrated?

Genomic analyses have shown that only 1.2 per cent of the genome is devoted to protein coding sequences (the most commonly invoked definition of genes), and that much of the remaining sequences are employed in regulation – that is, in responding to signals, first, from the immediate environment of the DNA, but ultimately from the distal environment – from the cytoplasm, from the environment outside the cell, and finally, from the environment beyond the organism. Such signals are not restricted to the simple physical and chemical stimuli that impinge directly on the DNA, on the surface of the cell, or even on the body as a whole: organisms with central nervous systems have receptors for forms of perception that are not only more complex but far longer range. Humans have especially sophisticated perceptual capacities, enabling them to respond to a wide range of complex visual, auditory, linguistic and behavioural/emotional signals in their extended environment. Research has recently begun to show that responses to such signals can extend all the way down to the level of gene expression. The question is this: to what extent are we witnessing (at last) a rapprochement between the natural science of biology and the human sciences of sociology and anthropology, and to what extent do the new promises of synthesis merely reflect an expansion of older reductionist aims, threatening once again to marginalize rather than incorporate the insights of cultural analysis? As in my earlier discussion of the nature/nurture debate (2010), my focus will be restricted to the Anglo-American context.