”Potato seeking rice”: language, culture, and identity in gay personal ads in Hong Kong

This paper examines the relationship between language, culture, and identity in a corpus of gay personal ads collected from two publications in Hong Kong in the three years before the 1997 transition of sovereignty. Gay personal ads are seen äs an "island of discourse," whose marginal nature is reflected in the use of language and in turn reflects issues of marginalization in the larger social context. Using Fairclough's (1992, 1993) three- dimensional model for critical discourse analysis, an attempt is made to uncover the relationship between text structure and issues ofpower/ideology in the society that produces the texts. On the level of text, it was found that structural components, particularly the degree of grammatical elaboration, differ according to the stated race or cultural background of the authors and their targets. On the level of discourse practice, authors were found to appropriate a variety of "voices"from the larger culture arena, the use of which amplifies or limits the participation of particular classes of individuals. Finally, on the level of social practice, the ads were found to reflect and re-create both the racial stereotypes and heterosexist ideology found in the dominant culture.

The Palaeolithic Rivers of Southwest Britain

The Palaeolithic Rivers of Southwest Britain (PRoSWeB) project synthesises the archaeological evidence for the Lower and Middle Palaeolithic occupation of south-west Britain (c. 500,000 - 40,000 BP), with a principal focus upon the archaeological and geological potential of the region's Middle Pleistocene fluvial environments. South-west Britain was defined as the region west of the headwaters of the Rivers Frome and Piddle and south-west of the River Avon.

Missing steps in a staircase: a qualitative study of the perspectives of key stakeholders on the use of adaptive designs in confirmatory trials

Background Despite the promising benefits of adaptive designs (ADs), their routine use, especially in confirmatory trials, is lagging behind the prominence given to them in the statistical literature. Much of the previous research to understand barriers and potential facilitators to the use of ADs has been driven from a pharmaceutical drug development perspective, with little focus on trials in the public sector. In this paper, we explore key stakeholders’ experiences, perceptions and views on barriers and facilitators to the use of ADs in publicly funded confirmatory trials. Methods Semi-structured, in-depth interviews of key stakeholders in clinical trials research (CTU directors, funding board and panel members, statisticians, regulators, chief investigators, data monitoring committee members and health economists) were conducted through telephone or face-to-face sessions, predominantly in the UK. We purposively selected participants sequentially to optimise maximum variation in views and experiences. We employed the framework approach to analyse the qualitative data. Results We interviewed 27 participants. We found some of the perceived barriers to be: lack of knowledge and experience coupled with paucity of case studies, lack of applied training, degree of reluctance to use ADs, lack of bridge funding and time to support design work, lack of statistical expertise, some anxiety about the impact of early trial stopping on researchers’ employment contracts, lack of understanding of acceptable scope of ADs and when ADs are appropriate, and statistical and practical complexities. Reluctance to use ADs seemed to be influenced by: therapeutic area, unfamiliarity, concerns about their robustness in decision-making and acceptability of findings to change practice, perceived complexities and proposed type of AD, among others. Conclusions There are still considerable multifaceted, individual and organisational obstacles to be addressed to improve uptake, and successful implementation of ADs when appropriate. Nevertheless, inferred positive change in attitudes and receptiveness towards the appropriate use of ADs by public funders are supportive and are a stepping stone for the future utilisation of ADs by researchers.

Cross-sector surveys assessing perceptions of key stakeholders towards barriers, concerns and facilitators to the appropriate use of adaptive designs in confirmatory trials

Background Appropriately conducted adaptive designs (ADs) offer many potential advantages over conventional trials. They make better use of accruing data, potentially saving time, trial participants, and limited resources compared to conventional, fixed sample size designs. However, one can argue that ADs are not implemented as often as they should be, particularly in publicly funded confirmatory trials. This study explored barriers, concerns, and potential facilitators to the appropriate use of ADs in confirmatory trials among key stakeholders. Methods We conducted three cross-sectional, online parallel surveys between November 2014 and January 2015. The surveys were based upon findings drawn from in-depth interviews of key research stakeholders, predominantly in the UK, and targeted Clinical Trials Units (CTUs), public funders, and private sector organisations. Response rates were as follows: 30(55 %) UK CTUs, 17(68 %) private sector, and 86(41 %) public funders. A Rating Scale Model was used to rank barriers and concerns in order of perceived importance for prioritisation. Results Top-ranked barriers included the lack of bridge funding accessible to UK CTUs to support the design of ADs, limited practical implementation knowledge, preference for traditional mainstream designs, difficulties in marketing ADs to key stakeholders, time constraints to support ADs relative to competing priorities, lack of applied training, and insufficient access to case studies of undertaken ADs to facilitate practical learning and successful implementation. Associated practical complexities and inadequate data management infrastructure to support ADs were reported as more pronounced in the private sector. For funders of public research, the inadequate description of the rationale, scope, and decision-making criteria to guide the planned AD in grant proposals by researchers were all viewed as major obstacles. Conclusions There are still persistent and important perceptions of individual and organisational obstacles hampering the use of ADs in confirmatory trials research. Stakeholder perceptions about barriers are largely consistent across sectors, with a few exceptions that reflect differences in organisations’ funding structures, experiences and characterisation of study interventions. Most barriers appear connected to a lack of practical implementation knowledge and applied training, and limited access to case studies to facilitate practical learning. Keywords: Adaptive designs; flexible designs; barriers; surveys; confirmatory trials; Phase 3; clinical trials; early stopping; interim analyses

Marketing the Damaged Self: The Construction of Identity in Advertisements Directed Towards People with HIV/AIDS

This paper explores the identities projected in advertisements directed towards HIV positive individuals and people with AIDS. Fifty such advertisements were collected from three popular American magazines for gay men over a period of seven months. Analysis of the ads reveals a paradoxical presentation of people with HIV/AIDS, which offers simultaneous conflicting images of hope and fear, power and weakness, innocence and guilt. An interactive sociolinguistic model through which this contradictory discourse might be understood is presented, drawing on Goffman’s insights on stigma management and the presentation of the self in social interaction. Advertisements directed towards people with HIV/AIDS, it is suggested, present a contradictory discourse in which the advertisers are positioned as ‘the wise’, offering to mediate the conflicting identities of the stigmatized. The identity values enacted in this contradictory discourse are further measured against American conceptions of communication and the self as observed by Carbaugh and others. The possible consequences of these positionings on the roles made available to people with HIV/AIDS in the wider social context are discussed.