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

Too much information? : Drama teachers’ perceptions of the value of subject knowledge

This paper reports on research into what drama teachers consider they really need to know as drama specialists. In the first instance the very concept of knowledge is discussed as it pertains to education in the arts as is the current situation in England regarding the extent to which new drama teachers’ subject specialist knowledge has been formally accredited and what the implications of this may be to an evolving curriculum. The research itself initially involved using a questionnaire to investigate the way in which drama teachers prioritised different aspects of professional knowledge. Results of this survey were deemed surprising enough to warrant further investigation through the use of interviews and a multiple-sorting exercise which revealed why the participants prioritised in the way they did. Informed by the work of Bourdieu, Foucault and Kelly, a model is proposed which may help explain the tensions experienced by drama teachers as they try to balance and prioritise different aspects of professional knowledge.

Domestically produced food: Consumer perceptions of origin, safety and the issue of trust

It is becoming increasingly difficult for the public to attempt to assess risks using traditional methods such as smell, taste or other physical attributes of food. The existence of extrinsic cues such as the country of origin (COO) of food can help to make food purchase decisions easier for consumers. However, the use of extrinsic cues depends heavily on the extent to which consumers trust such signals to be indicative of quality or safety, which in turn depends on the credibility behind that cue. This paper aims to examine consumers association of domestically produced food with increased food safety standards and the association of COO and food safety information with socio-demographics and other aspects of consumer psychology such as attitudes, risk perception and trust. Using an ordered probit model, domestic production is examined as an extrinsic cue for food safety by looking at the relationship with trust in food safety information provided by national food standards agencies (NFSAs) and other socio-demographic characteristics, based on nationally representative data from 2725 face-to-face interviews across five European countries. Results suggest that domestic production of food is an extrinsic cue for food safety and as consumers place increasing importance on food safety they are more interested in food produced in their own country. This, coupled with consumer trust in a strong, and independent national food standards agency, suggests the potential exists for the increased consumption of domestically produced foods.

Cost-sharing of agricultural technology transfer in Nigeria: perceptions of farmers and extension professionals

Cost-sharing, which involves government-farmer partnership in the funding of agricultural extension service, is one of the reforms aimed at achieving sustainable funding for extension systems. This study examined the perceptions of farmers and extension professionals on this reform agenda in Nigeria. The study was carried out in six geopolitical zones of Nigeria. A multi-stage random sampling technique was applied in the selection of respondents. A sample size of 268 farmers and 272 Agricultural Development Programme (ADP) extension professionals participated in the study. Both descriptive and inferential statistics were used in analysing the data generated from this research. The results show that majority of farmers (80.6%) and extension professionals (85.7%) had favourable perceptions towards cost-sharing. Furthermore, the overall difference in their perceptions was not significant (t =0.03). The study concludes that the strong favourable perception held by the respondents is a pointer towards acceptance of the reform. It therefore recommends that government, extension administrators and policymakers should design and formulate effective strategies and regulations for the introduction and use of cost-sharing as an alternative approach to financing agricultural technology transfer in Nigeria.

The cell wall and secretory proteome of a tobacco cell line synthesising secondary wall

The utility of plant secondary cell wall biomass for industrial and biofuel purposes depends upon improving cellulose amount, availability and extractability. The possibility of engineering such biomass requires much more knowledge of the genes and proteins involved in the synthesis, modification and assembly of cellulose, lignin and xylans. Proteomic data are essential to aid gene annotation and understanding of polymer biosynthesis. Comparative proteomes were determined for secondary walls of stem xylem and transgenic xylogenic cells of tobacco and detected peroxidase, cellulase, chitinase, pectinesterase and a number of defence/cell death related proteins, but not marker proteins of primary walls such as xyloglucan endotransglycosidase and expansins. Only the corresponding detergent soluble proteome of secretory microsomes from the xylogenic cultured cells, subjected to ion-exchange chromatography, could be determined accurately since, xylem-specific membrane yields were of poor quality from stem tissue. Among the 109 proteins analysed, many of the protein markers of the ER such as BiP, HSP70, calreticulin and calnexin were identified, together with some of the biosynthetic enzymes and associated polypeptides involved in polymer synthesis. However 53% of these endomembrane proteins failed identification despite the use of two different MS methods, leaving considerable possibilities for future identification of novel proteins involved in secondary wall polymer synthesis once full genomic data are available.

Water reuse for irrigation in Jordan: perceptions of water quality among farmers

The reuse of treated wastewater (reclaimed water) for irrigation is a valuable strategy to maximise available water resources, but the often marginal quality of the water can present agricultural challenges. Semi-structured interviews were held with Jordanian farmers to explore how they perceive the quality of reclaimed water. Of the 11 farmers interviewed who irrigate with reclaimed water directly near treatment plants, 10 described reclaimed water either positively or neutrally. In contrast, 27 of the 39 farmers who use reclaimed water indirectly, after it is blended with fresh water, viewed the resource negatively, although 23 of the indirect reuse farmers also recognised the nutrient benefits. Farmer perception of reclaimed water may be a function of its quality, but consideration should also be given to farmers’ capacity to manage the agricultural challenges associated with reclaimed water (salinity, irrigation system damage, marketing of produce), their actual and perceived capacity to control where and when reclaimed water is used, and their capacity to influence the quality of the water delivered to the farm.

Consumer perceptions of poultry meat: a qualitative analysis

Consumer studies of meat have tended to use quantitative methodologies providing a wealth of statistically malleable information, but little in-depth insight into consumer perceptions of meat. The aim of the present study was therefore, to understand factors perceived important in the selection of chicken meat, using qualitative methodology. Focus group discussions were tape recorded, transcribed verbatim and content analysed for major themes. Themes arising implied that “appearance” and “convenience” were the most important determinants of choice of chicken meat and these factors appeared to be associated with perceptions of freshness, healthiness, product versatility and concepts of value. A descriptive model has been developed to illustrate the interrelationship between factors affecting chicken meat choice. This study indicates that those involved in the production and retailing of chicken products should concentrate upon product appearance and convenience as market drivers for their products.

Visualizing probabilistic flood forecast information: expert preferences and perceptions of best practice in uncertainty communication

The aim of this article is to improve the communication of the probabilistic flood forecasts generated by hydrological ensemble prediction systems (HEPS) by understanding perceptions of different methods of visualizing probabilistic forecast information. This study focuses on interexpert communication and accounts for differences in visualization requirements based on the information content necessary for individual users. The perceptions of the expert group addressed in this study are important because they are the designers and primary users of existing HEPS. Nevertheless, they have sometimes resisted the release of uncertainty information to the general public because of doubts about whether it can be successfully communicated in ways that would be readily understood to nonexperts. In this article, we explore the strengths and weaknesses of existing HEPS visualization methods and thereby formulate some wider recommendations about the best practice for HEPS visualization and communication. We suggest that specific training on probabilistic forecasting would foster use of probabilistic forecasts with a wider range of applications. The result of a case study exercise showed that there is no overarching agreement between experts on how to display probabilistic forecasts and what they consider the essential information that should accompany plots and diagrams. In this article, we propose a list of minimum properties that, if consistently displayed with probabilistic forecasts, would make the products more easily understandable. Copyright © 2012 John Wiley & Sons, Ltd.

Cancer patients taking herbal medicines: a review of clinical purposes, associated factors, and perceptions of benefit or harm

Ethnopharmacological relevance: Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. Materials and methods: the international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. Results: Medline yielded 5,638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. Conclusions: Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.

Using the Technology Acceptance Model to explore community dwelling older adults’ perceptions of a 3D interior design application to facilitate pre-discharge home adaptations

Background In the UK occupational therapy pre-discharge home visits are routinely carried out as a means of facilitating safe transfer from the hospital to home. Whilst they are an integral part of practice, there is little evidence to demonstrate they have a positive outcome on the discharge process. Current issues for patients are around the speed of home visits and the lack of shared decision making in the process, resulting in less than 50 % of the specialist equipment installed actually being used by patients on follow-up. To improve practice there is an urgent need to examine other ways of conducting home visits to facilitate safe discharge. We believe that Computerised 3D Interior Design Applications (CIDAs) could be a means to support more efficient, effective and collaborative practice. A previous study explored practitioners perceptions of using CIDAs; however it is important to ascertain older adult’s views about the usability of technology and to compare findings. This study explores the perceptions of community dwelling older adults with regards to adopting and using CIDAs as an assistive tool for the home adaptations process. Methods Ten community dwelling older adults participated in individual interactive task-focused usability sessions with a customised CIDA, utilising the think-aloud protocol and individual semi-structured interviews. Template analysis was used to carry out both deductive and inductive analysis of the think-aloud and interview data. Initially, a deductive stance was adopted, using the three pre-determined high-level themes of the technology acceptance model (TAM): Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Actual Use (AU). Inductive template analysis was then carried out on the data within these themes, from which a number of sub-thmes emerged. Results Regarding PU, participants believed CIDAs served as a useful visual tool and saw clear potential to facilitate shared understanding and partnership in care delivery. For PEOU, participants were able to create 3D home environments however a number of usability issues must still be addressed. The AU theme revealed the most likely usage scenario would be collaborative involving both patient and practitioner, as many participants did not feel confident or see sufficient value in using the application autonomously. Conclusions This research found that older adults perceived that CIDAs were likely to serve as a valuable tool which facilitates and enhances levels of patient/practitioner collaboration and empowerment. Older adults also suggested a redesign of the interface so that less sophisticated dexterity and motor functions are required. However, older adults were not confident, or did not see sufficient value in using the application autonomously. Future research is needed to further customise the CIDA software, in line with the outcomes of this study, and to explore the potential of collaborative application patient/practitioner-based deployment.

Perceptions of the impacts of genetically modified cotton varieties: a case study of the cotton industry in Gujarat, India

The paper reports the findings of a study designed to consider the impact of the adoption of Bt cotton on markets, businesses, and institutional arrangements in India. Given that evidence to date suggests that widespread adoption of Bt cotton by farmers is likely to increase production, this study aims to assess possible implications for markets (access to inputs, prices of inputs and outputs, etc.) and local industries and to identify potential winners and losers. The results suggest that there are impacts on the cotton industry following from the release of Bt hybrids, and so far the impacts are most noticeable "upstream" (i.e., the input suppliers), where companies are rapidly moving away from the sale of bollworm insecticide and attempting to sell Bt seeds. Seed companies are looking for partnerships with Monsanto, the owner of the Bt gene. One reason that companies are keen to move away from insecticide is so they can avoid the need for credit supply to their customers. Seed purchase is not normally through credit, whereas insecticide purchase is. Issues for companies "downstream" (gins, textile manufacturers) relate more to the better quality of Bt cotton and the need for adequate segregation of Bt and non-Bt cotton.

Interdisciplinarity: perceptions of the value of computer-supported collaborative work in design for the built environment

This paper presents the findings from a study into the current exploitation of computer-supported collaborative working (CSCW) in design for the built environment in the UK. The research is based on responses to a web-based questionnaire. Members of various professions, including civil engineers, architects, building services engineers, and quantity surveyors, were invited to complete the questionnaire. The responses reveal important trends in the breadth and size of project teams at the same time as new pressures are emerging regarding team integration and efficiency. The findings suggest that while CSCW systems may improve project management (e.g., via project documentation) and the exchange of information between team members, it has yet to significantly support those activities that characterize integrated collaborative working between disparate specialists. The authors conclude by combining the findings with a wider discussion of the application of CSCW to design activity-appealing for CSCW to go beyond multidisciplinary working to achieve interdisciplinary working.