Interim analyses and sequential designs in phase III studies

Recruitment of patients to a clinical trial usually occurs over a period of time, resulting in the steady accumulation of data throughout the trial's duration. Yet, according to traditional statistical methods, the sample size of the trial should be determined in advance, and data collected on all subjects before analysis proceeds. For ethical and economic reasons, the technique of sequential testing has been developed to enable the examination of data at a series of interim analyses. The aim is to stop recruitment to the study as soon as there is sufficient evidence to reach a firm conclusion. In this paper we present the advantages and disadvantages of conducting interim analyses in phase III clinical trials, together with the key steps to enable the successful implementation of sequential methods in this setting. Examples are given of completed trials, which have been carried out sequentially, and references to relevant literature and software are provided.

Evaluation of a cognitive behavior therapy program for people with sexual dysfunction

This article reports on an evaluation of a cognitive behavioral program for the treatment of sexual dysfunction. Frequency data are provided on the sexual dysfunction of 95 males (mean age = 41.6 years) and 105 females (mean age = 36.4 years). The effectiveness of a cognitive behavioral program among 45 sexually dysfunctional males (mean age = 39.9 years) and 54 sexually dysfunctional females (mean age = 36.2 years) was assessed. The results demonstrated that, after therapy, respondents experienced lower levels of sexual dysfunction, more positive attitudes toward sex, perceptions that sex was more enjoyable, fewer affected aspects of sexual dysfunction in their relationship, and a lower likelihood of perceiving themselves as a sexual failure. The implications of these findings for the treatment of sexual dysfunction are discussed.

Today's news tomorrow : researching archival television

Television may be the most pervasive medium of mass communication but, unlike the print media. Australian television news and current affairs have largely defied the efforts of researchers to mount comprehensive retrospective research into their form and content. This paper looks at the reasons for the dearth of this research. It considers the technical and the policy issues involved in preserving Australian television and argues that media researchers need to take a greater interest in the preservation of and access to archival television.

Technology student learning preferences and the design of flexible learning programs

The learning preferences of three hundred and thirty eight technology students enrolled in sub-degree programs at an Australian institution of Technical and Further Education were tested using the Canfield Learning Styles Inventory (CLSI). The results have been interpreted in a learning preferences framework and provide supportive evidence for the preferences factors of print-nonprint, collaborative, dependent,and autonomous learning identified by Sadler-Smith & Riding (1999). Although there search focussed on learning preferences the analysis also indicated support for the Wholist-Analytic cognitive style proposed by Riding & Cheema (1991). Gender differences were shown for the Interest subscales of the CLSI. Age-group differences were shown for several Conditions of Learning and Modes of Learning subscales. Implications for the design of training programs, and the skills that may need to be developed in technology learners to enable effective use of flexible delivery, are also discussed.

Effects of message framing on breast-cancer-related beliefs and behaviours: the role of mediating factors

The effects of gain-loss message framing on breast-cancer-related cognitions and behaviors were assessed among 539 women aged 30 to 70 years. The design involved a prebrochure telephone interview, followed by a brochure mailout, and a postbrochure telephone interview. The brochures contained information about breast cancer and the risk of family history. Recommended behaviors were framed to emphasize gains, losses, or were neutral; and statistical risk information was presented either positively or negatively. Measures included demographics, family history, breast self-examination (BSE) performance, BSE intention, self-efficacy in performing BSE, perceived early detection risk of breast cancer, perceived susceptibility to breast cancer, and anxiety about breast cancer. A loss-framed message led to greater positive change in BSE behavior. Interactions between framing effects and variables of issue involvement, perceived early detection risk, and self-efficacy indicated effects on behavior, but not beliefs.

Comparing alternate teaching styles to teach computing skills to girls in their English classes

Low female participation rates in computing are a current concern of the education sector. To address this problem an intervention was developed — computing skills were introduced to girls in their English classes using three different teaching styles: peer tutoring, cross-age tutoring and teacher instruction (control). The sample comprised 136 girls from Years 8 and 10 from a single-sex government school. A pre-test post-test quantitative design was used. To describe the students perspectives, qualitative data were collected from six focus groups conducted with 8–10 students — one from each of the six classes. It was predicted that cross-age tutoring would yield more positive effects than peer tutoring which, in turn, would yield more positive effects than traditional teacher instruction as assessed by achievement on class tasks and attitudes towards computing. The hypothesis was not supported by the quantitative analysis, however in the qualitative data cross-age tutoring was appraised more favourably than peer tutoring or teacher instruction. The latter was the least preferred condition due to: (1) inefficiency; (2) difficulty understanding teachers' explanations; and (3) lack of teacher knowledge. Problems with the implementation of the intervention identified in the focus groups were teacher differences, system failures, missed classes, lack of communication, and selection of computing activities. Practical suggestions were provided relevant to the introduction of cross-age tutoring and the use of computers within secondary level English classes.

Self-interest and ideology : bureaucratic corruption in Vietnam

Remedies for corruption in socialist-transforming East Asia (China and Vietnam) primarily apply ‘public choice’ theory, invoking Weberian imagery of socially detached bureaucratic decision-making. However, as the episodes of corruption accumulate, it is becoming clear that existing legalistic conceptions of corruption must give way to analytical methods that take into account broader social and institutional perspectives. This article evaluates public choice theory by examining ideological explanations for bureaucratic corruption in Vietnam.

Judgement, decision, and integrity

Although Aristotle did not mention it, integrity can be understood in an Aristotelian framework. Seeing it in these terms will show that it is an executive virtue which concerns the existential well being of an agent. This analysis is not offered as an exegesis of Aristotle's text, but as an attempt to use an Aristotelian framework to understand a virtue deemed important today. This account will have the benefit of solving some problems relating to motivational internalism and, as such, will contribute to that recent current of thought which has been highlighting the importance of virtue thinking in moral theory. I will distinguish moral judgement from decision and show that moral judgement is dependent upon virtue more strongly than it is upon impartial rationality. I will suggest that integrity is the virtue to which moral judgement gives expression and is the virtue which links judgement to decision so as to overcome akrasia.

Menopausal stage and age and perceptions of body image

The aim of This study was to investigate the association between menopausal stage and age and women's perception of their body image. Females from a community sample (n = 304. age range from 35 to 65 years) volunteered to complete a structured questionnaire which contained the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the Stunkard Body Shape Figure Scale. One hundred and twenty women were premenopausal, 76 women were perimenopausal and 108 were postmenopausal. The effects of age and menopausal stage could not be separated in ratings of appearance evaluation, fitness evaluation, current, ideal and societal ratings of the Stunkard Body Shape Figure Scale. Premenopausal women (who were likely to be younger) had more positive ratings of appearance evaluation and fitness evaluation than menopausal women (who were likely to be older). Women who were premenopausal nominated smaller figures from the Stunkard Body Shape Figure Scale for ratings of the current, ideal and societal body shape than women who were perimenopausal and postmenopausal. The implications of these findings as they relate to women as they progress through the menopausal transition and as they become older is discussed.