Post-trial Evaluation Research Articles

Caractéristiques sociodémographiques, psychopathologiques et criminologiques de femmes auteurs d’infraction sexuelle

IntroductionSince 2000, the phenomenon of female sexual offenders has been more and more studied in many countries, although it has been minimized for a long time. This population seems to present specific characteristics, different from those of male sexual offenders. ObjectivesStudying sociodemographic, psychopathological and criminological characteristics of a French population of female sexual offenders. Material and methodsThis study is descriptive and retrospective. The first author collected data from a database made of 30 years of psychiatric assessments written by the second author for French courts. The material was created in order to respond to court's questions. The inclusion criteria was being a female sexual offender, according to a wide definition of sexual offending, including rapes, sexual assaults, sexual harassment, corruption of a minor, pimping, exhibitionism. No exclusion criteria were defined. The assessments could be made for pre-trial evaluation of the women or for post-trial evaluation during custody. The data were then collected thanks to a systematic analysis of listed sociodemographic characteristics, psychopathological characteristics and criminological characteristics. Sociodemographic characteristics included: age when the assessment was made and when the offending occurred, year of the assessment, date and place of birth, living department, sentence, level of education, working status, marital status, motherhood, number of children, separation of parents, relationship with the father during childhood, relationship with the mother during childhood, physical, emotional or sexual violence incurred during childhood, life-time history of sexual abuse. Psychopathological characteristics were composed of medical, chirurgical, gynaecological and psychiatric history. The psychiatric history was made of: outpatient follow-up, hospitalization, medical treatment, suicidal, addictive comorbidities, legal protection, allowance for adult disabilities. Criminological characteristics encompass the number of victims, their age, their gender, their link with the female sexual offender, the frequency of the assault, the presence of a co-offender, the level of implication of the female sexual offender. Expert's conclusions included presence of an acute mental trouble, accessibility to a sentence, abolished or altered discernment when it comes to pre-trail assessments. Post-trial assessment examined the presence of an acute mental trouble, implemented cares during custody, evolution of personality, recidivism risk, opportunity of a medial treatment order. Thirty-one cases of female sexual offenders were collected, 16 pre-trial assessment and 16 post-trial ones. Quantitative data were analysed by mean, minimum and maximum. Qualitative data were analysed by and percentage. Association between two qualitative data was led by Fisher exact test. Names were systematically removed from files. ResultsThe mean age of those 31 women is 37-years-old at expertise time and their educational level is low. Most of them are married, and have children (77.4%). They often describe a history of break-up and lack of stability as well as childhood violence or negligence (65.2%). An important number of those women has suffered or still suffers from psychiatric trouble, mostly mood disorders or personality disorder such as dependant personality (12.9% and 48.4%) or cluster-B personalities (32.3%). Yet, those troubles seldom led to an abolishment of discernment (12.5%). Altered discernment concerned more of these women (18.8%). Most of the time, their victims are juveniles and often are one of their children (67.7%). They often acted with a co-offender (57.1%), generally their husband or boyfriend (80%). The incarcerated women have been judged for numerous types of sexual infraction. Psychological and psychiatric cares have been implemented for all of them during their incarceration. A medical treatment order was recommended by the psychiatric expert most of the time in order to consolidate this work (68.8 %). ConclusionThis study raises the same specificities of this population as those found in other past studies, and highlights the important prevalence of chaotic, non-structuring or even traumatic life-pathways within this population.

Consistency checks to improve measurement with the Hamilton Rating Scale for Anxiety (HAM-A)

BackgroundMitigating rating inconsistency can improve measurement fidelity and detection of treatment response. MethodsThe International Society for CNS Clinical Trials and Methodology convened an expert Working Group that developed consistency checks for ratings of the Hamilton Anxiety Rating Scale (HAM-A) and Clinical Global Impression of Severity of anxiety (CGIS) that are widely used in studies of mood and anxiety disorders. Flags were applied to 40,349 HAM-A administrations from 15 clinical trials and to Monte Carlo-simulated data as a proxy for applying flags under conditions of inconsistency. ResultsThirty-three flags were derived these included logical consistency checks and statistical outlier-response pattern checks. Twenty-percent of the HAM-A administrations had at least one logical scoring inconsistency flag, 4 % had two or more. Twenty-six percent of the administrations had at least one statistical outlier flag and 11 % had two or more. Overall, 35 % of administrations had at least one flag of any type, 19 % had one and 16 % had 2 or more. Most of administrations in the Monte Carlo- simulated data raised multiple flags. LimitationsFlagged ratings may represent less-common presentations of administrations done correctly. Conclusions-Application of flags to clinical ratings may aid in detecting imprecise measurement. Flags can be used for monitoring of raters during an ongoing trial and as part of post-trial evaluation. Appling flags may improve reliability and validity of trial data.

Self-managed aged home care in Australia - Insights from older people, family carers and service providers.

This paper presents findings from the evaluation of an Australian trial of self‐managed home aged care. The self‐management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self‐management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self‐managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre‐test post‐test quasi‐experimental design and mixed‐methods design were used to collect data over nine months in 2018–2019. The pre‐trial methods and findings have been published. The post‐trial evaluation replicated the pre‐trial data collection method of an online survey (n = 60) and semi‐structured telephone interviews with consumers (n = 9), family carers (n = 13), and consumers and carers jointly (n = 2), totalling 24 interviews. Semi‐structured telephone interviews were also conducted with CEOs and senior managers from each of the seven providers (n = 14). Three providers had prior experience supporting self‐management. Parametric and non‐parametric tests examined the statistical data. Qualitative data were analysed thematically and framed according to self‐determination principles and ecological systems theory. Both datasets demonstrated that consumers reported greater choice and control at post‐trial than pre‐trial. This finding was not affected by providers' prior experience with self‐management; therefore, it was not a confounding factor. Participants reported improved wellbeing in interviews, however this was not reinforced statistically. Key desirable features of self‐management included greater autonomy and control over spending, recruiting support staff and paying lower administration fees. There was no evidence of increased risks or fraud. The research limitations included a small sample size, convenience sampling with providers recruiting interview participants, no control group and differences in trial implementation. The findings support the expansion of self‐management opportunities and more comprehensive evaluations that use mixed methods.

Process Evaluation of MAPS: A Highly Tailored Digital Intervention to Support Medication Adherence in Primary Care Setting.

Background: Medication adherence can prevent health risks, but many patients do not adhere to their prescribed treatment. Our recent trial found that a digital intervention was effective at improving medication adherence in non-adherent patients with Hypertension or Type 2 Diabetes; but we do not know how it brought about behavioural changes. This research is a post-trial process evaluation of the mechanism by which the intervention achieved its intended effects.Methods: A mixed methods design with quantitative and qualitative evidence synthesis was employed. Data was generated by two studies. Study 1 used questionnaires to measure the underlying mechanisms of and the medication adherence behaviour, and digital logfiles to objectively capture intervention effects on the process of behaviour change. Multilevel regression analysis on 57 complete intervention group cases tested the effects of the intervention at modifying the mechanism of behaviour change and in turn at improving medication adherence. Study 2 used in depth interviews with a subsample of 20 intervention patients, and eight practise nurses. Thematic analysis provided evidence about the overarching intervention functions and recommendations to improve intervention reach and impact in primary care.Results: Study 1 found that intervention effectiveness was significantly associated with positive changes in the underlying mechanisms of behaviour change (R2 = 0.26, SE = 0.98, P = 0.00); and this effect was heightened twofold when the tailored intervention content and reporting on medication taking (R2 = 0.59, SE = 0.74, P = 0.00) was interested into the regression model. Study 2 suggested that the intervention supported motivation and ability to adherence, although clinically meaningful effects would require very brief medication adherence risk appraisal and signposting to ongoing digitally delivered behavioural support during clinical consultations.Conclusion: This post trial process evaluation used objective methods to capture the intervention effect on the mechanisms of behaviour change to explain intervention effectiveness, and subjective accounts to explore the circumstances under which these effects were achieved. The results of this process evaluation will inform a large scale randomised controlled trial in primary care.

Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching

BackgroundHealth coaching is a patient-centred approach to supporting self-management for the chronic conditions. However, long-term evidence of effectiveness of health coaching remains scarce. The object of this study was to evaluate the long-term effect of telephone health coaching (THC) on mortality and morbidity among people with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF)..Methods1535 T2D, CAD and CHF patients with unmet treatment targets were randomly allocated into an intervention group (n = 1034) and control group (n = 501). Intervention group received monthly individual strength-based, autonomy supportive THC sessions (average 30 min) for behavior change with a specially trained nurse for 12 months additional to usual health care. Control group received usual health care services. The primary outcome was a composite of death from cardiovascular causes or non-fatal stroke or non-fatal myocardial infarction (AMI) or unstable angina pectoris (UAP) during a follow-up of 8 years Three other composite endpoints with distinct combinations of fatal and non-fatal cardiovascular events and death from any cause were used as secondary outcomes. Other outcomes followed were the most relevant components of the composite endpoints. Randomized controlled trial (RCT) data was linked to Finnish national health and social care registries and electronic health records (EHR). Post-trial eight-year evaluation was conducted using intention-to-treat (ITT) and per-protocol (PP) analysis.ResultsThe composite primary outcome event rate per 100 person years was lower in the intervention group (3.45) than in control group (3.88) in ITT -analysis, but the difference was not statistically significant (hazard ratio in the intervention group 0.87; 95% CI, 0.71 to 1.07; P = 0.19). In the subgroup (T2D, CAD/CHF) analysis, there were no statistically significant effects. The secondary PP-analysis showed statistically significant benefits for those who participated in the study.ConclusionsNo statistically significant effect of health coaching on mortality and morbidity was found in intention to treat analysis. The per protocol results suggest, however, that the intervention may be effective among patients who are willing and able to participate in health coaching. More research is needed to identify patients most likely to benefit from low-intensity health coaching.Trial registrationNCT00552903 (registration date: the 1st of November 2007, updated the 3rd of February 2009).

Clinical Effectiveness of an At-Home Auditory Training Program: A Randomized Controlled Trial.

To investigate the effectiveness of an at-home frequent-word auditory training procedure for use with older adults with impaired hearing wearing their own hearing aids. Prospective, double-blind placebo-controlled randomized trial with three parallel branches: an intervention group who received the at-home auditory training; an active control group who listened to audiobooks using a similar platform at home (placebo intervention); and a passive control group who wore hearing aids and returned for outcomes, but received no intervention. Outcome measures were obtained after a 5-week period. A mixed research design was used with a between-subjects factor of group and a repeated-measures factor of time (pre- and post-treatment) to evaluate the effects of the at-home auditory training program. The intervention was completed in participants' own homes. Baseline and outcomes measures were assessed at a university research laboratory. The participants were adults, aged 54 to 80 years, with the mild-to-moderate hearing loss. Of the 51 identified eligible participants, 45 enrolled as a volunteer sample and 43 of these completed the study. Frequent-word auditory training regimen completed intervention at home over a period of 5 weeks. The active control group listened to audiobooks (placebo intervention) and the passive control group completed no intervention. The primary outcome measure is a Connected Speech test benefit. The secondary outcome measure is a 66-item self-report profile of hearing aid performance. Participants who received the at-home training intervention demonstrated significant improvements on aided recognition for trained materials, but no generalization of these benefits to nontrained materials was seen. This was despite reasonably good compliance with the at-home training regimen and careful verification of hearing aid function throughout the trial. Based on follow-up post-trial evaluation, the benefits observed for trained materials in the intervention group were sustained for a period of at least 8.5 months. No improvement was seen for supplemental outcome measures of hearing aid satisfaction, hearing handicap, or tolerance of background noise while listening to speech. The at-home auditory training procedure utilizing frequently occurring words was effective for the trained materials used in the procedure. No generalization was seen to nontrained materials or to perceived benefit from hearing aids.

การพัฒนาระบบคิวอาร์โค้ดเพื่อป้ องกันอาชญากรรมสำหรับผู้โดยสารรถยนตร์ ับจ้าง (รถแท็กซี่) (Development of QR Code System to Prevent Crime for Taxi Passenger)

Thai Abstract: การวจยนมวตถประสงคเพอพฒนาและประเมนประสทธภาพของระบบควอารโคดเพอปองกนอาชญากรรมสาหรบผโดยสารรถยนตรบจาง (รถแทกซ) โดยตวอยางของการวจย คอ ผโดยสารรถยนตรบจาง (รถแทกซ) โดยแบงเปนกลมตวอยางขนาด 10 คน และกลมตวอยางภาคสนาม ขนาด 30 คน โดยวธการดาเนนการวจยและพฒนา 5 ขน ตอนไดแก 1)การตรวจสอบกรอบแนวความคดเชงทฤษฎ จากผทรงคณวฒ ทง3ดานไดแก ดานวจยและพฒนา ดานเทคโนโลยสารสนเทศ และดานอาชญาวทยา 2) ขน ตอนการสรางรายละเอยดระบบควอารโคดและคมอการใหความร 3)ขน ตอนการพฒนา 4) การทดลองนาระบบควอารโคดไปใชในกลมตวอยางและประเมนผล 5)การนาระบบควอารโคดไปทดลองใชในกลมตวอยางภาคสนาม พรอมทง ประเมนผล ผลการวจยพบวา ฐานขอมลตางๆ ของระบบควอารโคดทนาไปใชในกลมตวอยางมความสอดคลองกบทฤษฎการปองกนอาชญากรรม สามเหลยมอาชญากรรมและการปองกนอาชญากรรมเชงสถานการณ โดยทกฐานขอมลมผลการประเมน อยในระดบมากทสด รวมไปถงผลการนาระบบควอารโคดไปใชในภาคสนาม 30 คน โดยการประเมนผลกอนและหลงการทดลอง พบวา มความสอดคลองกบทฤษฎการปองกนอาชญากรรม สามเหลยมอาชญากรรมและการปองกนอาชญากรรมเชงสถานการณ ซงผลการประเมนกอนการใหความรพบวาทกฐานขอมลมผลการประเมนอยในระดบนอยทสด และหลงจากการใหความรและทดลองใชระบบควอารโคดพบวา ทกฐานขอมลมผลการประเมนอยในระดบมากทสด English Abstract: The purpose of this research was to develop and evaluate the efficiency of the QR code system for the prevention of crime for taxi passengers. The sample of the study was the taxi passengers which divided into 10 samples and 30 field samples by 5 steps of research and development: 1) Theoretical Framework Examination by 3 experts in research and development, information technology including criminology. 2) The process of creating the description of the QR code system and the knowledge guidelines. 3) The development procedure. 4) Experimental implementation of the QR code system for the sample and evaluation. 5) The implementation of the QR code system for field trial and evaluation. Result shows that; all database of the QR code system used in the sample is consistent with the crime prevention theory, Triangular crime and situational crime prevention. And all databases have evaluation results at the highest level. The results of the pre-test and post-trial evaluation were consistent with the anti-crime theories, Triangular crime and situational crime prevention which the results of the pre-knowledge assessment showed that all databases had the lowest level of evaluation. And after learning and experimenting with the QR code system, all databases have the highest rating.

Reducing alcohol-related harm in disadvantaged men: development and feasibility assessment of a brief intervention delivered by mobile telephone

AbstractBackgroundSocially disadvantaged men suffer substantial harm from heavy drinking. Brief alcohol interventions are effective in reducing consumption when delivered via health care. There is a need for tailored brief interventions for disadvantaged men who seldom attend health care.Objectives(1) To investigate the best ways to recruit and retain disadvantaged men in a study aimed at reducing the frequency of heavy drinking. (2) To identify the type of content and timing of the delivery that is most likely to engage disadvantaged young to middle-aged men in an intervention delivered by text messages. (3) To determine whether or not the intervention is likely to be an acceptable way to influence the frequency of heavy drinking.DesignA three-phase study involving the development of the recruitment strategy and the intervention, an assessment of the feasibility of a randomised controlled trial, and a post-study evaluation.SettingCommunity-based study, conducted in Dundee, UK.ParticipantsDisadvantaged men aged 25–44 years who had two or more episodes of heavy drinking (≥ 8 units in a single session) in the preceding month. Two recruitment strategies were employed: recruitment through general practice (GP) registers and recruitment through a community outreach strategy.InterventionsFocus groups explored drinking motives and behaviours of the target group. The intervention also drew on reviews of the literature on: alcohol brief interventions, text message studies, communication theory and behaviour change theories and techniques. The intervention group received 36 text messages with images sent over a 28-day period.Main outcome measuresThe outcome measures evaluated the likely success of a full trial: recruitment of the participants; construction and delivery of a theoretically and empirically based intervention that successfully engages disadvantaged men; potential for the intervention to influence binge drinking.ResultsThe focus group analyses identified that personal experience and knowledge of the harmful effects of alcohol was widespread. Furthermore, there was a discrepancy between frequent binge drinking and perceived social expectations and duties. This could usefully be targeted in the intervention. Theoretically and empirically based behaviour change strategies were successfully rendered in attractive, colourful, brief text messages. Both recruitment strategies (GP registers and community outreach) proved successful and a total of 67 men were recruited, exceeding the target of 60. The participants were at high risk of harm because of frequent episodes of heavy binge drinking. Baseline interviews established that those recruited through community outreach drank substantially more and had more frequent binge drinking sessions than those recruited through GP registers. Retention at follow-up was 96%. Extensive process evaluation was conducted. The evaluation showed that 95% of text messages were successfully delivered to participants' telephones. Furthermore, there was a high level of engagement with text messages which sought responses. Most men replied to these texts, often giving carefully structured personal responses. Analyses of the responses indicated a high level of engagement with key components of the behaviour change strategy. Post-trial evaluation showed high levels of satisfaction with the intervention.ConclusionsThis study has shown that disadvantaged men can be recruited and retained in an alcohol intervention trial. A theoretically and empirically based intervention was successfully delivered by text message. Furthermore, the messages were well received and elicited the types of response intended. A full trial of the intervention, incorporating a cost-effectiveness study, should be carried out.Study registrationThis study is registered as ISRCTN10515845.FundingThe National Institute for Health Research Public Health Research programme.

Randomised clinical trial: the effectiveness of Lactobacillus reuteri ATCC 55730 rectal enema in children with active distal ulcerative colitis

Intestinal microbiota manipulation, one of the pathogenetic components of inflammatory bowel disease (IBD), has become an attractive therapy for ulcerative colitis (UC). To assess in children with active distal UC the effectiveness of Lactobacillus (L) reuteri ATCC 55730 enema on inflammation and cytokine expression of rectal mucosa. A total of 40 patients (median age: 7.2 years range 6-18) with mild to moderate UC were enrolled in a prospective, randomised, placebo-controlled study. They received an enema solution containing 10(10) CFU of L. reuteri ATCC 55730 or placebo for 8 weeks, in addition to oral mesalazine. Clinical endoscopic and histological scores as well as rectal mucosal expression levels of IL-10, IL-1β, TNFα and IL-8 were evaluated at the beginning and at the end of the trial. Thirty-one patients accomplished the trial (17 males, median age 13 year, range 7-18). Mayo score (including clinical and endoscopic features) decreased significantly in the L. reuteri group (3.2 ± 1.3 vs. 8.6 ± 0.8, P < 0.01) compared with placebo (7.1 ± 1.1 vs. 8.7 ± 0.7, NS); furthermore, histological score significantly decrease only in the L. reuteri group (0.6 ± 0.5 vs. 4.5 ± 0.6, P < 0.01) (placebo: 2.9 ± 0.8 vs. 4.6 ± 0.6, NS). At the post-trial evaluation of cytokine mucosal expression levels, IL-10 significantly increased (P < 0.01) whereas IL-1β, TNFα and IL-8 significantly decreased (P < 0.01) only in the L. reuteri group. In children with active distal ulcerative colitis, rectal infusion of L. reuteri is effective in improving mucosal inflammation and changing mucosal expression levels of some cytokines involved in the mechanisms of inflammatory bowel disease.

Vocational rehabilitation services for patients with cancer: design of a feasibility study incorporating a pilot randomised controlled trial among women with breast cancer following surgery

BackgroundDue to improvements in cancer survival the number of people of working age living with cancer across Europe is likely to increase. UK governments have made commitments to reduce the number of working days lost to ill-health and to improve access to vocational rehabilitation (VR) services. Return to work for people with cancer has been identified as a priority. However, there are few services to support people to remain in or return to work after cancer and no associated trials to assess their impact. A pilot randomised controlled trial among women with breast cancer has been designed to assess the feasibility of a larger definitive trial of VR services for people with cancer.MethodsPatients are being recruited from three clinical sites in two Scottish National Health Service (NHS) Boards for 6 months. Eligible patients are all women who are: (1) aged between 18 and 65 years; (2) in paid employment or self-employed; (3) living or working in Lothian or Tayside, Scotland, UK; (4) diagnosed with an invasive breast cancer tumour; (5) treated first with surgery. Patients are randomly allocated to receive referral to a VR service or usual care, which involves no formal employment support. The primary outcome measure is self-reported sickness absence in the first 6 months following surgery. Secondary outcome measures include changes in quality of life (FACT-B), fatigue (FACIT-Fatigue) and employment status between baseline and 6- and 12-months post-surgery. A post-trial evaluation will be conducted to assess the acceptability of the intervention among participants and the feasibility of a larger, more definitive, trial with patients with lung and prostate cancer.DiscussionTo our knowledge this is the first study to determine the feasibility of a randomised controlled trial of the effectiveness of VR services to enable people with cancer to remain in or return to employment. The study will provide evidence to assess the relevance and feasibility of a larger future trial involving patients with breast, prostate or lung cancer and inform the development of appropriate VR services for people living with cancer.Trial RegistrationISRCTN: ISRCTN29666484Registration date: 07/10/10; Randomisation of first patient: 03/12/10

P0129 PP NUTRITIONAL THERAPY ALONE WITH A POLYMERIC DIET (MODULEN) IS MORE EFFECTIVE THAN CORTICOSTEROIDS IN INDUCING HEALING OF INTESTINAL MUCOSAL LESIONS IN ACTIVE CROHN???S DISEASE

Introduction: Therapy of active Crohn’s disease (CD) should be aimed at obtaining clinical remission, improving quality of life and healing gut inflammatory lesions. The latter is a critical factor to provide a long term remission. Traditional treatment for active pediatric CD includes corticosteroids or nutritional therapy alone; however, very few studies have compared the two treatment regimens taking into account inflammatory lesions of the gut as documented by endoscopy and histology. Aim of the study was to compare the efficacy of an oral polymeric diet (Modulen), rich in transforming growth factor beta2, versus oral corticosteroids in inducing clinical and inflammatory remission in children with a newly diagnosed or relapsed CD. Methods: Thirty-two patients (pts) were enrolled in a 10 week randomized study: 17 received the polymeric diet alone, 15 were treated with methylprednisolone (1.6 mg/kg/day for 4 weeks, followed by gradual tapering) and azathioprine. Pre-and post-trial evaluation in all pts included PCDAI, ileo-colonoscopy with histology, bioumoral parameters. Endoscopy and histology scores were measured according to methods previously published. Clinical remission was defined by a PCDAI <10, and inflammatory remission as a decrease in both endoscopic and histological scores for > 50 % when compared to baseline. Patients were evaluated by physicians unaware of the therapeutic allocation. Results: There was dramatic improvement in PCDAI both in nutritional group (pre, 37.91±10.32; post, 6.58±5.35, p<0.01) and steroid group (pre, 36.72±8.27; post, 8.72±5.33, p<0.01); however, endoscopic and histologic score significantly decreased only in the nutritional group (endoscopy; pre, 3.58±0.51; post, 1.66±0.49, p<0.01; histology; pre, 10.41±1.72; post, 3.41±0.99, p<0.01), whereas no significantly change occurred in the steroid group (endoscopy; pre, 3.54±0.52; post, 2.69±0.30, NS; histology; pre, 11.09±1.75; post, 8.50±1.54, NS). Inflammatory remission was obtained in 14 pts of nutritional group (82.35%) and only in 6 pts on steroids (40%) (X2: 7.93; p<0.01). Conclusion: In children with active CD, nutritional treatment alone with an oral polymeric diet is efficacious as an oral corti-costeroid course in inducing clinical remission; however, only nutritional therapy is able to promote healing of gut inflammatory lesions as shown by endoscopy and histology. Nutritional therapy alone should be the treatment of choice in children with active CD and can be viewed as a disease-modifying therapy due to mucosal healing properties.

Cognitive response involvement model of the process of product evaluation through advertising exposure and trial

A model is proposed of the effect of advertising exposure and trial upon product evaluation from a cognitive response perspective. LISREL VI was utilized to test the hypothetical model under conditions that vary in terms of the degree of advertising content processing involvement. The results reveal that across involvement conditions, different cognitions intervene between disconfirmation and posttrial evaluation. That is, under higher involvement conditions, counterargumentation shows a negative linkage to posttrial evaluation, whereas under relatively lower involvement, support argumentation is directly linked to posttrial evaluation. Moreover, ad exposure proved to be more influential in the formation of product evaluation in the higher involvement condition.

Moderating disconfirmation of expectations through the use of two-sided appeals: A longitudinal approach

This study utilizes a longitudinal approach to investigate the effects of agradual versus a more dramatic increase in prior consumer expectations on post-trial evaluation and purchase intention through subjects' exposure to a one-sided or two-sided refutational appeal.The results show that (1) the two-sided refutational appeal resulted in higher product evaluations and intention ratings after trial relative to the one-sided appeal for all experimental conditions; and (2) the two-sided appeal moderates consumer disconfirmation and an observed contrast effect when expectations are increased gradually. For these reasons, increased use of two-sided refutational appeals by advertisers is recommended.

Adapting the jury trial for program evaluation: A report of an experience

A portion of the graduate program in clinical community psychology at SUNY Buffalo was subjected to a jury trial as a form of program evaluation. The theory of the trial as evaluation, the problems of implementation, and a posttrial evaluation are discussed. The trial, while time-consuming, especially in its pretrial phases, has the potential for presenting a dramatic picture of a program through the medium of human testimony. The jury was able to arrive at clear decisions on questions put to it, with a high degree of confidence. Decision makers accepted some of the jury's conclusions, and subjective evidence suggests that many of the controversial issues which generated the trial were resolved for the group by the procedure. The posttrial evaluation revealed limitations, such as evidence which was not presented at the trial. The experience proved useful for purposes of interdisciplinary education, providing another lens through which the evaluation problem could be viewed.