The Wildcard Workbook: A Practical Guide to Jokering Forum Theatre -- An Introduction and Background

This is a short article introducing the Wildcard Workbook, and the journey we took to translate our understanding of the core ethics of Theatre of the Oppressed into a resource for all kinds of facilitators. In our years of practice, we wished for a book we couldn’t yet find: a truly accessible, visual, and interactive guide that could prepare us to work with a community in real-time. That was the spark for the book, and the values of the project grew from there. In this essay, we reflect on our collaboration process, and on the ways this book may be useful for our fellow practitioners. The Wildcard Workbook: A Practical Guide for Jokering Forum Theatre is a resource for facilitators of all kinds looking for new ways to bring fun, creativity, and critical thinking into their work! Why Wildcard? Because to be a “Joker” in the Theatre of the Oppressed is to play many different roles and to navigate uncertainty with joy. Written by experienced Jokers from Theatre of the Oppressed NYC (TONYC), this workbook is a graphic, interactive, and accessible guide to inspire and support facilitation and difficultation in many contexts

Natural variation in chemosensation: Lessons from an island nematode

All organisms must interact with their environment, responding in behavioral, chemical, and other ways to various stimuli throughout their life cycles. Characterizing traits that directly represent an organism's ability to sense and react to their environment provides useful insight into the evolution of life-history strategies. One such trait for the nematode Pristionchus pacificus, chemosensation, is involved in navigation to beetle hosts. Essential for the survival of the nematode, chemosensory behavior may be subject to variation as nematodes discriminate among chemical cues to complete their life cycle. We examine this hypothesis using natural isolates of P. pacificus from La Réunion Island. We select strains from a variety of La Réunion beetle hosts and geographic locations and examine their chemoattraction response toward organic compounds, beetle washes, and live beetles. We find that nematodes show significant differences in their response to various chemicals and are able to chemotax to live beetles in a novel assay. Further, strains can discriminate among different cues, showing more similar responses toward beetle washes than to organic compounds in cluster analyses. However, we find that variance in chemoattraction response is not significantly associated with temperature, location, or beetle host. Rather, strains show a more concerted response toward compounds they most likely directly encounter in the wild. We suggest that divergence in odor-guided behavior in P. pacificus may therefore have an important ecological component

Reflection on modern methods: Calculating a sample size for a repeatability sub-study to correct for measurement error in a single continuous exposure

Using a continuous exposure variable that is measured with random error in a univariable linear regression model leads to regression dilution bias: the observed association between the exposure and outcome is smaller than it would be if the true value of the exposure could be used. A repeatability sub-study, where a sample of study participants have their data measured again, can be used to correct for this bias. It is important to perform a sample size calculation for such a sub-study, to ensure that correction factors can be estimated with sufficient precision. We describe how a previously published method can be used to calculate the sample size from the anticipated size of the correction factor and its desired precision, and demonstrate this approach using the example of the cross-sectional studies conducted as part of the International Project on Cardiovascular Disease in Russia study. We also provide correction factors calculated from repeat data from the UK Biobank study, which can be used to help plan future repeatability studies

Increasing the Availability of Psychological Treatments: A Multinational Study of a Scalable Method for Training Therapists.

BACKGROUND: One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. A highly scalable form of Web-centered therapist training, undertaken without external support, has recently been shown to have promise in promoting therapist competence. OBJECTIVE: The aim of this study was to conduct an evaluation of the acceptability and effectiveness of a scalable independent form of Web-centered training in a multinational sample of therapists and investigate the characteristics of those most likely to benefit. METHODS: A cohort of eligible therapists was recruited internationally and offered access to Web-centered training in enhanced cognitive behavioral therapy, a multicomponent, evidence-based, psychological treatment for any form of eating disorder. No external support was provided during training. Therapist competence was assessed using a validated competence measure before training and after 20 weeks. RESULTS: A total of 806 therapists from 33 different countries expressed interest in the study, and 765 (94.9%) completed a pretraining assessment. The median number of training modules completed was 15 out of a possible 18 (interquartile range, IQR: 4-18), and 87.9% (531/604) reported that they treated at least one patient during training as recommended. Median pretraining competence score was 7 (IQR: 5-10, range: 0-19; N=765), and following training, it was 12 (IQR: 9-15, range: 0-20; N=577). The expected change in competence scores from pretraining to posttraining was 3.5 (95% CI 3.1-3.8; P<.001). After training, 52% (300/574) of therapists with complete competence data met or exceeded the competence threshold, and 45% (95% CI 41-50) of those who had not met this threshold before training did so after training. Compliance with training predicted both an increase in competence scores and meeting or exceeding the competence threshold. Expected change in competence score increased for each extra training module completed (0.19, 95% CI 0.13-0.25), and those who treated a suitable patient during training had an expected change in competence score 1.2 (95% CI 0.4-2.1) points higher than those who did not. Similarly, there was an association between meeting the competence threshold after training and the number of modules completed (odds ratio, OR=1.11, 95% CI 1.07-1.15), and treating at least one patient during training was associated with competence after training (OR=2.2, 95% CI 1.2-4.1). CONCLUSIONS: Independent Web-centered training can successfully train large numbers of therapists dispersed across a wide geographical area. This finding is of importance because the availability of a highly scalable method of training potentially increases the number of people who might receive effective psychological treatments

Applying the estimands framework to non-inferiority trials: guidance on choice of hypothetical estimands for non-adherence and comparison of estimation methods

A common concern in non-inferiority (NI) trials is that non adherence due, for example, to poor study conduct can make treatment arms artificially similar. Because intention to treat analyses can be anti-conservative in this situation, per protocol analyses are sometimes recommended. However, such advice does not consider the estimands framework, nor the risk of bias from per protocol analyses. We therefore sought to update the above guidance using the estimands framework, and compare estimators to improve on the performance of per protocol analyses. We argue the main threat to validity of NI trials is the occurrence of trial specific intercurrent events (IEs), that is, IEs which occur in a trial setting, but would not occur in practice. To guard against erroneous conclusions of non inferiority, we suggest an estimand using a hypothetical strategy for trial specific IEs should be employed, with handling of other non trial specific IEs chosen based on clinical considerations. We provide an overview of estimators that could be used to estimate a hypothetical estimand, including inverse probability weighting (IPW), and two instrumental variable approaches (one using an informative Bayesian prior on the effect of standard treatment, and one using a treatment by covariate interaction as an instrument). We compare them, using simulation in the setting of all or nothing compliance in two active treatment arms, and conclude both IPW and the instrumental variable method using a Bayesian prior are potentially useful approaches, with the choice between them depending on which assumptions are most plausible for a given trial