The importance of cross‐disciplinary scientific engagement in the development of quantitative procedures for aggregate safety assessments

Recent guidance on safety monitoring during drug development, issued by regulatory authorities in the United States and European Union, indicate a shift in focus towards aggregate safety monitoring and scientific evaluation of integrated safety data. The call for program‐level reviews of accumulating safety data, including from ongoing studies, provides an opportunity to leverage the scientific expertise and medical judgment of safety management teams with (a) a multidisciplinary approach, (b) quantitative frameworks to measure level of evidence, and (c) assessments that are product‐specific and driven by medical judgment. A multidisciplinary team, regularly reviewing aggregate safety data throughout the development program, is vital not only for early signal detection but also for generating a better understanding of the accumulating data and context needed for decreasing false alarms.     

Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Power play: the use of space to control and signify power in the workplace

ABSTRACT

The findings of this article emerge from an eight-month study examining career identity practices amongst a select group of fitness professionals in the U.K. We examine how the inter-relationship between physical and social space can denote how power is acquired, displayed, and used by individuals interacting in a shared space. The findings show that power is signified through spatial practices as individuals negotiate through triadic space, creating an identity of space and place for both trainer and client that identifies power, and signifies who has power. Fitness professionals with high levels of symbolic power are able to subvert organizational spatial norms to better serve themselves and their clients, while those with lower levels of symbolic power are forced to, or choose to, negotiate or abdicate space to others. These findings are relevant to a wide range of occupations where self-employment and contract workers interact in shared space.     

Compulsory income management: Combatting or compounding the underlying causes of homelessness?

Compulsory Income Management (CIM) is a form of conditional welfare that involves the mandatory quarantining of a portion of welfare recipients’ social security payments. Quarantined funds are accessible via a government-issued debit card, with restrictions surrounding where and on what funds can be spent. Official justifications of CIM have framed these policies as attempts to combat substance abuse and gambling problems, and to thus secure better outcomes for welfare recipients and their families. Central to this narrative has been the argument that welfare quarantining will ensure more money is spent on ‘essentials’, including accommodation. No existing studies, however, have specifically interrogated the impacts of CIM on housing security. This article responds to this gap in the literature by reviewing existing research concerning CIM's impacts and locating this research within broader debates regarding the causes of homelessness and the efficacy of individualised policy interventions. In doing so, it highlights CIM's potential to exacerbate housing insecurity not only through technical issues such as rental transfer failures, but also by contributing to underlying stressors such as economic disadvantage; relationship difficulties, poor health and addiction; and social stigma. The article concludes that – far from addressing the structural causes of homelessness – CIM has enflamed them.     

Social Return on Investment for Good Foot Delivery

This article provides reflections on a social return on investment (SROI) research process with Good Foot Delivery, a work integration social enterprise in Toronto, Canada, engaged in package delivery and employing people with developmental challenges. The article has three aims: (1) to assess Good Foot's key business inputs, activities, and outputs, and the social impact that these have had on its key stakeholders for the 2013 calendar year; (2) to critically reflect on how the research team arrived at the SROI’s inputs, outputs, outcomes, proxies, and other findings; and (3) to discuss some of the strengths and challenges of the SROI process in practice.     

Resolving mobility constraints impeding rural seniors' access to regionalized services

Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.     

Simultaneous confidence band for the difference of segmented linear models

Consider comparing between two treatments a response variable, whose expectation depends on the value of a continuous covariate in some nonlinear fashion. We fit separate segmented linear models to each treatment to approximate the nonlinear relationship. For this setting, we provide a simultaneous confidence band for the difference between treatments of the expected value functions. The treatments are said to differ significantly on intervals of the covariate where the simultaneous confidence band does not contain zero. We consider segmented linear models where the locations of the changepoints are both known and unknown. The band is obtained from asymptotic results.     

Impact of the National Minimum Wage on Disabled People

The survey reported here found disparities in the impact of the introduction of the National Minimum Wage on disabled people. These were associated with age, gender, impairment and type of employment setting. The main determinant of whether individuals gained from the NMW was their status as claimants of welfare benefits. We also found evidence that paid hours had been reduced to implement the NMW with no net increase in earnings, possibly to enable people to retain benefits entitlements. We make recommendations about how the anomalies can be tackled. It may be unrealistic to expect the Act to have been implemented fully so soon after it became law and some of the anomalies found may eventually disappear. However, many of the inequalities uncovered by this survey are not addressed by the NMW, specifically those inequalities associated with impairment and gender.     

The role,power and influence of company chairs

This paper develops an analytical framework to depict the heterogeneity that characterises the role of board chair and demonstrate the potential variability in how chairs operate boards and exercise power and influence on strategy, control and resource related tasks at board level. Theories of power and influence, as applied to top management teams and boards of directors, are explicated within the context of contemporary governance practices that are establishing the role of the board chair as distinct to that of the chief executive officer. Specifically, the paper maps sources of power and varying contemporary chair practices, including chair nomenclature (i.e. executive vs. non-executive chairs), chair origin (insider vs. outsider) and chair time (full-time vs. part-time). A number of theoretical chair-power models emerge from this analysis and are subject to empirical analysis using data collected from 160 chairs of 500 FTSE-listed companies. Theoretically and empirically, the paper complements structural approaches to studying boards with attention to behaviour on boards. By linking board structure, board process and the exercise of influence, the study reveals both differences amongst chairs in how they run the board, but also that chairs’ differ in the influence they exert on board-related tasks. Full-time executive chairs exert their greatest influence in strategy and resource dependence tasks whereas part-time, non-executive chairs seem to exert more influence over monitoring and control tasks.