Ten steps to developing a national agenda to address financial conflicts of interest in industry sponsored clinical research

Financial liaisons between clinical researchers, research institutions, and industrial sponsors have gained momentum in recent years. In the process, it has been argued by many that trust in the research infrastructure is being eroded by the financial conflicts of interest that emerge from these arrangements. Yet, the financial resources of industry are needed to continue technology transfer from the bench to the bedside. Policy makers and government regulators are currently struggling to determine how to best manage financial conflicts of interest that emerge from these liaisons. Various organizations and government entities have proposed different strategies. This paper explores the limitations of existing measures and recommends that a unified national agenda is needed. We propose 10 steps to develop an agenda to address financial conflicts of interest in industry-sponsored clinical research.     

On the Relative Strengths of Altruism and Fairness

Some researchers have attributed deviations from selfish behavior to fairness. Violations of fairness theories, however, are observed in experimental dictator games with transfer rates greater than 1 (a transfer of x from the dictator yields an income of tx for the beneficiary, where x < tx): the dictator’s final income is less than the beneficiary’s. We theoretically propose that dictator giving also involves altruism, further supporting our claim with empirical evidence from four separate samples of dictator game experiments. Our nonlinear specification allows the relative measurement of the independent motives in dictator behavior.     

Toward a Viable Progressive Third Party in 2020 and Beyond1

Creating a strong, influential third party has been an abiding aspiration on the American left, and were this goal to be achieved, it could be a great boon to subordinate groups in the United States. Yet widespread doubts persist, even among progressives that this is desirable, and especially that it is possible. Here, I briefly review compelling reasons for thinking otherwise; I then consider in some depth the potential for starting to build a viable left third party leading up to and after the pivotal 2020 election. In doing so, I go beyond the existing literature on third parties, which has yet to reflect systematically on progressive third party prospects in this period. Specifically, I assess how the emerging political environment may shape left third-party building, and I evaluate ongoing and developing attempts by key groups engaged in that effort. I find a distinct tension between conditions encouraging progressives to reform versus abandon the Democratic Party, and I identify one alternative party-building tendency that seems most able to exploit the latter impulse due to its already established electoral viability. Last, I highlight relevant questions that remain for activists hoping to create an effective national left third party.     

Social Control and Emotions

This is the first article in Symbolic Interaction's symposium in tribute to Tamotsu (Tom) Shibutani (1920–2004). The author, a student in Shibutani's graduate course on social control, discusses his teacher's ideas and their evolution into his own. The article provides ample basis for the author's observation: a scholar's contribution can be measured not only by the cumulative corpus of his or her published work, but also by the influence that this individual has had on the work of others.     

Union survival strategies for the twenty-first century

Clearly, the necessary changes in the law and culture will not come easily or quickly. But, transcending all forms of these labor market segments is a set of concerns that arguably should spur a search for common ground between labor and management. The proliferation of automated technologies, together with the continuing impact of foreign competition with cheap labor markets, has led some to predict that, over the next quarter century, we will witness the elimination of the blue-collar, mass assembly-line worker from the production process.¹⁴ Moreover, the theory that those losing jobs in the manufacturing sector will be generally absorbed into the service sector is losing currency as it is becoming clear that service jobs are, themselves, not invulnerable either to offshore outsourcing (e.g., telephone operators, data processors) or to automated technology (e.g., bank tellers, office secretaries). Nor is it realistic to expect the new “knowledge sector” to absorb more than a fraction of the unemployed and underemployed casualties of this transformation. As a result, the widening gap between the haves and have nots will only continue to grow. As the trend accelerates, certain possibilities for a labor-management accommodation emerge. For one thing, although corporations may be enjoying short-term gains from present wage stagnation, downsizing, outsourcing, and casting off of permanent employees, the longer term effects include a work force with considerably diminished consumer purchasing power. In some industries, corporations are already acknowledging the adverse effects of this trend. Furthermore, as employers are contributing into pension funds on behalf of fewer and fewer “employees,” the forced savings pool that has for many years constituted a primary financing source of capital investments in our economy, will gradually be depleted.¹⁵ At the same time as employers are coming face to face with the disadvantages of the union-free environment they have so long sought, employers are also rediscovering the contributions to productivity, quality, and efficiency that can be gained from a truly empowered work force with an independent voice in the workplace. All of this should lead an enlightened management to place less currency on resisting unionization and other legitimate forms of independent employee representation, and to join labor in advocating strong labor standards and effective labor law for all four of the labor market segments that exist today and will exist tomorrow. The authors wish to convey their deep appreciation for the invaluable contributions to this paper made by David Silberman of Bredhoff & Kaiser and Craig Becker, Associate General Counsel, Service Employees International Union. Another version of this paper was published in Labor Lawyer.     

Seeking common ground for people: Livelihoods, governance and waste

Jam Chakro is a large International Donor-funded landfill site in Karachi, when opened in 1996 it was intended to be carefully managed by the Karachi municipal authorities. However, within weeks of opening it was overtaken by informal-sector waste workers. They are mostly poor rural migrants who have gravitated towards urban areas seeking work. Their waste sorting and recycling work, which involves burning waste, is now responsible for serious environmental degradation and poor waste management.Nearby residents are being affected by the smoke, and wish to see an end to the burning. Local authorities are under pressure to manage the waste better and wish to see an end to the recycling activities. However, initial attempts to stop these activities and relocate people, sometimes involving force, have been unsuccessful. The workers complain that they depend on the waste work for their survival.This paper is concerned with the problems caused by the informal-sector recycling work at Jam Chakro, and the need for finding environmentally and financially sustainable solutions which respect the interests of all stakeholders. It is based on fieldwork which involved detailed stakeholder identification and consultation, to ensure that different perspectives were heard and accounted for. In the light of research findings, the paper discusses some of the proposed options for integrating informal-sector livelihoods into the formal operation of the landfill site. These are based around organising waste reclamation and recycling work and enabling it to take place without burning waste.The paper proposes that the problems at Jam Chakro can in part be attributed to not having accounted for the poor in planning, necessary for developing sustainable solutions to the problems.Approximate exchange-rate at time of writing: US$1: Rs. 60.     

A knowledge chain management framework to support integrated decisions in global supply chains

Knowledge management has been identified as a key enabler to achieve organisation’s value chain competitiveness. It, however, has been facing fresh challenges in a global supply chain setting. This paper proposes a global knowledge chain management (GKCM) framework that identifies and prioritises critical knowledge that a global supply chain can focus on to support integrated decisions. The framework explores three types of global context knowledge, namely global market knowledge, global capacity knowledge and global supply network configuration knowledge. Empirical study has been undertaken within the manufacturing industry to evaluate the GKCM framework. Analytic network process has been explored as a key method to assess the importance of the global knowledge constructs from supply chain managers’ perspectives. A key contribution of the paper is that it advances existing knowledge chain management approaches within one organisation and its local supply chain to include the global context knowledge applicable to global manufacturing settings, and highlights how the GKCM framework can support global supply chain integrated decisions.     

Overcoming Market Constraints on Pro‐Poor Agricultural Growth in Sub‐Saharan Africa

In sub‐Saharan Africa, there is fairly broad agreement that increased investment in key public goods such as roads and communications infrastructure, agricultural research and water control will be required if revitalised agricultural development is to take place. However, it has proved more difficult to reach agreement on what needs to be done to improve the performance of agricultural markets. In this article we set out an agenda for investment and policy reform in this area, providing a brief theoretical examination of the co‐ordination problems involved before examining in turn demand and supply constraints affecting smallholder farmers, and policies for price stabilisation and the co‐ordination of support services. We also argue that increased attention needs to be paid to governance issues.     

Intended Message Versus Message Received in Hypothetical Physician Risk Communications: Exploring the Gap

We examined the risk perception that is derived from hypothetical physician risk communications. Subjects (n= 217) completed a questionnaire on the Web for $3. Subjects were presented with four hypothetical cancer risk scenarios that included a physician risk communication in one of three risk communication formats: verbal only, verbal plus numeric probability as a percent, and verbal plus numeric probability as a fraction. In each scenario, subjects were asked to imagine themselves as the patient described and to state their perceived personal susceptibility to the cancer (i.e., risk perception) on a 0 to 100 scale, as well as responses to other measures. Subjects' risk perceptions were highly variable, spanning nearly the entire probability scale for each scenario, and the degree of variation was only slightly less in the risk communication formats in which a numeric statement of risk was provided. Subjects were more likely to overestimate than underestimate their risk relative to the stated risk in the numeric versions, and overestimation was associated with the belief that the physician minimized the risk so they wouldn't worry, innumeracy, and worry, as well as decisions about testing for the cancer. These results demonstrate significant gaps between the intended message and the message received in physician risk communications. Implications for medical decisions, patient distress, and future research are discussed.