Decision-making Bodies Research Articles

Acceptance of Evidence Transfer Within German Early Benefit Assessment of New Drugs for Pediatric and Adolescents Target Populations.

In Germany, all new drugs undergo an early benefit assessment (EBA) by the decision-making body (G-BA). Due to limited access to clinical data in pediatric healthcare since 2017, evidence transfer has allowed for data from adult studies to be used in the EBA of pediatric drugs. This study examines the acceptance of evidence transfer, aiming to understand its correlation with granted added benefit. By searching the G-BA database, relevant EBAs were identified. In addition to descriptive statistics, agreement statistics regarding binary and ordinal extent of added benefit and binary logistic regression with and without intercept were performed to investigate acceptance of evidence transfer, juxtaposing it with manufacturers' claims, and to evaluate the impact of identified factors on evidence transfer. In 14 of 36 identified EBAs, the evidence transfer was accepted by the G-BA. They referred to four therapeutic areas, received a non-quantifiable added benefit and were subject to a pediatric investigation program. Non-quantifiable added benefit implies an added value in itself which can range from minor to major added benefit and is considering the genuine uncertainty mainly induced in theese EBAs due to evidence transfer, which is not allowing a quantification of an added benefit. The binary agreement between manufacturers' claims and G-BA's appraisals was less than by chance [kappa - 0.054 (- 0.158 to 0.050)] whereas the ordinal agreement became fair [kappa 0.333 (0.261-0.406)]. Congruence of the mechanism of action, alignment of disease pattern, transferability of efficacy and safety, and same comparator were fundamental for evidence transfer. Additionally, supportive evidence, therapeutic breakthroughs, and small-scale approval enhanced the acceptance of evidence transfer. The regression models yielded similar results showing different model fit and explained variance. Evidence transfer hinges upon fulfilling various minimum criteria and additional supportive evidence. Availability of study data from adult or older patients and the pediatric group under evaluation is crucial.

A Juxtaposed Analysis of the Challenges and Prospects of Attaining Universal Human Rights in African Polities

Abstract The call for implementation of universal human rights in Africa is principally perceived to be a mixed bag of potential triumphs and setbacks. A core principle of any (political or) scientific study is that data underdetermines theory, i.e., one can look at the same data and reasonably see different phenomena. Simply put, there is no exclusive way of assessing information or determining (better) ways of life. In Africa, the question of whether human rights should be universal or national/cultural remains contested with both the opposers and proponents presenting fathomable reasons. At the core of controversies surrounding universal rights are issues of global inequality, poverty and Africa’s underrepresentation or otherwise misrepresentation in key global decision-making bodies. From the turn of the new millennium, discourses on jurisprudence about universal human rights have intensified whereby, the definition, meanings, functions and scope of what constitutes fundamental human rights have expanded beyond the often too familiar rigid and orthodox domestic law regimes. Today, national sovereignty claims on human rights are only valid to the extent that those assertions are not at loggerheads with the spirit and principles contained either in the Bill of Rights or the Universal Declaration of Human Rights (udhr) (1948). Furthermore, Human Rights Watch (2021) argues that in contemporary international relations, human rights are no longer conceived only in a vertical lens, i.e., only seen as the mere concern of the state, but now necessarily includes a horizontal lens consideration, whereby, private entities are also included because they are equally capable of violating human rights. Knox (2008) also hinted that discourse on this subject matter seems unavoidable as it has continued to gain traction in modern jurisprudence. As such, public law remedies have expanded into the private realm to protect individual rights. This has become necessary because the services provided by private local entities including conglomerates and transnational corporations have increased considerably. For instance, private medical facilities, private schools, media houses, digital and telecommunication companies, and water and sanitation services, all count among several private entities that are prone to abuses of human rights. Consequently, legislative administrators have devised the term ’the contracting state’ to define a setting where a variety of public interests are increasingly being provided by the private sector rather than by the state. In providing their services, the private entities cannot do as they please or ignore the rule of law governing international human rights protection. This essay argues that given the increasing intertwining of regional and global governance activities in finance, trade, commerce, education, agriculture, and medical advances, the implementation of universal human rights would best serve the collective interests of all stakeholders. In advancing this argument, this essay critically analyses the plausible obstacles on the path towards the attainment of universal rights in Africa while also identifying silver linings.

Exclusionary bargaining behavior in 14 countries: Prevalence and predictors.

Primates are known to engage in exclusionary behavior, forming alliances to block a minority from accessing scarce resources. Humans are no exception, and examples of exclusionary behavior abound in political, business, and social settings. However, despite its socio-economic relevance, little is known about the prevalence and determinants of such behavior worldwide. Conducting an experimental game in which a group divides resources by majority rule, we document considerable global heterogeneity in exclusionary behavior. Whereas exclusion is modal in some countries, inclusive behavior is the norm in others. Despite significant cross-country variability, we nevertheless find that individual-level characteristics matter similarly across contexts. Men, individuals with a deliberative reasoning style, and ideologically right-leaning individuals, are consistently and substantially more exclusionary. Cross-country differences in the formation of exclusionary alliances correlate with an original Hierarchy Tolerance Index, derived from variables measuring cultural acceptance of power inequalities. Our findings carry important implications for decision-making bodies, as they indicate that the identity of decision-makers and the culture in which they are embedded can affect how equitably resources are divided.

Stackelberg game-based optimal scheduling of two-level virtual power plant

In order to rationally solve the problem of distributing the interest of each decision-making body in the transaction of virtual power plant (VPP) participating in the energy market, this paper introduces game theory into the VPP energy system (VPPES) and makes a more in-depth study on its joint scheduling on the basis of economy and low carbon. First, this paper constructs a bi-level VPP system with a new type of VPP and studies its optimal operation strategy under the Stackelberg game framework. The strategy takes the energy seller as the leader and the VPP supplier and the loader as the followers, and the upper and lower layers optimize the seller’s pricing strategy, the VPP’s output plan, and the user’s demand at the same time through real-time information exchange and loop iteration. Second, the energy trading process and mathematical model of the bi-level VPP system are introduced, and it is proved that there exists a unique Stackelberg equilibrium in the proposed game model, which is optimally solved by using an improved coyote optimization algorithm combined with a solver. Finally, it is verified through examples that the proposed operation strategy can significantly reduce the generation cost of the VPP and maximize the benefit of the seller and the utility of the loader, so as to realize economic energy supply and scientific energy use, which can provide a new paradigm for the economic and environmental development of the new energy system.

Implications of living evidence formats for coverage decisions in the German health care system

Decision-makers consult systematic reviews and clinical guidelines to make informed coverage decisions based on the current state of evidence. Outdated recommendations in rapidly evolving areas such as lung cancer treatment, are challenging. The COVID-19 pandemic highlighted the need for good decision-making under uncertainty.The descriptive analysis of two samples of evidence bases for evidence synopses to prepare the decision on appropriate comparators shows that living systematic reviews and living clinical guidelines are rare (41/5,463; 0.75%) but present, with COVID-19 being the most common indication. We also describe some characteristics and quality issues of these living formats in the German context.We note an overlap between living and rapid formats, where updates may not adhere to methodological standards in evidence selection, appraisal and formulation of recommendations, or may lack transparency in their methodological processes. The need for critical appraisal of living formats is highlighted as crucial aspect.The production of living systematic reviews and clinical guidelines requires considerable resources and expertise. While there is a need for timeliness in decision making, especially in situations of high uncertainty such as the COVID-19 pandemic, the trade-off between time and quality needs to be balanced. The focus should therefore be on how best to select and process recommendations that are relevant for updating and those that are not.Regularly updated systematic reviews and clinical guidelines that adhere to recommended standards are important for decision-making bodies such as the Federal Joint Committee (G-BA). Transparent documentation of the process and methods used increases confidence in decision-making, even when the evidence base is not perfect.

The judicialization of medicines in a Western Amazon State: a patient and state relationship

Introduction: during the process of becoming ill, users of the Unified Health System may need to access health technologies, including medication, to regain their health. Given the diversity of technologies used in health care and their constantly growing arsenal, it is difficult to make them viable for public health agencies. However, given the limitation of the public power in providing medication, the judicialization of medication materializes, since Brazilians, protected by the Federal Constitution of Brazil, are assured the right to health, established in Art. 196, as a right of all and a duty of the State, including pharmaceutical assistance. Objective: analyze the Unified Health System users’ access to medication, through the intervention of the Judiciary. Methods: this is a qualitative study conducted with two focus groups, divided into two consecutive days, in Rio Branco/Acre, in November 2017. Ten users of the Unified Health System who resorted to the Judiciary to obtain medication, five prescribing physicians working in the Unified Health System and three employees of the Judiciary participated, totaling a sample of eighteen participants. The users were randomly selected from among those patients existing in the State Department of Health of Acre judicialization database. The data obtained in the focus groups were treated according to the content analysis proposed by Bardin. Results: the majority of users demonstrate a clear perception of their constitutionally established right to access medication, regardless of the purchase price, although they feel of lesser value, since it is necessary to face an arduous battle until reaching the Judiciary. Prescribing physicians understand that some medications, in some situations, may be prescribed in disagreement with their indication/protocols/lists of the Unified Health System, in the search for the recovery of the citizen’s health. The employees of the Judiciary recognize the issue of the citizen’s constitutional right to health, refer to the difficulty of the State in enforcing health rights and the possible disorganization of management, including the inadequate management of public resources, and consider compliance with current health policies, although, in most cases, they tend to be favorable to the users demanding the medication. Conclusion: in the process of accessing necessary health treatments, Unified Health System users occasionally seek the prescribed medication, included (30%) or not (70%) in the Unified Health System protocols, from the state/municipal health management (health care networks), and, when denied, they resort to the Judiciary via the judicialization of health. Financial vulnerability of users, non-inclusion of medications requested in court in the Unified Health System medication lists, administrative denial of the medication and high financial cost of the medications were pointed out by users as determining factors for the judicialization of health. There is a clear perception of the fundamental right to prescribed medication, and that the judicial system is the decision-making and resolution body when they are denied access to necessary health treatments by the State’s administrative bodies.

Qualitative Analysis of Social Factors Contributing to Gender Inequality: Evidence from Rural Bangladesh

Gender is a sensitive issue in the traditional societal setup of Bangladesh. People hesitate to discuss gender even in the 21st century. The problem of gender inequality has been widespread in Bangladesh since the ancient and medieval periods. Moreover, this problem is more acute in rural parts of the country, where people have less privilege and live in a more conservative society. This qualitative study explored rural communities' social, cultural, and economic structure to determine the social factors of gender inequality in rural Bangladesh. To do that, this study used a qualitative research approach. Employing semi-structured in-depth interviews and critically analyzing secondary data, the research scrutinized the perspectives of male and female village residents across diverse roles, such as students, employees, farmers, homemakers, and entrepreneurs. The findings highlighted several social factors causing gender disparity, including the inescapable influence of patriarchal structures, gender stereotypes, preference for male offspring, child marriage, the notion of girls as liabilities, a lack of awareness, socioeconomic barriers, and a lack of explicit policy. With nearly 60.29% of the total population residing in remote areas where gender gaps persist, this research sheds light on the urgent need for intervention. Moreover, this study provided significant recommendations after critically examining the findings. Finally, the study underlined the imperative for governmental and decision-making bodies to prioritize these findings, advocating for the introduction of comprehensive gender awareness initiatives within rural communities to combat deep-rooted inequalities and pave the way toward a more equitable society.

Harnessing the Power of Emotions: How Women of Color Use Emotional Appeals in Their Campaign Messages

Women of color are running for political office at higher rates in recent U.S. elections, and existing scholarship is only starting to investigate the communication strategies of women of color and how voters respond to their campaign messages. We shed light on how women of color use emotions in campaign messages and how voters respond to these emotional appeals. We employ an analysis of campaign advertising data across multiple election years from the Wesleyan Media Project to show that both white women and women of color rely heavily on enthusiasm in their campaign messages, even though white women use anger appeals at higher rates than women of color. We complement these results with an original survey-based experiment to examine how emotional appeals affect voting preferences for women of color candidates. Our results suggest that when women of color employ positive emotions, the effects of these messages do not differ when compared to positive emotions from white women. We also find that positive emotions in messages are especially beneficial for Black women candidates compared to negative emotions in messages. These results offer insights into how women of color can build effective communication strategies to broaden their representation in U.S. decision-making bodies.

Reshaping the European Union Landscape: The Rise of Far-Right Movements and Their Potential Impact on Middle East Policy

The rise of far-right parties within the European Union has raised significant concerns about potential shifts in EU foreign policy, particularly with regard to the Middle East. This development challenges the core values of the EU and has the potential to markedly reshape its diplomatic strategies, aid distribution, and regional engagement. This analysis examines key areas of Middle East policy likely to be influenced by the growing presence of far-right parties in EU institutions, including immigration and refugee policies, the EU's stance on the Israeli-Palestinian conflict, relations with Iran, and involvement in peace processes in the region. Additionally, the study emphasizes potential shifts in power dynamics within EU decision-making bodies concerning Middle East policy, underscoring the urgency of the issue. The hypotheses suggest that the increased influence of far-right parties may result in more restrictive immigration policies, stronger pro-Israel positions, a more confrontational approach towards Iran, diminished EU involvement in Middle East peace initiatives, and a reduction in regional financial aid. The research also explores the likelihood of greater bilateral engagement between individual EU member states and Middle Eastern countries, which could weaken the EU's common foreign policy and lead to a more fragmented regional strategy. This study highlights the critical importance of understanding the complexities of this phenomenon, as the mainstreaming of far-right ideologies has profound implications for European politics and the EU’s role in the Middle East. Addressing these challenges is essential for safeguarding the EU’s foundational values and maintaining its ability to navigate intricate geopolitical landscapes.

영국 학부모정책의 동향 및 시사점: 학부모 참여 활성화 및 책무성 강화를 위한 학부모정책

This study analyzed recent trends in UK parent involvement policies to draw implications for parent policies in South Korea. A comprehensive literature review revealed four key areas. First, while the UK has long encouraged parental involvement, recent discussions have increasingly centered on strengthening parental accountability. Second, the UK emphasizes the shared responsibilities of schools, students, and parents, as outlined in family-school agreements. Third, the UK's School Governing Bodies act as major decision-making bodies, while parent councils facilitate effective communication between schools and parents, and PTAs encourage active voluntary parental participation. Finally, the UK’s parent policies clearly define the roles, powers, and responsibilities of parents through systematic legal frameworks. Based on these findings, this study proposes enacting 「The Family and School Partnerships for Student Education Act」 and introducing the School-Parent Agreement system in Korea.

Create and strengthening innovation ecosystem: roles of policy-affiliated transition intermediaries in latecomers

Purpose This study aims to explore the functions of policy-affiliated intermediaries and their roles in driving innovation in latecomers. Design/methodology/approach Latecomers have recently recognized the significance of an innovation ecosystem in transitioning to an innovation-driven economy. However, these countries encounter various market and system failures, making policy-affiliated transition intermediaries crucial in orchestrating innovation ecosystems. To achieve this, this study used a case study of a policy-affiliated intermediary and conducted interviews with 19 managers. The results from the content analysis revealed that innovation intermediaries in latecomers perform more comprehensive duties than those mentioned in the literature in the transition to innovation-based development. Findings Results show that the most important of policy-affiliated innovation intermediaries’ roles is orientation to the government and private sector market, attracting the participation of the private sector through the implementation of tax credits and the development of the corporate innovation ecosystem, developing science and technology parks, developing laboratory research infrastructure, supporting prominent and capable professors to create innovation networks, developing innovation zones around research institutions and leading universities and developing international scientific cooperation. These are new and important functions that innovation intermediaries should play in the transition process. Originality/value The research found that the innovation intermediary acts as a change agent in the mental model of other executive and decision-making bodies. Also result shows that this intermediaries can play more roles than what is mentioned in the literature for the development of innovation.

Gender-Sensitive Approaches In Women's Involvement In Constitution-Making And Peacebuilding Processes In South Sudan

Constitutions play a pivotal role in shaping the political, economic, and social equality of both women and men. As the supreme law, they establish the state's framework, allocate political authority, delineate governance systems, dictate leadership selection, and safeguard fundamental rights. Constitutional reform presents a unique chance to reshape governance structures by enshrining women's rights, incorporating inclusive language, and establishing institutions that ensure and advance gender equality. In South Sudan, akin to many African nations, a pluralistic legal system merges customary practices, religious laws, common law, and statutory regulations. While customary and religious laws hold recognition, they remain unwritten, flexible, and often linked to ethnic concerns, varying across communities. Rooted in generations of tradition, these laws seek to uphold positive community values and norms. However, they frequently disadvantage women, despite the presence of traditional justice mechanisms that some argue are more accessible, cost-effective, prompt, and culturally apt. These alternative justice systems are deeply entrenched in patriarchal norms, often excluding women from comprehensive rights, including equitable participation in governance and decision-making bodies. Drawing lessons from post-conflict nations, this paper contends that the transformative potential of constitutions materializes when women capitalize on constitution reform opportunities to redefine the constitutional community's ambit, compelling the state to honor, safeguard, and fulfill women's rights

The Role of Social Impact Bond on Utilizing Impact Investment to Develop Asir District in Line with the Kingdom’s Vision 2030: Academics and Economists' Perspectives

The social impact bond (SIB) is a new tool for financing innovative social projects and impact investment. This financial method has since been introduced (Warner,2013) in the whole world. SIBs are a strategically double-edged policy tool and policymakers should be prudent about SIBs because of legitimate convolution and management, responsibility, and precision (Tan, et al., 2021). The current study aims to explore the perspectives of academics and economists on the role played by Social Impact Bond in utilizing impact investment to develop Asir district in line with the Kingdom’s Vision 2030. The descriptive-analytical method was adopted by the researcher in this study to describe the responses of the study sample to its topic. Some indicators of the mean, standard deviation, and relative significance of each item of the study area were employed. This paper is eminently reflective, and the methodology on relies on an analytical research method. In addition, the results of 100 brief investigations collected in the Kingdom of Saudi Arabia are summed up to show the role played by Social Impact Bond in using Impact Investment and the circular economy's principles by businesses at the micro-level is underexplored in the literature. The findings of the study revealed that 82.3% of Academics and Economists perceive that the role played by social impact bond on utilizing impact investment to develop Asir district in line with the Kingdom’s Vision 2030 is effective, and the percentage of approval on the domain was high in terms of the mean of 3.86. Also, the study showed that Academics and Economists perceive Social impact bonds to include a wide range of interested parties such as Saudi governmental bodies, and investors to work together significantly to set up a SIB has many advantages as the mean hits 4.48 with a percentage of97.8 %. In light of the results, the study recommends decision-making bodies assess carefully what is the value added for applying social impact bonds.

The Cost of Lipoedema Treatment Exceeds the DRG Revenues - Evaluation of the Surgical Treatment Costs of Lipoedema (Stage III) at a German University Clinic

Liposuction for stage III lipoedema is a guideline-based but also time-consuming treatment, which can be carried out under specific conditions at the expense of the German statutory health insurance companies (SHI) based on a decision made by the German Federal Joint Committee ("Gemeinsamer Bundesausschuss", G-BA), the highest decision-making body in the German healthcare system, in 09/2019. We postulate that the treatment is not reflected in a cost-covering manner in the university cost system. This monocentric, retrospective study examined the economic aspects of 92 cases in 48 lipoedema patients treated during the period from 09/2019 to 08/2023 at the expense of the SHI. These cases were filtered out using DRG coding and the Operation and Procedure Classification system ("Operationen- und Prozedurenschlüssel", OPS), and the costs and revenues per patient were calculated using the data from our internal service accounting. After an inpatient stay of 2.64±1.33 days, the total revenue was € 4,726.79±680.98. This included € 1,532.92±856.99 inpatient costs, € 2,686.02±1,174.70 in operating costs, € 940.76±189.18 in anaesthesia costs and € 63.19±125.38 in other costs that had to be paid within the clinic. On average across all treatments, this resulted in a loss of -€ 875.22 /case. In 54 cases (59%), the costs exceeded the revenue. In total, the calculation of all cases resulted in a loss of € -80,520.63. If medical personnel costs are included, this amount rises to over € 100,000. The results show that the surgical treatment of lipoedema in the German DRG and university cost systems is not cost-covering. This could be relevant in the final economic assessment of the G-BA, which may result in an adjustment of the DRG revenue.

Re-Evaluation of The Judicial System: Competence and Role of Religious Courts in Blasphemy Cases

Cases of blasphemy in Indonesia are a problem that still occurs frequently, such as the interpretation of verses in the holy book for personal and/or political gain. The main challenge in blasphemy legal cases is that the jurisdiction is under the District Court, but this raises questions about the role of the Religious Courts that already exist in Indonesia regarding blasphemy cases. Supposedly, religious courts should have proper knowledge and correct interpretation for cases related to religion, however, due to Indonesia's democratic and plural legal system, blasphemy cases fall under criminal law and are considered criminal cases, not civil cases, which makes them outside the jurisdiction of religious courts in terms of judgments. In comparison, Saudi Arabia has a form of religious court in its implementation, but the existence of the court is due to a national idea based on Sharia Law and not based on plural democracy, thus signifying major differences in national identity and basis, which leads to differences in decision-making bodies and law enforcers.

What are the drivers of sustainable development web-reporting in Portuguese local governments?

Purpose Local governments (LGs) play a crucial role as policymakers and catalysts for change at the local level, making them well-positioned to connect the United Nations’ 2030 Agenda goals with local communities. Therefore, LGs should collect and analyze data to monitor progress toward the sustainable development goals (SDGs) and report on the outcomes. In this regard, webpages on the internet stand out as a valuable tool to enhance accountability in LGs and to promote stakeholder engagement with the community. Thus, this paper aims to analyze whether Portuguese municipalities disclose information regarding the SDGs on their websites, and to identify the main drivers of SDG web-reporting. Design/methodology/approach Drawing on the theoretical foundation of legitimacy theory, this study examines the relationship between SDG reporting and the characteristics of several municipalities (such as geographical location, municipality size, financial performance, political ideology and gender), as well as adherence to some programs/networks/platforms (such as CESOP_Local and ODSLocal). The websites of 306 Portuguese municipalities were analyzed using the content analysis technique. A bivariate and multivariate statistical analysis was applied. Findings Bivariate analysis shows that coastal, larger and financially efficient municipalities are more likely to disclose SDG information on their websites due to visibility and stakeholder pressure. Contrary to extant literature, left-wing municipalities are not necessarily more inclined to embrace the 2030 Agenda. However, the presence of women in decision-making bodies and adherence to networks and sustainable programs positively influence SDG disclosure. In multivariate analysis, logistic regression identifies two significant factors impacting online SDG disclosure: the representation of women in municipal plenaries; and adherence to the CESOP_local network. Other factors show no significant influence, highlighting these two variables as the main drivers for SDG information disclosure. Practical implications The findings are in line with the literature review and lead us to conclude that SDG reporting in LGs is still in its infancy. Therefore, policymakers and regulators need to work together to implement and standardize sustainability reporting within LGs. Social implications Considering the significance of the gender variable, the findings could have implications for policy formulation, promoting gender diversity and its impact on the quality of SDG reporting. Originality/value Empirical research on SDG reporting remains limited, particularly within the context of LGs. To the best of the authors’ knowledge, no previous studies have delved into the reporting of SDGs specifically in this Portuguese context.

Evolutionary game analysis and efficiency test of water pollution control driven by emission trading: Evidence from Zhejiang Province, China

Presently, China is actively endorsing the pilot initiative for the remunerative use and trading of emission. By examining the operation and efficacy of emission trading in the context of water pollution control, one can contribute to the advancement and refinement of this system, thereby facilitating the attainment of regional pollution reduction, carbon reduction, and high-quality development objectives. In pursuit of this objective, we develop a theoretical framework for the local government and sewage enterprises evolutionary game of water pollution control, which includes two scenarios without considering and considering emission trading for studying the influencing factors and evolution trajectory of the game subject's. Through the stability analysis, the game interactive mechanism, the difference in evolutionary trajectory, and the response logic of the decision-making body in different situations become clearly visible. Further, the system sensitivity factors are analyzed by solving the partial derivation of the area formula of the phase diagram. And the efficacy of the sewage trading system in water pollution control in Zhejiang Province is empirically examined at the micro level by adopting the trading data of the first pilot area of sewage trading in the country and the case of pollution control in Jinhua City. The research reveals the following conclusions: Under specific circumstances, emission trading can incentivize businesses and even industries to enhance pollution control measures as a whole. The performance and degree of sensitivity factors vary across gaming systems, with public reputation evaluation and central government inspection serving as positive constraints. The initial cost of paid use of emission permits, as a fixed cost component for firms to address pollution, has no effect on the enterprises' behavioral actions to satisfy emission regulations. The findings can furnish local governments with a theoretical foundation and decision support in order to optimize regulatory strategies and enhance pollution control policies.

Strategic Choices of General Contractors in the Context of China’s Industry Chain of Construction Industrialization

Amidst the challenges of economic downturn and construction industrialization, the profits obtained by general contractors through comparative advantage strategies are slowly decreasing, and thus, new strategic choices are required. The collaborative division of labor effect in the industry chain can improve profits and labor productivity, which is an important driving force for enterprise transformation and development. Therefore, a need arises to improve the profits of general contractors in the industrial chain system composed of prefabricated component suppliers, general contractors, and building development enterprises. Accordingly, this paper constructs a backward integration, forward integration, and bidirectional integration Stackelberg game model based on the proportion of resource investments, with general contractors as the main decision-making body. It then compares and analyzes the optimal decision-making values in different situations to study the optimal strategic decision-making problem of general contractors. Research results indicate the following. (1) All three integrated strategies can improve the profits of general contractors. When the proportion of resource investment meets certain conditions, the profits of general contractors under the bidirectional integration strategy are the highest, while the sustainable performance of the industrial chain and prefabricated buildings can be increased and the coordination of the industrial chain can be achieved. Thus, it is the best choice for a general contractor. (2) As a prefabricated component supplier needs to carry out continuous technological innovation activity to obtain a cumulative effect, the return on investment of forward integration is less than that of backward integration. (3) General contractors may consider choosing to carry out bidirectional integration strategies of forward integration followed by backward integration.

Operationalizing Racism as a Public Health Crisis: Moving Beyond the Rhetoric!

It is well documented that systemic racism and social injustice result in health inequities for communities of color, including premature death. To date, more than 260 municipalities across the United States have declared racism as a public health crisis. In January 2021, the Nation’s Health, a monthly American Public Health Association newsletter, acknowledged Genesee County, Michigan, as one of the communities leading the work in operationalizing these declarations. This research highlights community engagement and participatory processes, models, and tools used to operationalize racism as a public health crisis in Genesee County. A participatory approach grounded in community-based participatory research (CBPR) methods was used to operationalize Genesee County’s resolution declaring racism a public health crisis. To ensure our efforts centered community voices, experiences, and priorities, our methodology consisted of: 1) hosting community dialogues focused on systemic racism; 2) the novel application of a committee composition matrix to develop a geographically and socially diverse Community Action Council to serve as the decision-making body for our strategic plan to identify and address systemic racism within Genesee County; 3) the development of a draft county-wide strategic plan; and 4) focus groups to review and provide feedback on the drafted strategic plan. CBPR provides guidance for effective community engagement and ensures that community voices are centered when identifying effective responses to systemic racism. CBPR principles also foster co-ownership of solutions, increasing trust, transparency, and accountability between researchers, community members, and other stakeholders.

Speed-Ups and Related Problems: The UAW and Grassroots Grievances in the Immediate Post-World War II Period

Scholarship on the United Automobile Workers – for many decades the largest industrial union in the USA – has focused heavily on the landmark wage and benefit gains that the union won, especially through pattern bargaining in the post-World War II era. The UAW has been praised as an “American Vanguard” that secured landmark wages and benefits for its members in widely publicised national contracts, especially in the 1940s and 1950s. This article interrogates this image through the lens of the UAW’s executive board minutes, its top decision-making body. Although bargaining gains in these years were real, the national “pattern” was not as uniform as was reported and was constantly under pressure. Despite the gains, post-war autoworkers had many grievances, especially over workloads and “speed-ups.” Workers testified before the board about these complaints, showing that plant conditions were more important to many than wages and benefits. Usually precipitated by these issues, local strikes were a constant problem. As these records show, there was more to the UAW’s history in these years than pattern bargaining. These findings build on literature that has explored rank-and-file dissatisfaction in the auto industry, but extend it beyond local studies, showing how the union’s top leaders experienced the impact of members’ restlessness. The article also demonstrates that workers’ dissatisfaction occurred much earlier than the 1960s and 1970s, the era that has received more attention, throwing light on the roots of subsequent discontent.