THE GOOD PRODUCTIVITY GAME: INCREASING WORK PERFORMANCE IN A REHABILITATION SETTING1

Simple reinforcement systems have been used to improve performance in a broad range of settings. For example, in classrooms, the “Good Behavior Game” has been shown to be very effective (Barrish, Saunders, and Wolf, Journal of Applied Behavior Analysis, 1969, 2 , 119–124). In industry, small bonuses were used to increase the punctuality of workers (Hermann, deMontes, Dominquez, Montes, and Hopkins, Journal of Applied Behavior Analysis, 1973, 6 , 503–572). In a sheltered workshop setting, Shroeder (Journal of Applied Behavior Analysis, 1972, 5 , 45–52) examined work rates under varying frequencies and amounts of reinforcement and response force. The present study involved the utilization of simple group contingencies to increase productivity in a rehabilitation industry. Four state hospital residents who were trainees at a rehabilitation industry participated in the study which examined the effects of feedback, and feedback plus the “Good Productivity Game” to improve work output. The task, for which the employees were paid a wage, involved sorting boards by size. When the employees were provided with feedback on the number of boards sorted during the observation period, productivity increased slightly over baseline. After a return to baseline, the “Good Productivity Game” was played. For performance, the game afforded the employees pseudo-competition (in that teams were paired against each other, but both teams always “won”) and simple rewards such as candy and early work termination. The game improved performance by 104% over the second baseline and by 64% over the third baseline. Data gathered on rates of on-task behavior by the employees correlate with the productivity rates. Data gathered on rates of staff attention paid to employees show little difference across conditions, thus corroborating the function of the “Good Productivity Game” in increasing work output. Although no formal data were collected, the staff continued to use the game with considerable success after the formal termination of the study. The “Good Productivity Game” appears useful in increasing work output in a rehabilitation setting. Further research should concentrate on the utility of the game throughout longer periods of the workday and over extended periods of time.     

Ethically Allocating COVID-19 Drugs Via Pre-approval Access and Emergency Use Authorization

Abstract

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research. In conditions of scarcity, prioritization approaches should minimize harm, maximize benefit, and promote fairness. To promote continued data collection, patients seeking access to unproven COVID-19 drugs should receive lower priority for allocation when they decline to participate in clinical trials, either of the requested drug or other investigational products, offering a comparable balance of risks and benefits; special attention should be paid to concerns of voluntariness and distrust. In addition, institutional treatment protocols that can contribute more robust real world data should be preferred to single patient requests for access, with priority for inclusion based on traditional clinical allocation criteria relying on available evidence. Fairness demands distribution of these protocols across a diverse range of sites, particularly those serving marginalized populations, among other protections.     

Medicine and pharmacy — facts and myths about the development of an innovative pharmaceutical industry in Poland

Innovation is fundamental to the pharmaceutical industry and a key to improvements in healthcare. Its effectiveness depends on huge, constant investments in research. This innovative industry directly affects the course of studies in healthcare and medicine. Its efforts translate directly into the length and quality of our lives. For several years now, the progress underway in pharmaceutical industry has produced measurable benefits. Doctors have new pharmaceuticals at their disposal, including many types of antibiotics and anti-viral drugs, vaccines and a wide range of drugs which save lives or make them more comfortable. In the near future, ever more efficient cures for neoplastic, rheumatic, neurological, psychic, metabolic, circulatory or respiratory diseases can be expected. Innovation is necessary. The human population is ageing, and the task of an innovative pharmaceutical industry is to keep it in a good condition. The use of innovative drugs can translate directly into lowering the costs of illness. A continuous reduction in spending on healthcare has been observed. The costs of inventing an innovative drug are enormous though (US$ 800 million), and studies on a new drug last between 10 and 13 years. An essential element in recovering the incurred costs and ensuring funds needed for new research is protection by patent. Innovative pharmaceutical companies in Poland are committed to increasing the competitiveness and sustaining the development of not only the market, but also the entire pharmaceutical sector. It is a group of companies of crucial importance to the Polish healthcare system, as it influences improvement in the quality of medical services. Through their investments and spending on research and development, innovative companies accelerate economic growth. In Poland, the innovative pharmaceutical industry is represented by the Association of Pharmaceutical Companies Representatives in Poland (SPFFwP). An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

医生与药业的关系：利益冲突重要根源

药业与医生的关系在最近40年日益受到医学界与社会的重视。药业以并不昂贵的馈赠及其他手段,资助学术交流、医学教育和医学研究,深刻地影响着临床医生的行为和诊治决策,从而危及医学的科学性和医学职业精神,加重了病人的负担,且祸及病人健康。药业与医生的这种关系,是道德与金钱关系的赤裸表现,是资本对医学的无情侵略。从道德、法律、行业管理等诸多方面正确规范行业与医生的相互关系,避免当前面临的种种弊端,维护医学的科学性,保护病人与社会公众的利益,刻不容缓。     

Agricultural Research in Romania: Rival Institutional Dependencies on Private Companies

In Romania, agricultural researchers are enlisted to promote the agrochemical industry and large-scale intensive agriculture. This role can be made intelligible through notion of a scientific field, highlighting rivalries between the Academy of Agricultural Sciences and the University sector. The former has lost its public funding but maintains its responsibilities within bodies devising and leading agricultural policy. The latter gives primacy to peer recognition and integration within international networks, but lacks co-financing required for being effectively included in international research projects. Each academic institution tries to devalue the rival's strong points and gain recognition for the superior value of its own assets. The funding provided by the private agrochemical industry adapts to the scientific field's structure: leading multinational firms take advantage of rivalries between academic institutions and fuel them at the same time. They consolidate current orientation taken by members of the Academy of Agricultural Sciences, especially when seeking their support for authorization for seeds and plant-protection products. Industry funds also create new rewards for University staff, emphasizing international connections but disconnecting them from purely academic achievements. Meanwhile Romanian agronomists tend to defend the type of agriculture promising the most significant business opportunities for the agrochemical industry. Thus, it uses institutional rivalries for its agenda, though without directly influencing the direction of research.     

The Ethics of Pharma–Physician Relations in Pakistan: “When in Rome”

This article investigates the pervasive influence of the pharmaceutical industry in Pakistan and primarily the attitudes of the medical community toward such interactions. We used an inductive approach informed by grounded theory principles to analyze interviews and focus groups with consultants, residents, medical students, and a pharmaceutical industry representative in Karachi and Lahore (n = 27), and participant-observation data from two biomedical conferences. Data were then analyzed through a deontological and teleological ethical theoretical framework. Findings highlight the reasons leading to the continuation of norms including weak regulations, physicians’ expectations of receiving favors, and limited exposure to bioethics education. Recommendations for practice, policy, and research are discussed.     

Strategic hybrid approach for selecting suppliers of high‐density polyethylene

Supplier selection is an important process for companies in the plastic sector due to its influence on firm performance and competitiveness. For a proper selection, a number of criteria from different aspects need to be considered by decision makers. Yet, as in different fields, because there are numerous criteria and alternatives to be considered in the plastic industry, choosing an appropriate multicriteria decision‐making approach has become a critical step for selecting suppliers. Therefore, the aim of this research is to define the most suitable supplier of high‐density polyethylene through the integration of powerful multicriteria decision‐making methods. For this purpose, the fuzzy analytic hierarchy process (FAHP) is initially applied to define initial weights of factors and subfactors under uncertainty, followed by the use of decision‐making trial and evaluation laboratory (DEMATEL) to evaluate interrelations between the elements of the hierarchy. Then, after combining FAHP and DEMATEL to calculate the final contributions of both factors and subfactors on the basis of interdependence, the technique for order of preference by similarity to ideal solution is used to assess the supplier alternatives. In addition, this paper also explores the differences between the judgments of decision makers for both AHP and DEMATEL methods. To do these, a case study is presented to demonstrate the validity of the proposed approach.     

服务业员工个人-组织匹配对组织公民行为的影响：有调节的中介模型

根据社会交换理论和人与情境互动理论,研究探讨了个人-组织匹配对员工组织公民行为的影响机制。通过对12家餐饮连锁店225位员工进行的问卷调查,结果表明：个人-组织匹配正向预测组织公民行为,员工工作敬业度在两者关系中起中介作用;此外,分别作为情境因素和个体因素的主管支持、员工主动性人格对个人-组织匹配与组织公民行为之间的关系具有调节作用。主管支持的程度越高,个人-组织匹配与组织公民行为的正向关系更强;而对于高主动性人格的员工,个人-组织匹配与组织公民行为之间的正向关系反而更弱。     

近视激光手术治疗几个问题的探讨

近视眼是目前全球发生率最高的屈光不正,我国的近视准分子激光手术水平已与世界先进水平同步,并处于快速、稳健的发展中。依据辩证法正确评价近视激光手术的优缺点,遵循系统论的整体性、最优化、动态化和模型化的基本原则,可以进一步提高激光手术治疗的视觉质量,促进近视激光手术治疗的健康发展。     

医疗监管的自律与他律

自律和他律理论对加强和完善我国医疗行业监管具有重要的理论价值。自律和他律在医疗行业监管领域中的具体表现为,卫生行政部门的监督管理与医疗机构的自我约束和医疗行业的自律监管。指出我国医疗行业监管中存在的主要问题并提出健全医疗行业监管机制的思路。