Innovation and public accountability in clinical research.
For more than 20 years, clinical researchers have expressed alarm about the decline of their field, but they have failed to achieve a consensus on policies to revitalize and sustain it. Although they have traced the plight of clinical research to profound changes in science, medicine, and public expectations, their conservative vision and preference for short-term measures inhibit effective policy formulation. These trends are the outcome of historical developments, and they seem to mandate a new approach to public policy. A potential source for more viable and socially accountable policies lies in practitioners' notion that clinical research bridges basic and applied science (by translating scientific innovations into practical measures). Exploiting that idea, however, would require a major reorientation of the field toward health services research and the institutions that are struggling to support it. (+info)
Tolerance in a rigorous science.
Scientists often evaluate other people's theories by the same standards they apply to their own work; it is as though scientists may believe that these criteria are independent of their own personal priorities and standards. As a result of this probably implicit belief, they sometimes may make less useful judgments than they otherwise might if they were able and willing to evaluate a specific theory at least partly in terms of the standards appropriate to that theory. Journal editors can play an especially constructive role in managing this diversity of standards and opinion. (+info)
The transition to agricultural sustainability.
The transition to sustainable growth in agricultural production during the 21st century will take place within the context of a transition to a stable population and a possible transition to a stable level of material consumption. If the world fails to successfully navigate a transition to sustainable growth in agricultural production, the failure will be due more to a failure in the area of institutional innovation than to resource and environmental constraints. (+info)
Challenge of Goodness II: new humanitarian technology, developed in croatia and bosnia and Herzegovina in 1991-1995, and applied and evaluated in Kosovo 1999.
This paper presents improvements of the humanitarian proposals of the Challenge of Goodness project published earlier (1). In 1999 Kosovo crisis, these proposals were checked in practice. The priority was again on the practical intervention - helping people directly - to prevent, stop, and ease suffering. Kosovo experience also prompted us to modify the concept of the Challenge of Goodness. It should include research and education (1. redefinition of health, 2. confronting genocide, 3. university studies and education, and 4. collecting experience); evaluation (1. Red Cross forum, 2. organization and technology assessment, 3. Open Hand - Experience of Good People); activities in different stages of war or conflict in: 1. prevention (right to a home, Hate Watch, early warning), 2. duration (refugee camps, prisoners-of-war camps, global hospital, minorities), 3. end of conflict (planned, organized, and evaluated protection), 4. post conflict (remaini ng and abandoned populations, prisoners of war and missing persons, civilian participation, return, and renewal). Effectiveness of humanitarian intervention may be performed by politicians, soldiers, humanitarian workers, and volunteers, but the responsibility lies on science. Science must objectively collect data, develop hypotheses, check them in practice, allow education, and be the force of good, upon which everybody can rely. Never since the World War II has anybody in Europe suffered in war and conflict so much as peoples in Croatia, Bosnia and Herzegovina, and Kosovo. We should search for the meaning of their suffering, and develop new knowledge and technology of peace. (+info)
Closer to a compromise on the direction of environmental research.
The Committee for the National Institute for the Environment (CNIE) was created in 1990 "to improve the scientific basis for making decisions on environmental issues," possibly through the establishment of a separate institute devoted to the environmental sciences. But while the goals proposed for the National Institute for the Environment were universally applauded, Congress was averse to adding a new agency to the federal bureaucracy. Recently, a compromise plan has been proposed that could expand the science base without having to create a new agency. On 29 July 1999, the National Science Board approved an interim report recommending an expanded program of environmental research and research planning, education, and scientific assessment with a funding target of an additional $1 billion over five years. The report stresses the importance of environmental research in formulating environmental protection programs and contains 12 recommendations intended to enhance and complement existing research activities in environmental sciences and engineering. If the National Science Foundation implements the recommendations in the report and if Congress appropriates funds for that purpose, the need for additional funding for new science activities identified by the CNIE should be satisfied. (+info)
The scientist's world.
This paper describes the features of the world of science, and it compares that world briefly with that of politics and the law. It also discusses some "postmodern" trends in philosophy and sociology that have been undermining confidence in the objectivity of science and thus have contributed indirectly to public mistrust. The paper includes broader implications of interactions of government and science. (+info)
The myth of objectivity: is medicine moving towards a social constructivist medical paradigm?
Biomedicine is improperly imbued with a nomothetic methodology, which views 'disease' in a similar way to other 'natural' phenomena. This arises from a 300-year history of a positivist domination of science, meaning that objectivist research (e.g. randomized controlled trials or biochemical research) attracts more funding and is more readily published than 'softer' qualitative research. A brief review of objectivism and subjectivism is followed by a definition of an emerging medical paradigm. Current 'inappropriate' medical practices become understandable in this broader context, and examples are given. A constructivist paradigm can continue to incorporate 'objective' clinical findings and interventions, as well as the recent evidence for the doctor-patient relationship as a major contributor to patient outcomes. (+info)
Organizational interventions: facing the limits of the natural science paradigm.
This paper reviews current challenges in the conceptualization, design, and evaluation of organizational interventions to improve occupational health. It argues that attempts to confirm cause-and-effect relationships and allow prediction (maximize internal validity) are often made at the expense of generalizability (external validity). The current, dominant experimental paradigm in the occupational health research establishment, with its emphasis on identifying causal connections, focuses attention on outcome at the expense of process. Interventions should be examined in terms of (i) conceptualization, design and implementation (macroprocesses) and (ii) the theoretical mediating mechanisms involved (microprocesses). These processes are likely to be more generalizable than outcomes. Their examination may require the use of both qualitative and quantitative methodologies. It is suggested that such an approach holds unexplored promise for the healthier design, management, and organization of future work. (+info)