‘I'm still a hustler’: entrepreneurial responses to precarity by participants in phase I clinical trials

Abstract

This paper questions the implications of entrepreneurial responses to conditions of employment precarity by ‘healthy volunteers’ in phase I clinical trials in the United States. Such individuals are typically serial participants who often identify as professional volunteers and seek out drug studies as their primary source of income. Drawing on extensive qualitative research, this paper illustrates how healthy volunteers selectively import the identity of ‘hustler’ from the street environment and reposition it as connoting a set of valuable creative skills that give them a competitive edge over other participants. An entrepreneurial ethos allows them to view personal sacrifice and exposure to potentially dangerous drugs as smart investments leading to financially stable futures. These discursive moves normalize extractive, and at times dehumanizing, labour relations that offload expenses and risks to workers.     

Intellectual Property Rights and the Potential for Universal Access to Treatment: trips,acta and hiv/aids medicine

Where hiv/aids is concerned, the twin goals of ‘zero new infections’ and an ‘aids-free generation’ are now, due to advances in treatment (and treatment as prevention), a realistic possibility. However, these goals can only be achieved through the scaling-up of treatment to the point of universal access. It is inevitable that the success of any scaling-up will be predicated on cost, particularly of hiv/aids medicines. This article argues that recent changes in the global intellectual property landscape—effected by way of bilaterally- and plurilaterally-negotiated trade agreements initiated by developed countries—jeopardise the target of universal access. Enhanced protection of international intellectual property rights increasingly poses a threat to the development of, and international trade in, generic medicines. Unless developing countries move to reinvigorate moribund multilateral institutions, particularly the wto, they will lose control of the intellectual property agenda, and thus the ability to impose an alternative vision regarding universal access.     

State of the world 2018: democracy facing global challenges*

This article analyses the state of democracy in the world in 2018, and recent developments building on the 2019 release of the V-Dem dataset. First, the trend of autocratization continues and 24 countries are now affected by what is established as a “third wave of autocratization”. Second, despite the global challenge of gradual autocratization, democratic regimes prevail in a majority of countries in the world (99 countries, 55%) in 2018. Thus, the state of the world is unmistakably more democratic compared to any point during the last century. At the same time, the number of electoral authoritarian regimes had increased to 55, or 31% of all countries. Third, the autocratization wave is disproportionally affecting democratic countries in Europe and the Americas, but also India’s large population. Fourth, freedom of expression and the media, and the rule of law are the areas under attack in most countries undergoing autocratization, but toxic polarization of the public sphere is a threat to democracy spreading across regimes. Finally, we present the first model to predict autocratization (“adverse regime transitions”) pointing to the top-10 most at-risk countries in the world.     

The Joint Effects of Gender and Race/Ethnicity on Sentencing Outcomes in Federal Courts

Using data from the U.S. Sentencing Commission, the present study examines the interaction effects of gender and race/ethnicity on sentencing outcomes of male and female offenders in federal courts. Findings indicate that female offenders in all racial/ethnic categories receive less severe sentence outcomes than male offenders in the same categories, even after legal, extralegal, and contextual factors are controlled. In addition, racial/ethnic differences are found within gender groups, such that Hispanic males are more likely to be incarcerated and Black males receive longer sentence terms compared to White male offenders. However, contrary to expectations, the analysis indicates that White females are more likely to be incarcerated than Black and Hispanic females and receive longer sentence terms than Hispanic females. Gender and racial/ethnic interactions are also explored across offense type (drug vs. non-drug) and type of sentencing departure (no departure, downward, or substantial assistance). Implications for future research are also discussed.     

Using Cost Analysis to Examine Variability in Replications of an Efficacious Child Neglect Prevention Program

This article reports on a program- and case-level cost analysis of five replication sites of an efficacious child neglect prevention program. Approximately one-third of all sites' total labor hours were expended on direct family services and casework support for a specific family, with the remainder spent on indirect implementation support and program administration activities. Including non-personnel costs, the all-site mean total cost per family was $6,276, ranging across sites from $2,245 to $10,260. Costs varied greatly among individual families within sites. More research is needed to understand factors associated with differences in cost.     

Trust, Distrust and Betrayal: A Social Housing Case Study

This paper discusses the importance of trust, distrust and betrayal in the context of relational contracts in the modern welfare state. We use a specific case study of the allocation of social housing. That context is one in which the local authority has statutory obligations towards households in housing need but limited ability to fulfil those obligations without reliance on other social housing providers, specifically registered social landlords. Relationships between providers are, in theory, negotiated through nominations agreements. In this paper, we draw on data from a research project concerned with 'problematic nominations' to illustrate the production of trust, distrust and betrayal. Our analysis is structured by reference to three frameworks for the production of trust: characteristic-based, process-based and institutional based trust.     

Predicting Short-Term Institutional Aggression in Forensic Patients: A Multi-Trait Method for Understanding Subtypes of Aggression

Accurately predicting inpatient aggression is an important endeavor. The current study investigated inpatient aggression over a six-month time period in a sample of 152 male forensic patients. We assessed constructs of psychopathy, anger, and active symptoms of mental illness and tested their ability to predict reactive and instrumental aggression. Across all levels of analyses, anger and active symptoms of mental illness predicted reactive aggression. Traits of psychopathy, which demonstrated no relationship to reactive aggression, were a robust predictor of instrumental aggression. This study (a) reestablishes psychopathy as a clinically useful construct in predicting inpatient instrumental aggression, (b) provides some validation for the reactive/instrumental aggression paradigm in forensic inpatients, and (c) makes recommendations for integrating risk assessment results into treatment interventions.

Female Sex Offenders: A Controlled Comparison of Offender and Victim/Crime Characteristics

The current study was a chart review of 31 female sex offenders (FSO), 31 male sex offenders (MSO), 31 female violent offenders (FO), and 31 male violent offenders (MO) using a 2 (female or male) by 2 (sex or violent offender) design. This is the first known study to employ three control groups when researching female sex offenders. Multiple variables appeared related to gender and crime. However, some variables emerged as FSO specific. They reported the least alcohol abuse history and had fewer admissions of guilt to the crime than the two violent offender samples. More FSOs knew their victim and were biologically related to their victim than MSOs. Lastly, the FSO sample was the least discriminating as to their victim’s gender and had the highest overall rate of sexual victimization.     

‘A Figure of Annihilated Human Existence’: Agamben and Adorno on Gesture

In this paper, I consider Giorgio Agamben’s essays on gesture, and the loss of gesture, in relation to Theodor Adorno’s account of gesture given in his work on Kafka. I argue that both share an account of gesture as an involuntary, yet non-intentional figure of a generalised destruction of experience. However, in their respective accounts of an emphatic possibility that can be located in the loss of gesture, Agamben and Adorno move in fundamentally different philosophical directions. For Agamben, the loss of gesture opens up the possibility of a space of existing within the pure possibility of speaking itself. For Adorno, the loss of gesture returns us to a reified embodiment that can nevertheless image the possibility of a different way of relating to materiality. I argue that, in the attempt to immanently construct forms of resistance within a generalised destruction of experience, Agamben’s articulation of an absolute gesturality tends towards an immuring of the subject within the repetitive space of what Adorno terms ‘objectless inwardness’. Although Adorno’s account of gesture and its relation to metaphysics and politics is equally problematic in many ways, I argue that his account of a metaphysical experience that appears within alienated gestures offers the possibility for moving beyond the destruction of experience.     

What is the goal of access to health care?

This article first examines the justifications for the goal of access to health care and the variations between health systems in their endorsement of individuals' rights to health care irrespective of income, ethnicity, age and other characteristics. It then examines the meanings of the goal of "access" to health care and considers four key dimensions--service availability ("having" access), service utilisation ("gaining" access), the relevance and effectiveness of services and equity of access. These dimensions provide a common framework that can be applied across countries and health systems and employed to assess the extent to which access to health care is actually achieved.