It is contended that value is a social construct, and that the processes of social construction are rooted in language. On this basis we argue that value creation is a process which lends itself to ...interpretation from a narrative perspective. Previous attempts at value creation have been promoted under the label of ‘value management’. There are two approaches which are identifiable in the literature. The first is based on the traditional narrative of value engineering (aka Hard VM) and is primarily directed towards cost reduction. The second more recent variant is labelled ‘soft’ value management (Soft VM) and is primarily directed towards the achievement of a shared understanding of the value criteria relating to an individual project. The two approaches are critiqued in terms of their underlying assumptions and it is suggested that they are best understood as different forms of narrative. The emerging literature on value creation is similarly critiqued in accordance with the adopted narrative perspective. The distinction is made between formalised narratives of value on the level of the organisations involved in the project coalition and the anecdotal stories which individuals use to make sense of their own lived experiences. Emphasis is given to the ways in which different narratives interact, and to the way in which they remain contestable over time. Particular attention is given to the confluence between storytelling and identity work.
•Value is in essence a social construct, and the processes of social construction are rooted in language•Value creation in projects is a process which lends itself to interpretation from a narrative perspective•There has been shifts in understanding value creation in projects: from 'hard' value engineering to ‘soft’ value management•Narratives of value on the level of the organisations interact with anecdotal stories which individuals use to make sense of their lived experiences•Personal values are inherently inseparable from 'identity work'
Gefapixant is an oral P2X3 receptor antagonist that has previously shown efficacy and safety in refractory chronic cough and unexplained chronic cough. We therefore aim to confirm the efficacy and ...safety of gefapixant in participants with refractory chronic cough and unexplained chronic cough.
COUGH-1 and COUGH-2 were both double-blind, randomised, parallel-group, placebo-controlled, phase 3 trials. COUGH-1 was done in 156 sites in 17 countries and COUGH-2 in 175 sites in 20 countries. We enrolled participants who were 18 years or older with a diagnosis of refractory chronic cough or unexplained chronic cough of 1 year duration or more. Participants were also required to have a cough severity visual analogue scale score of 40 mm or more at screening and baseline. Eligible participants were randomly allocated (1:1:1), using a computer-generated allocation schedule, to one of three treatment groups: placebo, gefapixant 15 mg twice per day, or gefapixant 45 mg twice per day. All study treatments were given orally. Participants were treated over a 12-week main study period in COUGH-1 and a 24-week main study period in COUGH-2; followed by extension periods for a total of up to 52 weeks of treatment in both trials. The primary outcome was placebo-adjusted mean change in 24-h cough frequency at 12 weeks in COUGH-1 and 24 weeks in COUGH-2. Both studies were registered with ClinicalTrials.gov, NCT03449134 (COUGH-1) and NCT03449147 (COUGH-2).
From March 14, 2018, (first participant screened) to July 26, 2019, (last participant screened) 732 patients were recruited in COUGH-1 and 1317 in COUGH-2. COUGH-1 randomly assigned and treated 730 participants (243 33×3% with placebo, 244 33×4% with gefapixant 15 mg twice per day, and 243 33×3% with gefapixant 45 mg twice per day); COUGH-2 randomly assigned and treated 1314 participants (435 33×1% with placebo, 440 33×5% with gefapixant 15 mg twice per day, and 439 33×4% with gefapixant 45 mg twice per day). Participants were mostly female (542 74×2% of 730 in COUGH-1 and 984 74×9% of 1314 in COUGH-2). The mean age was 59×0 years (SD 12×6) in COUGH-1 and 58×1 years (12×1) in COUGH-2, and the mean cough duration was 11·6 years (SD 9·5) in COUGH-1 and 11·2 years (9·8) in COUGH-2. Gefapixant 45 mg twice per day showed significant reductions in 24-h cough frequency compared with placebo at week 12 in COUGH-1 (18·5% 95% CI 32·9–0·9; p=0·041) and at week 24 in COUGH-2 (14·6% 26·1–1·4; p=0·031). Gefapixant 15 mg twice per day did not show a significant reduction in cough frequency versus placebo in both studies. The most common adverse events were related to taste disturbance: ageusia (36 4·9% of 730 in COUGH-1 and 86 6·5% of 1314 in COUGH-2), dysgeusia (118 16·2% in COUGH-1 and 277 21·1% in COUGH-2), hypergeusia (3 0·4% in COUGH-1 and 6 0×5% in COUGH-2), hypogeusia (19 2·6% in COUGH-1 and 80 6·1% in COUGH-2), and taste disorder (28 3·8% in COUGH-1 and 46 3·5% in COUGH-2).
Gefapixant 45 mg twice per day is the first treatment to show efficacy with an acceptable safety profile in phase 3 clinical trials for refractory chronic cough or unexplained chronic cough.
Merck Sharp & Dohme.
The picture of crime that dominates the popular imagination is one of unambiguous wrong-doing - manifestly harmful acts that are clearly worthy of condemnation. The accompanying picture of the ...criminal - the thief, the murderer - is a picture of society's failures - to be cast out and re-integrated through a process of punishment and penance. Our understanding of white-collar crime, by contrast, is pervaded by moral and imaginative ambiguity. Such crimes are committed by society's success stories, by the rich and the powerful, and frequently have no visible victim at their root. The problem of marrying these disparate pictures has led to a confusion of the boundaries of white-collar crime. How is it possible to distinguish criminal fraud from mere lawful "puffing", tax evasion from "tax avoidance", insider trading from "savvy investing", obstruction of justice from "zealous advocacy", bribery from "log rolling", and extortion from "hard bargaining"? How should we, as scholars and students, lawyers and judges, law enforcement officials and the general public, distinguish the lawful from the unlawful, the civil from the criminal? In the first in-depth study of its kind, Stuart Green exposes the ambiguities and uncertainties that pervade the white-collar crimes, and offers an approach to their solution. Drawing on recent cases involving such figures as Martha Stewart, Bill Clinton, Tom DeLay, Scooter Libby, Jeffrey Archer, Enron's Kenneth Lay and Andrew Fastow, and the Arthur Anderson accounting firm, Green weaves together disparate threads of the criminal code to reveal a complex and fascinating web of moral insights about the nature of guilt and innocence and what, fundamentally, constitutes conduct worthy of punishment by criminal sanction. Green argues that white-collar crime is best understood through a framework of everyday moral concepts that include not only lying, cheating and stealing, but also coercion, exploitation, disloyalty, promise-breaking, disobediance, and other forms of deception. In the process, he reveals the essentially moral fabric underlying the legal category of white-collar crime. Available in OSO: http://www.oxfordscholarship.com/oso/public/content/law/9780199225804/toc.html
The organization of construction in the People's Republic of China has over recent decades undergone radical restructuring. The announcement of Deng Xiaoping's Open Door strategy in 1978 marked the ...beginning of the transition towards the espoused socialist market economy and the progressive introduction of market mechanisms. Existing research tends to focus on the derivation of "critical success factors" rather than the lived realities of those directly involved. In contrast, the current paper adopts a sensemaking perspective that privileges the transient roles and identities of those involved in the micro-processes of project organizing. The empirical focus lies on the sensemaking narratives of middle managers within three state-owned construction enterprises in the Chongqing city region. The findings illustrate how market mechanisms such as bidding and tendering play out in complex ways involving hybrid arrangements between new and pre-existing ways of working. The terminology of project management is seen to have played a performative role in establishing the "project" as the essential unit around which the socialist market is organized. Middle managers are further found to maintain multiple identities in response to the experienced paradoxes of the socialist market economy. The research provides new insights into the micro-processes of project organizing in China with broader implications for transitional economies elsewhere.
Innovation is invariably accepted as a central component of construction sector competitiveness. Yet, there remains a paucity of empirical research, which explores the gap between the way innovation ...is promoted in the policy discourse and how it is interpreted in practice. We follow the "narrative turn" in organization studies to explore the ways in which senior executives in the UK construction sector ascribe themselves with informal roles while advocating the cause of innovation. Empirical data is derived from narrative interviews with 32 senior executives who self-identify as "innovation champions". When talking about innovation, the respondents were found to oscillate between performative narratives of innovation and more personalized stories derived from their own experience. The narratives were invariably pre-rehearsed often to the point of being monotonous. In contrast, the personalized stories tended to be engaging and emotionally laden. The tendency for senior executives to oscillate between narratives and stories is seen as an important means through which they search for meaning while at the same time legitimizing their self-identities as "innovation champions". Of particular note is the way in which senior managers self-ascribe themselves with informal roles which are notably at odds with those described in more formalized narratives.
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