Exploring legitimacy and exposing legitimising myths : a critical analysis of corporate social responsibility in global supply chains

University of Technology Sydney. Faculty of Business.This research critically explores corporate social responsibility in global supply chains. It specifically focuses on efforts by companies and civil society organisations to redress labour and human rights abuses. It considers the significance of global supply chains as the dominant mode sourcing and manufacturing, and the human costs associated with this production regime. The overarching aim is to explain why labour and human rights abuses in global supply chains are a recurring feature, despite a range of voluntary and self-regulatory initiatives that seek to address these issues. The objectives of this research are twofold. First, to empirically explore why corporate social responsibility has not structurally addressed exploitation in global supply chains. Second, to examine to what extent legitimacy theory can explain this failure and how this theory can be expanded to increase its explanatory power. The starting point of the analysis is the assumption that the corporate social responsibility paradigm is entwined with neoliberal ideology. As a voluntary and self-regulatory corporate mechanism, it seeks to balance social, environmental, and financial interests guided by the invisible hand of the market. This research examines the effectiveness of the corporate social responsibility paradigm and exposes its flaws. It furthermore focuses on developments that contest the dominant corporate social responsibility paradigm. Specifically, the research explores the United Nations Guiding Principles on Business and Human Rights, which seek to overcome the dichotomy between voluntary and binding approaches to mitigate the social and environmental impact of companies. It also examines the rise of multistakeholder initiatives, in which companies and civil society organisations work together. This research examines how stakeholders question organisational legitimacy and how companies manage threats to their legitimacy. It makes a practical as well as a theoretical contribution. It identifies shortcomings underlying current approaches to exploitation in supply chains. It explains that reputational damage campaigns by civil society organisations are not an effective long-term strategy in improving working conditions, as companies can neutralise these threats without making substantive changes. The research finds that innovative approaches face similar challenges to conventional strategies. These are marked by an ongoing reliance on corporate voluntarism, self-regulation and market mechanisms to solve labour and human rights abuses. The introduction of legitimising myths broadens the use of legitimacy theory in a management context. This research advances the analysis of stakeholder dynamics in addressing supply chain abuses, and it explains how social agents challenge and maintain the dominant corporate social responsibility paradigm

Australian Census of Women in Leadership

The business case for advancing more women into leadership is clear for companies globally. Whilst this is an issue of equality, it’s also about accessing markets, productivity and economic opportunity. ANZ has made good progress: three women sit on our Management Board; 38% of all management roles and 24% of our most senior executive positions are held by women; and females lead key global businesses and countries in our super regional growth strategy. However, further gains are now hard won and largely incremental. Looking at the results of EOWA’s 2012 Australian Census of Women in Leadership, it seems we are not alone. Given the high proportion of Australian women with a tertiary education - and indeed placed within junior and middle management ranks - the Census results demonstrate the pace of progression is far too slow. Extensive local and international research tells us there is no ‘silver bullet’. In fact, I believe as CEOs and business leaders our approach must now focus on gender balancing our businesses with a fine tooth comb. We need to go beyond high level targets, discrete programs and initiatives and engage women and men in this major opportunity. For example, at ANZ we are working to ensure women have access to a breadth of critical experiences and development opportunities throughout their careers to position them well for senior executive roles into the future. We have set targets for at least 40% female representation amongst participants in our key recruitment, talent and development programs, in addition to our medium term goal to achieve at least 40% representation of women in management overall. More broadly, senior women consistently cite an inclusive and supportive line manager as a defining factor in their progression. It follows that if we want more women in our senior ranks, constructive, inclusive and supportive leaders should become the norm in Australian business rather than the exception. Flexible work options assist in helping people balance their caring responsibilities and other commitments. But there’s more we can do to role model and promote flexibility, especially as such practices also build a more agile, productive and capable workforce. I recommend this report to all business leaders and urge all executives and directors to accept accountability for ensuring the next Census delivers better results

Platelet Glycoprotein IIb/IIIa Receptor Inhibition in Non-ST-Elevation Acute Coronary Syndromes

BACKGROUND: Glycoprotein (GP) IIb/IIIa receptor blockers prevent life-threatening cardiac complications in patients with acute coronary syndromes without ST-segment elevation and protect against thrombotic complications associated with percutaneous coronary interventions (PCIs). The question arises as to whether these 2 beneficial effects are independent and additive. METHODS AND RESULTS: We analyzed data from the CAPTURE, PURSUIT, and PRISM-PLUS randomized trials, which studied the effects of the GP IIb/IIIa inhibitors abciximab, eptifibatide, and tirofiban, respectively, in acute coronary syndrome patients without persistent ST-segment elevation, with a period of study drug infusion before a possible PCI. During the period of pharmacological treatment, each trial demonstrated a significant reduction in the rate of death or nonfatal myocardial infarction in patients randomized to the GP IIb/IIIa inhibitor compared with placebo. The 3 trials combined showed a 2.5% event rate in this period in the GP IIb/IIIa inhibitor group (N=6125) versus 3.8% in placebo (N=6171), which implies a 34% relative reduction (P<0.001). During study medication, a PCI was performed in 1358 patients assigned GP IIb/IIIa inhibition and 1396 placebo patients. The event rate during the first 48 hours after PCI was also significantly lower in the GP IIb/IIIa inhibitor group (4. 9% versus 8.0%; 41% reduction; P<0.001). No further benefit or rebound effect was observed beyond 48 hours after the PCI. CONCLUSIONS: There is conclusive evidence of an early benefit of GP IIb/IIIa inhibitors during medical treatment in patients with acute coronary syndromes without persistent ST-segment elevation. In addition, in patients subsequently undergoing PCI, GP IIb/IIIa inhibition protects against myocardial damage associated with the intervention

A heart failure phenotype stratified model for predicting 1-year mortality in patients admitted with acute heart failure:results from an individual participant data meta-analysis of four prospective European cohorts

Background Prognostic models developed in general cohorts with a mixture of heart failure (HF) phenotypes, though more widely applicable, are also likely to yield larger prediction errors in settings where the HF phenotypes have substantially different baseline mortality rates or different predictor-outcome associations. This study sought to use individual participant data meta-analysis to develop an HF phenotype stratified model for predicting 1-year mortality in patients admitted with acute HF. Methods Four prospective European cohorts were used to develop an HF phenotype stratified model. Cox model with two rounds of backward elimination was used to derive the prognostic index. Weibull model was used to obtain the baseline hazard functions. The internal-external cross-validation (IECV) approach was used to evaluate the generalizability of the developed model in terms of discrimination and calibration. Results 3577 acute HF patients were included, of which 2368 were classified as having HF with reduced ejection fraction (EF) (HFrEF; EF &amp;lt; 40%), 588 as having HF with midrange EF (HFmrEF; EF 40-49%), and 621 as having HF with preserved EF (HFpEF; EF &amp;gt;= 50%). A total of 11 readily available variables built up the prognostic index. For four of these predictor variables, namely systolic blood pressure, serum creatinine, myocardial infarction, and diabetes, the effect differed across the three HF phenotypes. With a weighted IECV-adjusted AUC of 0.79 (0.74-0.83) for HFrEF, 0.74 (0.70-0.79) for HFmrEF, and 0.74 (0.71-0.77) for HFpEF, the model showed excellent discrimination. Moreover, there was a good agreement between the average observed and predicted 1-year mortality risks, especially after recalibration of the baseline mortality risks. Conclusions Our HF phenotype stratified model showed excellent generalizability across four European cohorts and may provide a useful tool in HF phenotype-specific clinical decision-making

Cardiac magnetic resonance findings predicting mortality in patients with pulmonary arterial hypertension: a systematic review and meta-analysis

Objectives: To provide a comprehensive overview of all reported cardiac magnetic resonance (CMR) findings that predict clinical deterioration in pulmonary arterial hypertension (PAH). Methods: MEDLINE and EMBASE electronic databases were systematically searched for longitudinal studies published by April 2015 that reported associations between CMR findings and adverse clinical outcome in PAH. Studies were appraised using previously developed criteria for prognostic studies. Meta-analysis using random effect models was performed for CMR findings investigated by three or more studies. Results: Eight papers (539 patients) investigating 21 different CMR findings were included. Meta-analysis showed that right ventricular (RV) ejection fraction was the strongest predictor of mortality in PAH (pooled HR 1.23 [95 % CI 1.07–1.41], p = 0.003) per 5 % decrease. In addition, RV end-diastolic volume index (po

Persistently elevated levels of sST2 after acute coronary syndrome are associated with recurrent cardiac events

Purpose Higher soluble ST2 (sST2) levels at admission are associated with adverse outcome in acute coronary syndrome (ACS) patients. We studied the dynamics of sST2 over time in post-ACS patients prior to a recurrent ACS or cardiac death. Methods We used the BIOMArCS case cohort, consisting of 187 patients who underwent serial blood sampling during one-year follow-up post-ACS. sST2 was batch-wise quantified after completion of follow-up in a median of 8 (IQR: 5-11) samples per patient. Joint modelling was used to investigate the association between longitudinally measured sST2 and the endpoint, adjusted for gender, GRACE risk score and history of cardiovascular diseases. Results Median age was 64 years and 79% were men. The 36 endpoint patients had systematically higher sST2 levels than those that remained endpoint free (mean value 29.6 ng/ml versus 33.7 ng/ml, p-value 0.052). The adjusted hazard ratio for the endpoint per standard deviation increase of sST2 was 1.64 (95% confidence interval: 1.09-2.34; p = 0.019) at any time point. We could not identify a steady or sudden increase of sST2 in the run-up to the combined endpoint. Conclusion Asymptomatic post-ACS patients with persistently higher sST2 levels are at higher risk of recurrent ACS or cardiac death during one-year follow-up

Dioxin and PCB levels in blood and human milk in relation to living areas in the Netherlands

Dioxins and polychlorinated biphenyls (PCBs) are ubiquitous toxic compounds in the environment. Negative influences of these compounds on the health status of human beings have been described. Especially susceptible might be the fetus, which is exposed in utero, and the newborn breast-fed infant, since both are exposed to relatively high levels of dioxins and PCBs during a critical period of organ growth and development. We investigated PCB levels in 406 maternal plasma samples as well as PCB and dioxin levels in 172 human milk samples with relation to living area of women living for at least five years in the western industrialized part of the Netherlands or the northern more rural part. The western part was further subdivided into one urban and two highly industrialized areas. After correction for covariates, we found significantly higher levels of PCB 118 in maternal plasma as well as significantly higher levels of the dioxin-TEQ and of ten individual dioxin and PCB congener levels in human milk in the western more industrialized areas of the Netherlands compared to the northern more rural part. We did not find significant differences in planar, mono-ortho or di-ortho PCB-TEQ levels in human milk between all different areas. We conclude that significantly higher levels of a number of dioxin and PCB congeners are found in women living in industrialized areas compared to women living in rural areas in the Netherlands