Recruitment in Recovery

Burgess (1993) finds that job finding rates for the unemployed do not move proportionately to changes in the overall hiring rate. Burgess hints at employed job seekers that start looking in tight conditions and crowd out the unemployed. But he leaves the search behaviour of firms unaddressed. Russo et al. (2000) and Russo et al. (2001), however, shows that firms switch their preferred recruitment channel in changing labour market conditions. We introduce recruitment channels in a search model and find an additional mechanism through which the unemployed obtain less than their `fair share' of the job offers. We then test our model's predictions using panel data from the Netherlands and find support for this hypothesis.employer search, job search, recruitment channels, tightness

Interregional migration: who decides to move?

The functionality of a region depends on its people. Yet for some regions within Australia, attracting and retaining varied skilled people continues to be a challenge. What influences people to want to stay, move away from or move into a region? Before we can answer this question, we firstly need to understand 'who' is making this decision. Much of past research assumes the decision is made at the individual head of household level or must assume the decision is made at the individual as opposed to the household level as a result of data availability. This paper highlights the limitations of making such an assumption and offers an alternative method transforming secondary microdata to reflect the collective household unit as the decision making unit. We find that our migration models are statistically robust with results consistent with conventional studies that show smaller, younger households are more mobile. Most importantly, however, we find evidence that our proxies which represent characteristics of the collective unit, termed "Decision Making Unit", are also statistically significant. Thus, justifying the need for migration models to reflect the collective unit and not just the individual, should we seek to better understand motives

Do Financial Constraints Reduce Process Innovation? Evidence from Australian Firms

Accessing external finance for innovation is difficult. We study the effect of financial constraints on the probability of conducting process innovation, while also considering the role of past experience. We show a firm’s optimal process innovation decision is a function of its previous decision and financial constraints, which naturally leads to a set of population moments for empirical testing with Australian microdata from 2006 to 2018. We find that if a firm did not conduct process innovation previously, financial constraints reduce its probability of process innovation by around 10 per cent. Whereas with previous process innovation, financial constraints reduce the probability by around 12 per cent

Resident perceptions of the relative importance of socio-cultural, biodiversity, and commercial values in Australia\u27s Tropical Rivers - Report for the North Australia Water Futures Assessment<br />

EXECUTIVE SUMMARYBackground and overview of project (chapter 1):This report describes research that was commissioned by the Northern Australia Water Futures Assessment (NAWFA) Cultural and Social program. The NAWFA Cultural and Social program has funded a number of research projects to help fill some of the critical information gaps about Social and Cultural values associated with Australia&rsquo;s Northern Rivers.The TRaCK NAWFA Social and Cultural project was comprised of three research activities that were carried out by CSIRO, Charles Darwin University (CDU), James Cook University (JCU) and Griffith University (GU) as part of the Tropical Rivers and Coastal Knowledge (TRaCK) program. The three activities ran in parallel from March 2011 for a period of 12 months, and were:&nbsp;&nbsp;&nbsp; &bull; Sub-project 1 &ndash; Social and cultural values in the planning cycle (CSIRO and CDU);&nbsp;&nbsp;&nbsp; &bull; Sub-project 2 &ndash; Relative values of water for trade-offs (JCU); and&nbsp;&nbsp;&nbsp; &bull; Sub-project 3 &ndash; Developing management models for Indigenous water strategies (GU). This report relates to Sub-project 2 &ndash; Relative values of water for trade-offs.The overarching aim of this project was to improve our understanding of the Social and Cultural values associated with Australia&rsquo;s Tropical Rivers. Its specific objectives were to improve our understanding of:&nbsp;&nbsp;&nbsp; 1. the relative values of water for different stakeholder groups;&nbsp;&nbsp;&nbsp; 2. the rate at which different stakeholder groups are willing to trade-off &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; economic development for those values;&nbsp;&nbsp;&nbsp; 3. the extent to which stream flow and/or water quality could change before there was a &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &lsquo;significant&rsquo; impact on Social and Cultural values; and hence&nbsp;&nbsp;&nbsp; 4. the likely response of stakeholders to the consequences of upstream development scenarios and &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; to potential changes in the downstream uses of water.The project was undertaken within a limited timeframe. Although data collection processes ensured that a reasonable cross section of views were obtained, these views are not considered to be&nbsp;&nbsp; representative of the views of all residents of Northern Australia. Furthermore, although researchers have been able to conduct a relatively detailed analysis of much of the data and&nbsp; produce useful results, there is scope for further, more sophisticated analysis that may generate further insights. As such, this work should be viewed as generating &lsquo;preliminary&rsquo; findings.Generic methods (chapter 2):A hammer is not capable of fixing all building problems. Likewise, no single valuation method can be used in all situations. One needs to consider a variety of different issues, including data availability, ethical and information requirements.Social and Cultural values are only loosely associated with the market (if at all). As such, many valuation techniques (particularly those which rely on observable market prices) could not be used to asses ALL values of interest. Instead, stated preference techniques were chosen since they alone are able to assess a full range of values (irrespective of whether or not they are associated with the market).However, researchers were aware of the fact that if they used stated preference techniques to measure preferences at an individual level by asking about Willingness to Pay (WTP), and if they then added those &lsquo;preferences&rsquo; across multiple individuals (each with a different income), they would create what is &ndash; in essence &ndash; a weighted index of value (where the weights are a function of income). Researchers therefore decided to use both dollar and non-dollar denominated stated preference techniques.Sampling (chapter 3):Researchers were cognizant of the fact that the work was commissioned by NAWFA, with the overarching goal of providing information (about Social and Cultural values) to assist water planners. These planners work, almost exclusively, with local residents. So, researchers decided to assess only the &lsquo;values&rsquo; of residents in the tropical river&rsquo;s region &ndash; although great care was taken to ensure that information was collected from a broad cross-section of those residents.A questionnaire was mailed out to more than 1500 residents across Northern Australia. Researchers received 252 usable responses, which were supplemented by interviews that were conducted with 39 residents of the Upper Mitchell River, QLD. The upper part of this catchment was chosen for an intensive case study for three reasons: (1) it is in the formative stages of water policy and planning, so a study such as this was well-timed to provide information that might assist those involved in the planning process; (2) Researchers needed to ensure that data were collected from both Indigenous and non-Indigenous residents, and they had already worked with several Indigenous people in and around the upper reaches of the Mitchell, making it relatively easy to engage with various groups in a short study period of time; and (3) development issues confronting those in the Mitchell Catchment are likely to precede those in other TR catchments (with the exception of regions in and around Darwin), meaning that lessons learned from this case-study could be useful in other regions in later years.The entire sample included a smaller percentage of Indigenous people, large families, young people and people who did not go to university, than the population from which the sample was drawn. The&nbsp; sample did, however, contain observations from a broad cross-section of most of our targeted&nbsp; &lsquo;stakeholder&rsquo; groups, namely residents who depend upon the agricultural, mining, government and &lsquo;other&rsquo; sectors for income and employment, allowing many important observations to be drawn.Readers are cautioned not to simply look at aggregate measures (e.g. means), and assume that those measures can be used to draw inferences about the population at large. Instead readers should first check to see if the variable of interest is &lsquo;consistent&rsquo; across stakeholder groups. Where differences exist, readers should look at the information most pertinent to the group(s) of interest, rather than at aggregate measures. If used in this way, the information generated in this report is likely to be very useful.Readers are, however, urged to exercise extreme caution when seeking to use insights from this study to draw inferences about Indigenous values in other parts of the TR region. This is because of the relatively low number of Indigenous responses received, and the fact that most Indigenous respondents came from one small area of the TR region. But readers should even be cautious about trying to draw inferences about the values of other Indigenous people within the study area; our Indigenous sample did not include people from ALL traditional owner groups in the Upper Mitchell.Objective 1 &ndash; (chapter 4):Researchers sought to assess the relative importance which a wide variety of residents of Northern Australia place upon nine different goods/services associated with Australia&rsquo;s Tropical Rivers, including the values associated with the &lsquo;use&rsquo; (consumptive or otherwise) of rivers for: supporting human life (referred to as Life); for supporting Biodiversity; for use in Commercial ventures; for future generations (termed Bequest); for simply &lsquo;being there&rsquo; even if never used (termed Existence); for recreational Fishing; for other types of Recreation; for Aesthetics; and for Teaching.Importantly, the list of values comprised six examples of Social and Cultural values, and three examples of other (non-Social/Cultural) values. These other values were included to enable researchers to gauge the importance of Social and Cultural values RELATIVE to other &lsquo;values&rsquo;.Respondents were presented with a list of those values and asked to indicate (i) how important each was to their overall well-being; and (ii) how satisfied they were with it. When not completely satisfied, they were asked to explain why. The data were analysed using several different approaches, clearly highlighting the following:&bull; In terms of importance, the top three values identified by respondents were Biodiversity,&nbsp; Life, and Bequest.&bull; The highest satisfaction ratings were associated with Biodiversity, while Life, Bequest and&nbsp; Aesthetics were equally second highest.&bull; Many of the stated causes of dissatisfaction related to concerns about what might happen in the &nbsp; future (rather than to concerns about what was happening now).&bull; Most stakeholder groups held similar views about the ranking of values (in terms of &lsquo;importance&rsquo;) &nbsp; from highest to lowest, although some socio-demographic, economic, and sense of place factors were &nbsp; found to have a minor influence on importance scores.&bull; One of the highest policy priorities seems to be that of Commercial values. This is not&nbsp; because such values were considered to be important (they were rarely in the &lsquo;top three&rsquo;), but &nbsp; because the satisfaction scores associated with these values were so low. Evidently, the issue here &nbsp; is not one of protecting Commercial values, but of addressing problems, and concerns relating to &nbsp; the commercial use of water. Resident concerns included, but were not limited to issues associated &nbsp; with: pollution (past, present, or potential future), pricing, overuse, lack of certainty in &nbsp; supply, allocation and lack of monitoring. Interestingly, there were no systematic or predictable &nbsp; differences in the responses of different stakeholder groups in either the satisfaction scores or &nbsp; the indices of dissatisfaction associated with Commercial values; evidently respondents were &nbsp; consistently &lsquo;dissatisfied&rsquo; with this value (although for many different reasons).A small subset of respondents (interviewees) were also asked to participate in a cognitive mapping exercise &ndash; the aim being to determine the extent to which the values assessed in the survey could be viewed as complementary or competitive. Biodiversity, Life and Social/Cultural values were viewed as being largely complementary to each other. In contrast, Commercial values were consistently viewed as quite separate from &ndash; and often competitive or detrimental to &ndash; these other values (with the important exception of tourism).Objective 2 (chapter 5):Respondents were also presented with a series of (hypothetical) development &lsquo;scenarios&rsquo;. First, they were asked to indicate how much they would be willing to pay (WTP) to prevent development that would impact upon Social and Cultural values. Then they were asked to indicate how much they would be willing to accept (WTA) as compensation if development caused damage to their Social and Cultural values. Finally they were asked how much they would be willing to pay to reduce current&nbsp; development, thus increasing their opportunity to enjoy Social and Cultural values.Data were analysed using a variety of different methods, highlighting the following:1) A large proportion of respondents were strongly opposed to the development scenarios, &nbsp;&nbsp;&nbsp; evidenced by the fact that&nbsp;- Fewer than 33 per cent of respondents indicated that they approved of the development scenarios &nbsp;&nbsp; presented in the first two scenarios &ndash; even when the impact on Social and Cultural values was &nbsp;&nbsp; relatively small.- A relatively large percentage of respondents refused to consider any trade-off at all (between &nbsp; 30% and 70%, depending upon the format of questionnaire presented).- Some respondents noted that they had already spent thousands of dollars fighting development &nbsp; proposals in and around &lsquo;their&rsquo; rivers.- Of the group that agreed to &lsquo;play&rsquo; the trade-off &lsquo;game&rsquo;, approximately 5 per cent were WTP/A &nbsp; significant sums of money to avoid damage or to &lsquo;repair&rsquo; damage to their Social and Cultural &nbsp; values) with maximum values cited in the survey of $1 million and many values in excess of$10,000. &nbsp; These maximum values generated highly skewed distributions with mean WTP/A ranging between almost &nbsp; $6000 per annum per household, to almost$28,000; median values were much more modest (between 15   and 100).- More than 50 per cent of respondents indicated that they would be willing to accept a DECLINE in income if it was associated&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; with improved opportunities to enjoy their Social and Cultural values.This strong sentiment is not altogether surprising given the fact that the previous chapter clearly showed that Commercial values were, almost always, rated as being less important than some Social and Cultural values &ndash; particularly Bequest. Moreover, it is consistent with previous studies in the region (e.g. Straton and Zander, 2010).This strong sentiment may also at least partially reflect an assumption on the part of respondents that the scenarios would affect more than just Social and Cultural values (i.e. they may be assuming that the development will also impact values such as Biodiversity which are viewed by some as essentially inseparable from Social and Cultural values).2) When outliers (i.e. the very high WTP/A dollar votes) were excluded, researchers found that:- WTP was strongly linked to ability to pay, but that those on low incomes are willing to sacrifice &nbsp; a much higher proportion of their income to protect their rivers than those on high incomes (three &nbsp; to four times higher). This is also consistent with previous findings of Straton and Zander (2010).- The importance which people place on Biodiversity is, almost always, a positive and statistically &nbsp; significant determinant of their WTP to protect Social and Cultural values (reinforcing earlier &nbsp; observations about the complementarity of these values).- People&rsquo;s expressed willingness to accept compensation for &lsquo;damage&rsquo; to Social and Cultural &nbsp; values (which they are unable to prevent from occurring) is significantly higher than their &nbsp; expressed willingness to pay to avoid the damage from occurring in the first place. The potential &nbsp; policy significance of this is discussed in chapter 7 (summarised under issue 3, page vi).Objective 3 (chapter 6):Respondents were asked to consider a range of hypothetical scenarios that involved changes to stream flows and water quality in nearby rivers. Specifically, they were asked to indicate (on a five point Likert scale) how these changes would affect their satisfaction with Social and Cultural values. Analysis of the data highlighted the following issues:&bull; Any change which stops the flow of perennial rivers &ndash; even if only for a month or two &ndash; is likely &nbsp; to have a significant, negative impact on Social and Cultural values. (The term significant &nbsp; indicates that more than 50% of respondents said that such a change would either reduce or greatly &nbsp; reduce their satisfaction.)&bull; Respondents were generally positive or ambivalent about changes in stream flow which reduced dry &nbsp; periods. In other words, those who live near an intermittent river system stated that they would &nbsp; either have increased or consistent levels of satisfaction with their Social and Cultural values if &nbsp; the dry periods were shortened (or if the river becomes perennial). The important exception to this &nbsp; occurred with respect to perennial but UNPREDICTABLE flows. Perennial flows are viewed positively &ndash; &nbsp; as long as the flows are constant, or related to natural, seasonal fluctuations.&bull; Scenarios that reduce water quality (be it due to increased levels of turbidity or algae) are &nbsp; likely to create a significant negative impact on Social and Cultural values; improvements are &nbsp; likely to generate a significant positive impact.&bull; Respondents viewed reductions in water quality more negatively than reductions in stream flow, &nbsp; and were consistently more positive about scenarios that involved improvements in water quality &nbsp; than about scenarios that involved increases in stream flow. This may be at least partially due to &nbsp; the fact that respondents are used to living in regions that have extremely variable climates. &nbsp; Changes to stream flows may thus be considered somewhat &lsquo;normal&rsquo;.Concluding remarks and recommendations (Chapter 7):Objective 4 asked researchers to determine:What is the likely response of stakeholders to consequences of upstream development scenarios and to potential changes in the downstream usages of water?Chapter 4 clearly showed that Commercial values are considered to be less important than&nbsp; Biodiversity, Life and some Social/Cultural values, while chapter 5 clearly showed that at least some people are WTP substantial amounts of money to prevent development that impacts upon their&nbsp; Social/Cultural values. As such, it seems that developments which impact upon downstream usages of water are likely to be met with quite a negative reaction.The opposition is likely to be characterised by significant disquiet amongst a possibly vocal minority (those refusing to consider any trade off at all, or WTP very large sums of money to prevent the development from occurring) and a present, but less significant disquiet amongst a larger group of other residents.Those most willing to accept trade-offs for development include the wealthy and/or people who place highest values on Commercial uses of rivers; those who place a high value on Biodiversity (a significant proportion of respondents) and/or those who are relatively poor seem to be much less willing to trade their Social and Cultural values for greater income flows.Other important comments/insightsISSUE 1: Interviewee data indicates that Biodiversity, Life and Social/Cultural values are somewhat&nbsp; complementary to each other, whereas, Commercial values are almost always viewed as quite separate from &ndash; and often competitive or detrimental to &ndash; these other values (with the important exception of tourism). Moreover the larger (mail out) data set showed a strong correlation between WTP to protect Social/Cultural values and stated importance of Biodiversity values.Evidently, for many Northern Residents, the existence of biodiversity may be a necessary pre-condition for maintenance of many Social and Cultural values. Determining whether or not the existence of biodiversity is also a SUFFICIENT condition for the preservation of Social and Cultural values, stands as a vitally important topic for further, more thorough, research. Why is this so important?&bull; If the existence of high quality biodiversity values is both a necessary and sufficient condition &nbsp; for the existence of high quality socio-cultural values, then preservation of the former &nbsp; guarantees preservation of the latter. However, if the existence of high quality biodiversity &nbsp; values is a necessary, but not a sufficient condition for the existence of high quality socio- &nbsp; cultural values, then preservation of the former does not guarantee preservation of the later; &nbsp; other steps may be necessary (e.g. guaranteeing access to areas of high biodiversity value).&bull; Moreover, if the Biodiversity and Social/Cultural values that are derived from one &lsquo;area&rsquo; are &nbsp; non-rivalrous (meaning that society can benefit from both, simultaneously), then their values &nbsp; should be added together1 before being traded off against other competing uses of that &lsquo;area&rsquo;. This &nbsp; is analogous to the situation where a private property owner seeks to determine how much land to &nbsp; devote to cattle and how much to wheat: he/she should firstly estimate the value of &lsquo;cattle&rsquo; by &nbsp; considering potential income from both beef and leather, and then compare that (combined) value to &nbsp; the potential income that can be earned from the alternative (wheat). Failure to do so, would be to &nbsp; under-allocate resources (e.g. land, or in this case, possibly aquatic resources) to activities &nbsp; that generate multiple values (e.g. cattle, or in this case, possibly biodiversity and &nbsp; socio-cultural values).Until we are able to learn more about these important issues2, planners may, therefore, wish to adopt a pre-cautionary approach (as advocated by the NWI). That is, they may wish to proceed as if these values are non-rivalrous, perhaps setting aside MOREthan the &lsquo;bare minimum&rsquo; that is required to maintain biodiversity values, and also ensuring that other steps are taken to facilitate the appreciation of socio-cultural values (e.g. ensuring residents have access to important areas).ISSUE 2: Respondents were particularly concerned about changes which impact upon water quality, although those who live near perennial rivers were also very concerned about any change that would stop their stream/river flowing for even a short period each year. Moreover, comments made during focus groups and in interviews (as well as comments written on returned, mail-out questionaries) indicated that (a) many respondents have a holistic view of their environment (incorporating&nbsp; social, cultural, economic and biophysical values); (b) they did not feel as if all local environmental management issues were being dealt with effectively; and that (c) their oppositio

Developing creative industries in northern Australia: a report on key developments and outcomes in the city of Townsville, North Queensland

Creative industries with a typically commercial focus (e.g. film, design, software) are often cited as key areas of focus for economic and workforce development. This is typically due to creative industries’ low reliance on major infrastructure (e.g. dams, roads), as well as their capacity to value add to other industry sectors given they are often at the cutting edge of technological development and innovation processes. While there are a multitude of studies that measure and assess the size and contribution of creative industries to metropolitan – and to a lesser extent regional - economies across the globe, there is very little focus on the demand side for this sector. In what is arguably the first project of its kind, this presentation reports on the overarching findings and key economic development outcomes of a major supply/demand analysis of creative industries in Townsville, northern Australia, and which was completed in 2014-15. In addition to citing the major findings and which include an estimate of the import leakage to the local economy, this presentation discusses the development of a range of key strategies and outcomes designed to build on the research findings and boost the local workforce and economic activity within the sector. These key outcomes have included the development of creative industry industries growth through Entrepreneurial/Mentoring Program, a Creative Industries Cluster, a Film Industry Development group, and the formation of Townsville City Council’s first ever Innovation and Business Advisory Group. These various strategies are discussed in terms of their formation, delivery and either intended or achieved outcomes to date. As part of ongoing research and analysis of creative industries beyond capital cities, this presentation highlights a number of key issues of relevance to not only the regions but other key centres in northern Australia, whilst also highlighting the value of university and community engagement

Impact of financial pressure on unemployed job search, job find success and job quality

Research shows that financial pressure – implied as a consequence of benefit sanctions or exhaustion – prompts the unemployed to intensify their job search. However, there is less agreement about whether that intensified job search produces better quality job outcomes. Building on Self-Determination Theory we posit that financial pressure is a controlled motivator to search for work. Controlled motivators are conducive to goal pursuit (job search activity), yet unfavorable to goal achievement (job search success and job quality). Using the HILDA longitudinal data for Australia, we are able to include direct measures of both financial pressure (cash flow problems and hardship), objective job quality (hourly pay and hours worked) as well as subjective job quality (satisfaction with pay and hours). We find that financial pressure intensifies job search without improving the job find rate and job quality outcomes if a job is secured. Interestingly, if a job is secured the unemployed who searched under financial pressure perceive the job to be of lower quality (in terms of satisfaction with pay and hours worked) even though objectively (in terms of actual pay and hours worked) it is similar to the jobs found by the unemployed who searched without financial pressure. Policy implications are discussed

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570