Implementing a Clinical Research Department to Support Pediatric Studies: A SWOT Analysis

The safety, tolerability, pharmacokinetics and efficacy of most drugs used in pediatrics have not been studied in different age groups and are administered "off-label use". Clinical pediatric drug trials require specific and stringent compliance with laws, regulations, guidelines, and patient/parent/public involvement, which in turn increases resource use and makes support useful from a medical, qualitative, economic, and system perspective. We examined the strengths, weaknesses, opportunities and threats of implementing a Research Department for the Support of Pediatric Studies (RDPS) in Vienna. We used the SWOT ("strengths", "weaknesses", "opportunities", and "threats") analysis to collect comprehensive data and facts on the internal strengths, weaknesses (company analysis), and external opportunities and threats (environmental analysis). The company analysis revealed a productivity gain, due to a highly specialized team and standardized processes. The environmental analysis outlined a considerable 360-degree potential for a qualitative and quantitative medical- and social-scientific expansion of the service portfolio. The establishment of a RDPS leads to the centralization of pediatric studies by bundling tasks and concentration of specialist knowledge, which enables the exploitation of synergies, the standardization of processes, the promotion of professionalism, flexibility, innovations and the reduction of inefficiencies in the form of duplication of tasks. RDPS offers tailored advice and support for different types of pediatric studies.

The Dilemmas of Frontline Staff Working with the Homeless: Housing First, Discretion, and the Task Environment

This paper examines staff discretion in permanent supportive housing facilities run by a nonprofit agency claiming to use a housing-first approach. Field observation, archival data, and individual and group interviews with staff and clients were examined to better understand agency processes involved in intake, sanctions, and disposal of clients to evaluate housing-first fidelity. In their day-to-day interactions with clients, frontline workers' discretion is affected by working conditions such as lack of resources and heavy workloads, as well as by demands placed on the agency by members of the its task environment. Implications for housing-first programs and homeless clients are discussed.