Clean needle exchange programs may be both helpful and harmful

Here's a recent NBER working paper that looks at the effects of opening a place where intravenous drug users can get clean needles--it finds that this reduces blood borne disease, but may in fact increase drug use.

Are Syringe Exchange Programs Helpful or Harmful? New Evidence in the Wake of the Opioid Epidemic
by Analisa Packham
NBER Working Paper No. 26111,  July 2019

Abstract: "In light of the recent opioid crisis, many public health entities have called for an expansion in syringe exchange programs (SEPs), which provide access to sterile syringes and facilitate safe needle disposal for injection drug users. This paper investigates the effects of recent SEP openings on HIV diagnoses and drug-related overdoses in the wake of the opioid crisis. I find that SEP openings decrease HIV diagnoses by up to 18.2 percent. However, I present new evidence that SEPs increase rates of opioid-related mortality and hospitalizations, suggesting that needle exchanges alone may be less effective than other interventions at stimulating recovery."


"From an economic standpoint,SEPs have the potential to create large positive externalities by reducing the stock of used needles on the streets and preventing the spread of disease. Conversely, by providing clean needles to drug users, reducing the stigma of using drugs and/or creating a safe environment for networking with other users, SEPs may also generate untended consequences. In particular, lowering the cost of obtaining needles and other supplies incentivizes drug users to inject more frequently, potentially exacerbating rates of opioid misuse and abuse. 

"In this paper, I test the causal relationships between SEP openings and drug-related health and crime outcomes. Because no official national directory of SEPs exist, I construct a hand collected dataset on program locations and opening dates to identify areas exposed to SEPs within the last ten years. In particular, using health outcomes data from the CDC, I compare rates of HIV, drug- and opioid-related deaths, opioid-related overdoses, and drug-related crime in counties with SEP openings to other counties without SEPs before and after the initial year of implementation. I find that SEPs decrease the number of HIV cases in some areas, and that  this effect grows over time. However, estimates also indicate that SEP openings increase drug-related mortality. … Effects are largest in rural and high-poverty areas, suggesting that those with larger geographic or financial obstacles  to substance abuse treatment are most affected by such programs."

Black market in rosewood

National Geographic has the story on the trade in endangered rosewood, which pits forest rangers in Guatemala against Chinese furniture makers on the one hand and  impoverished villagers on the other, and makes clear why it is difficult to enforce bans that lack local support.

The fight to protect the world’s most trafficked wild commodity
Chinese demand for rosewood—trafficked more than ivory, rhino horn, and pangolin scales—is fueling a crisis in Guatemala's forests

"So coveted is rosewood that it’s now the world’s most trafficked wild product by value or volume—more than ivory, rhino horn, and pangolin scales combined. According to the Global Environment Facility, an international partnership among governments, civil society, and the private sector to support conservation, the illegal wild animal trade is worth between $5 billion and $20 billion a year; it’s often ranked as the world’s fourth most lucrative black market business after narcotics, human trafficking, and the weapons trade.

"According to Interpol, timber trafficking is valued at between $30 billion and $100 billion a year and accounts for 15 percent to 30 percent of the global timber trade. Sam Lawson, the director of Earthsight, a London-based nonprofit that investigates global environmental crime, estimates that the annual value of smuggled rosewood could exceed a billion dollars.
...
"The first time Guatemalan forest officials realized they had a rosewood problem was in 2011, according to documents submitted to the Convention on International Trade in Endangered Species of Wild Flora and Fauna (CITES), the body that regulates cross-border trade in wildlife, including rare timber. That’s when three shipping containers of the precious hardwood were discovered at Puerto Santo Tomas de Castilla, one of Guatemala’s two commercial shipping ports.
...
"The emergence of Guatemala's illegal rosewood trade has been driven largely by demand among China’s nouveau riche for traditional Ming and Qing dynasty-style rosewood furniture. Between 2009 and 2014, customs data analyzed by the Environmental Investigation Agency, a U.K.-based nonprofit, show a 14-fold increase in rosewood imports to China from around the world. This expansion coincided with (and contributed to) the decimation of preferred Southeast Asian rosewoods, which earlier had replaced depleted native rosewoods in southern China. Buyers searched for new sources, and Guatemala, which has at least four commercially desirable species, was one.

...

"CONAP’s Beltetón says “it’s terrible that [rosewood] is distributed in the poorest areas of Guatemala, and that that's where the trafficker goes, taking advantage of the poverty and ignorance of people who don't have other options.” He adds, “of course, the government also bears some responsibility”—for not providing state services and active law enforcement in the most contested and conflict-ridden areas, such as the Chiquibul Mayan Mountains Protected Area, where El Carrizal is located.

"On the evening of July 1, 2018, acting on an anonymous tip about the illegal transport of rosewood, three environmental police agents made the two-and-a-half hour drive from their post in La Libertad, Petén, to El Barillal, an unincorporated village neighboring El Carrizal.

"As they approached their destination, instead of encountering the suspect, they found themselves surrounded by at least 45 men, some armed, according to the report the police filed the next day. The report says the men prevented their vehicle from passing, threatened them, questioned them about their presence, detained them for over an hour, and fired their weapons, although no one was injured. In the end, the three policemen broke the standoff by returning to La Libertad empty-handed.

In the nine months since, the environmental police have not returned to El Barillal."

More chaos in the medical resident interviewing process

Not only do graduating medical students go on (too) many interviews for residency positions, but the process by which interviews are offered and accepted is chaotic. (I'm reminded of the process of offering and accepting actual positions in the 1940's, before a matching clearinghouse was first developed...)

Here's a paper from the August 2019 issue of the Journal of Graduate Medical Education, by three concerned doctors at Northwestern University, who describe the situation and then offer their own suggestions. (I admire the description, and am skeptical that the suggestions are radical enough to change the incentives responsible for the current congestion...)

A Challenge to Disrupt the Disruptive Process of Residency Interview Invitations
Matthew R. Klein, MD, MPH
Sandra M. Sanguino, MD, MPH
David H. Salzman, MD, MEd

"Residency programs may also contribute to the sense of urgency to secure an interview by offering
more invitations than available interview slots. The rise in the number of applications per
applicant, while certainly multifactorial, is facilitated in part by the ease of online interview scheduling...
...
"In the current environment, applicants who receive an interview invitation while they are in a situation where interruption is impossible—such as taking a clerkship examination, assisting in an operating room, performing a bedside procedure, participating in a difficult conversation with a patient or family, rounding on the wards, or simply being asleep as a result of time zone differences—are effectively penalized. A delay in response may result in the inability to schedule a favorable date or an increase in the cost to travel to an interview at a less convenient time, or it may preclude an interview altogether if all interview slots have been taken.
...
"We propose a 2-step process that we believe balances the need for residency programs to recruit
applicants and schedule interviews with the goal of preserving an environment that allows students to
maintain their commitment to their educational and patient care responsibilities. We recommend the
following process
Step 1: A program informs an applicant of an invitation for an interview. In that communication,
the program shares the interview dates and indicates the date and time when online interview
scheduling will become available. This allows medical students to plan in advance when they
need to be briefly excused from clinical or educational responsibilities to attend to interview
scheduling
Step 2: At the time indicated in the initial communication, and no earlier than the day after
that communication, the online interview scheduling system opens to applicants
...
"In an effort to further decrease pressure to reply immediately to an interview invitation, programs
should also ensure that the number of initial invitations does not exceed the number of interview
slots available. Additional interview offers from a wait-list could occur as needed based on unclaimed
interview slots or subsequent cancellations."

Black markets for academic work, not just for homework anymore

Inside Higher Ed lets you know where you can buy a Ph.D. dissertation...and Clarivate (which publishes the Web of Science) let's you know where you can buy co-authorship in an already accepted academic paper. And the WSJ reveals that some students complain to the Better Business Bureau about sub-par contract cheating services.

Ukraine hosts 46 firms selling ghost-written dissertations
In 2009, there were 16 firms that sold completed dissertations; in 2016, the number nearly tripled to 46 registered enterprises.
By Ararat L. Osipian

"An entire market emerged in Ukraine that offers ghost-written dissertations for a price. This market consists not only of individuals, but somewhat remarkably, also officially-registered firms. In 2009, there were 16 such firms; in 2016, the number nearly tripled with 46 registered enterprises that sell completed dissertations. Their clients lack time and knowledge, but certainly not money. Ukraine is a country with high levels of human capital but low average household incomes. This keeps dissertations reasonably priced and affordable to corrupt state bureaucrats and businesspersons. Highly educated academics earn additional income by producing dissertations for sale."
*************

Protecting the integrity of the scientific record from a new kind of academic misconduct
by VALENTIN BOGOROV

"At the Web of Science Group, we pride ourselves on protecting the integrity of the scholarly record. We are champions of high editorial standards and research practices, and our global team of in-house, publisher-independent editors are experts in their subjects.  So we are ever-vigilant to trends in unethical research practices, which pose a growing threat to legitimate scholarship worldwide.  Recently, we uncovered a new trend which we think is important to bring to light for wider discussion and action.

Our team in Russia received a tip from the local research community to a new form of publication fraud. The tip led to a website,  http://123mi.ru  set up by unscrupulous operators to serve as a virtual marketplace where authors can buy or sell authorship in academic manuscripts accepted for publication. This kind of peer-to-peer sharing, in “broad daylight” is not something we’ve seen before – so we conducted a quick analysis of the site, and its data, before taking swift action to alert our friends and colleagues in the scientific community.

...

"The geography of transactions covers primarily the post-Soviet area (Russia, Kazakhstan and Ukraine), but there are authorships sold outside of that region, notably to the United Arab Emirates, China and the UK."

************

And then there's homework...this from the WSJ

Schools Fight Websites That Sell Homework Help
Hundreds of sites claiming to offer tutoring services are often selling completed assignments to students
By Tawnell D. Hobbs, Aug. 12, 2019 

"The practice, sometimes called contract cheating by educators, was initially targeted at students in college but has since spread to include high-school students, according to a review of websites offering the service.
...
"A Wall Street Journal review of 100 websites offering tutoring help or writing services, or both, found they promise custom high-school and college work. Some websites offer to run work through anti-plagiarism programs to prove it is original.
...
"Seventeen states outlaw selling written work to another for academic credit, said Dr. Bertram Gallant, a board member of the International Center for Academic Integrity, a consortium of academic institutions and individuals focused on integrity in academic communities. But enforcement is difficult since the location of the sites can be hard to determine, she said.

Several sites reviewed by the Journal let students put the work out for bid. “Often, customers may have two or more writers bidding on their project, so before selecting a writer, customers can check the different writers’ ratings and reviews,” said Avery Morgan, spokesman for a site called EduBirdie that launched in 2015 and specializes in essay writing.
...
"Students unhappy with cheating websites cite missed deadlines and subpar work, according to complaints filed with the Better Business Bureau and online reviews. Some students also allege that tutors demanded more money than agreed upon and made threats."

Paternalism as a motivation for repugnance: Ambuehl, Bernheim and Ockenfels

When I talk about repugnant transactions, I mean transactions that some people would like to engage in, but others don't think they should be allowed to, even if those others don't suffer themselves when the transactions take place.  In this recent NBER working paper, Sandro Ambuehl (one of the leaders in the study of these things) teams up with Doug Bernheim and Axel Ockenfels to study paternalism, which is closely related and often a primary cause of a transaction being repugnant (e.g. you might not think I should chew tobacco, because you think it would be bad for me...)

PROJECTIVE PATERNALISM
by Sandro Ambuehl, B.Douglas Bernheim, and Axel Ockenfels
NBER Working Paper 26119 http://www.nber.org/papers/w26119

Abstract: "We study experimentally when, why, and how people intervene in others' choices. Choice Architects (CAs) construct opportunity sets containing bundles of time-indexed payments for Choosers. CAs frequently prevent impatient choices despite opportunities to provide advice, believing Choosers benefit. We consider several hypotheses concerning CAs' motives. A conventional behavioral welfarist acts as a correctly informed social planner; a mistakes-projective paternalist removes options she wishes she could reject when choosing for herself; an ideals-projective paternalist seeks to align others' choices with her own aspirations. Ideals-projective paternalism provides the best explanation for interventions in the laboratory and rationalizes support for actual paternalistic policies."

From the conclusion:

"This  paper  examines  when,  why,  and  how  people  intervene  in  others’  choices.   In  a  setting  involvingintertemporal tradeoffs, we find that Choice Architects frequently remove options that are attractive toimpatient decision makers.  Choice Architects believe their interventions benefit the Chooser, and are thusacting paternalistically.  How do Choice Architects judge what is good for others?  This is a difficult taskbecause, by definition, paternalists are hesitant to rely on the judgments implicit in Choosers’ decisions,and indeed may even question whether Choosers are aware of their own best interests.  Ideals-projectivepaternalism  emerges  from  our  empirical  analysis  as  the  key  organizing  principle.   An  ideals-projectivepaternalist acts as if she believes other share, or ought to share, the ideals to which she aspires for herself."
************

I think of paternalism as being one cause of a lot of repugnance to certain transactions, but certainly not the only cause. For example, I don't think that repugnance to same-sex marriage was intended to help those who wanted to marry...

Steve Leider celebrated for experimental economics

This cheerful email came in yesterday:

Dear ESA Colleagues,

We are pleased to announce that Stephen Leider has been selected as the 2019 recipient of the Vernon L. Smith Ascending Scholar Prize for his research on behavioral operations management.

This $50,000 prize is presented by the International Foundation for Research in Experimental Economics (IFREE).  You can learn more about IFREE, including its small grants program and workshops, at http://ifreeweb.org/.        

The Vernon L. Smith Ascending Scholar Prize is given to an exceptional scholar in the field of experimental economics whose work embodies IFREE’s mission to Promote Human Betterment through Experimental Economics to Improve the Understanding of Exchange Systems. Eligibility is limited to Assistant and Associate Professors (or equivalent). Dr. Leider was selected through a nomination process which identified many promising and highly-productive scholars in experimental economics who were then screened through peer review. Here is a link to the Prize announcement.

Please join us in congratulating Dr. Leider for his outstanding work and accomplishments!

Finally, mark your calendars, we will be sending out the call for nominations for next year's award in the Spring.

Jim Murphy & Cary Deck
IFREE Board Members

Here's a picture of Steve (wearing a tie) after his dissertation defense ten years ago:

Poll: majority of Canadians approve of paying plasma donors

New survey results from Peter Jaworski
Canadians think that pay-for-plasma is “morally appropriate.”

"A significant majority of Canadians (63%) believed that paying Canadians for plasma donations was “morally appropriate.”

By age, 18-34 year-olds were most likely to think that pay-for-plasma was “morally appropriate,” with 75% saying so. 70% of 35-54 year-olds, and 49% of those 55 or older thought pay-for-plasma was morally appropriate.

By region, 64% of Atlantic Canada, 69% in Quebec, 61% in Ontario, 70% in the Prairies, 65% in Alberta, and 56% in British Columbia held that opinion.

The provinces of Ontario (2014), Alberta (2017), and British Columbia (2018) have all recently banned pay-for-plasma citing moral objections as part of the motivation behind the prohibitions"