Statement of Interest for the ERR by birdmandaddy

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									Statement of Interest for the ERR
In order for the Editors of the ERR to make the best decision on how to handle a manuscript
it is important that any conflicts of interest that the authors or reviewers of a paper may
have are disclosed on submission.


A conflict of interest exists when professional judgement concerning such primary interests
as patients’ welfare or validity of research may be influenced by possible financial gain or
personal rivalry. It may arise for the authors of an article when they have a financial
interest that may influence their interpretation of their results or those of others.


The ERR will not reject papers simply because of a conflict of interest but believe that any
competing interests should be acknowledged and openly stated; therefore, a declaration of
interest will be printed along side the final published article.


Name:
Manuscript Title:

1. Have you, in the past 5 years, accepted the following from an
organisation that may in any way gain or lose financially from the results of
your study or the conclusions of your review, editorial or letter, please
answer yes or no:

    Reimbursement for attending a symposium?                                   YES/NO*

    A fee for speaking?                                                         YES/NO*

    A fee for organising education?                                             YES/NO*

    Funds for research?                                                          YES/NO*

    Funds for a member of staff?                                                 YES/NO*

    Fees for consulting?                                                         YES/NO*

    Gifts exceeding €500 per year?                                               YES/NO*
2. Have you, in the past 5 years, been employed by an organisation that may
in any way gain or lose financially from the results of your study or the
conclusions of your review, editorial or letter? Please answer yes or no.

YES/NO*

3. Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the results of your study or the conclusions of
your review, editorial or letter? Please answer yes or no.

YES/NO*

4. Have you acted as an expert witness on the subject of your study, review,
editorial or letter? Please answer yes or no.

YES/NO*

5. Do you have any other competing financial interests? If so, please specify.

YES/NO*

6. Are you or have you ever been in any relationship with or receipt of any
benefit (financial or other) from the tobacco industry or corporate
affiliates? Please answer yes or no.

YES/NO*

7. Do you or your spouse knowingly hold any shares in the Tobacco industry?
Please answer yes or no.

YES/NO*

*Please delete as necessary

If you have answered "yes" to any of the above questions, the ERR
considers that you or your institution may have a conflict of interest,
which, in the spirit of openness, should be declared. Please draft a
statement to publish with the article detailing these interests and add it
to this form. This statement will be published along side your article in
the event of acceptance. An example of such a statement is given below:

Conflict of interests: JB has received an educational grant from Acme
Pharmaceutical industries; KT has stocks in excess of £5000 in Grace Bros
drugs plc; and travel to the ERS congress was funded by Acme
Biotechnologies.




PLEASE ADD STATEMENT HERE:




If you did not answer "yes" to any of the questions above, we will publish
"Competing interests: None declared."
The above questions are limited to financial interests; however, you might
want to disclose another sort of conflict of interest that would embarrass
you if it became generally known after publication. The following list gives
some examples:

   A close relationship with, or a strong antipathy to, a person whose
   interests may be affected by publication of your paper.

   An academic link or rivalry with somebody whose interests may be
   affected by publication of your paper.

   Membership of a political party or special interest group whose interests
   may be affected by publication of your paper.

   A deep personal or religious conviction that may have affected what you
   wrote and that readers should be aware of when reading your paper.

If you want to declare such a competing interest then please add it to your
statement.

								
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