Turning marketing promises into business value: The experience of an industrial SME

The article studies the value that businesses should have for their customers and shareholders. It explains how to develop such value to meet or exceed customer's expectations through the application of the promise framework. The promise model includes promises made to customers, promises kept, and promises that involve a synchronized effort from the whole firm to create and deliver value to customers

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Knowing and complying: Patient awareness of aspirin use for secondary prevention of stroke and transient ischaemic attack

The aim of this study was to gain understanding into compliance behaviour with aspirin as prescribed for secondary prevention of stroke. The study used a convenience sample of 20 patients who had been admitted to a NHS Trust following a subsequent stroke or transient ischaemic attack. Semi-structured interviews were used to explore the use of aspirin at the time of admission. Patient perception of personal risk and risk factors for stroke were explored. Where appropriate, responses were checked against health care records for comparison. The findings suggested that the majority of patients were compliant with aspirin, however deficiencies in current practice were identified. Patients lacked awareness of their risk factors and their risk of having a further stroke. They were also unaware why they were taking aspirin. Strategies that assisted compliance behaviour and reasons for non-compliance were identified

Trusting children to enhance youth justice policy:The importance and value of children’s voices

Purpose: To explore the integration of children’s voices within youth justice policy and practice development. Design/methodology/approach: The authors theorise the efficacy of participatory practices in youth justice by presenting original empirical data drawn from innovative child friendly methodological approaches, including activity-oriented focus groups, questionnaires and in-depth interviews. Findings: Children’s voices have been noticeably absent from youth justice policy development in England. Children continue to be the recipients of adult-led, deficit-facing practices underpinned by a longstanding preoccupation with identifying and managing ‘risk’. These practices have undermined children’s knowledge and potential by distrusting their perspectives. In contrast, the internationally-relevant cogent arguments set out in this paper allude to the importance and benefits of engaging with children and listening to their voices in the planning and delivery of ‘Child First’ youth justice. Practical implications: It is recommended that youth justice professionals treat children in the Youth Justice System as children (not ‘offenders’), fostering non-hierarchical, empathic, trusting relationships with children, strengthen the child’s involvement in policy and practice processes and centralise their educative, health and wellbeing needs. Originality/value: The paper explores empirical examples from the emerging (but still limited) evidence-base of youth justice research studies that have placed the child’s voice at the centre of understanding their experiences at different stages of the Youth Justice System.</p

Trusting children to enhance youth justice policy: The importance and value of children’s voices

Purpose: To explore the integration of children’s voices within youth justice policy and practice development. Design/methodology/approach: The authors theorise the efficacy of participatory practices in youth justice by presenting original empirical data drawn from innovative child friendly methodological approaches, including activity-oriented focus groups, questionnaires and in-depth interviews. Findings: Children’s voices have been noticeably absent from youth justice policy development in England. Children continue to be the recipients of adult-led, deficit-facing practices underpinned by a longstanding preoccupation with identifying and managing ‘risk’. These practices have undermined children’s knowledge and potential by distrusting their perspectives. In contrast, the internationally-relevant cogent arguments set out in this paper allude to the importance and benefits of engaging with children and listening to their voices in the planning and delivery of ‘Child First’ youth justice. Practical implications: It is recommended that youth justice professionals treat children in the Youth Justice System as children (not ‘offenders’), fostering non-hierarchical, empathic, trusting relationships with children, strengthen the child’s involvement in policy and practice processes and centralise their educative, health and wellbeing needs. Originality/value: The paper explores empirical examples from the emerging (but still limited) evidence-base of youth justice research studies that have placed the child’s voice at the centre of understanding their experiences at different stages of the Youth Justice System

Basic science232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function

Background: Cardiovascular disease is a major comorbidity of rheumatoid arthritis (RA) and a leading cause of death. Chronic systemic inflammation involving tumour necrosis factor alpha (TNF) could contribute to endothelial activation and atherogenesis. A number of anti-TNF therapies are in current use for the treatment of RA, including certolizumab pegol (CZP), (Cimzia ®; UCB, Belgium). Anti-TNF therapy has been associated with reduced clinical cardiovascular disease risk and ameliorated vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function are largely unknown. Our aim was to investigate the mechanisms underpinning CZP effects on TNF-activated human endothelial cells. Methods: Human aortic endothelial cells (HAoECs) were cultured in vitro and exposed to a) TNF alone, b) TNF plus CZP, or c) neither agent. Microarray analysis was used to examine the transcriptional profile of cells treated for 6 hrs and quantitative polymerase chain reaction (qPCR) analysed gene expression at 1, 3, 6 and 24 hrs. NF-κB localization and IκB degradation were investigated using immunocytochemistry, high content analysis and western blotting. Flow cytometry was conducted to detect microparticle release from HAoECs. Results: Transcriptional profiling revealed that while TNF alone had strong effects on endothelial gene expression, TNF and CZP in combination produced a global gene expression pattern similar to untreated control. The two most highly up-regulated genes in response to TNF treatment were adhesion molecules E-selectin and VCAM-1 (q 0.2 compared to control; p > 0.05 compared to TNF alone). The NF-κB pathway was confirmed as a downstream target of TNF-induced HAoEC activation, via nuclear translocation of NF-κB and degradation of IκB, effects which were abolished by treatment with CZP. In addition, flow cytometry detected an increased production of endothelial microparticles in TNF-activated HAoECs, which was prevented by treatment with CZP. Conclusions: We have found at a cellular level that a clinically available TNF inhibitor, CZP reduces the expression of adhesion molecule expression, and prevents TNF-induced activation of the NF-κB pathway. Furthermore, CZP prevents the production of microparticles by activated endothelial cells. This could be central to the prevention of inflammatory environments underlying these conditions and measurement of microparticles has potential as a novel prognostic marker for future cardiovascular events in this patient group. Disclosure statement: Y.A. received a research grant from UCB. I.B. received a research grant from UCB. S.H. received a research grant from UCB. All other authors have declared no conflicts of interes

Solar ultraviolet radiation exposure, and incidence of childhood acute lymphocytic leukaemia and non-Hodgkin lymphoma in a US population-based dataset

Background: Acute lymphocytic leukaemia (ALL) and non-Hodgkin lymphoma (NHL) are among the commonest types of childhood cancer. Some previous studies suggested that elevated ultraviolet radiation (UVR) exposures increase ALL risk; many more indicate NHL risk is reduced. Methods: We assessed age<20 ALL/NHL incidence in Surveillance, Epidemiology and End Results data using AVGLO-derived UVR irradiance/cumulative radiant exposure measures, using quasi-likelihood models accounting for underdispersion, adjusted for age, sex, racial/ethnic group and other county-level socioeconomic variables. Results: There were 30,349 cases of ALL and 8062 of NHL, with significant increasing trends of ALL with UVR irradiance (relative risk (RR) = 1.200/mW/cm2 (95% CI 1.060, 1.359, p = 0.0040)), but significant decreasing trends for NHL (RR = 0.646/mW/cm2 (95% CI 0.512, 0.816, p = 0.0002)). There was a borderline-significant increasing trend of ALL with UVR cumulative radiant exposure (RR = 1.444/MJ/cm2 (95% CI 0.949, 2.197, p = 0.0865)), and significant decreasing trends for NHL (RR = 0.284/MJ/cm2 (95% CI 0.166, 0.485, p  Conclusions: Our more novel finding, of excess UVR-related ALL risk, is consistent with some previous studies, but is not clear-cut, and in need of replication

Solar ultraviolet radiation exposure, and incidence of childhood acute lymphocytic leukaemia and non-Hodgkin lymphoma in a US population-based dataset

Background: Acute lymphocytic leukaemia (ALL) and non-Hodgkin lymphoma (NHL) are among the commonest types of childhood cancer. Some previous studies suggested that elevated ultraviolet radiation (UVR) exposures increase ALL risk; many more indicate NHL risk is reduced. Methods: We assessed age&lt;20 ALL/NHL incidence in Surveillance, Epidemiology and End Results data using AVGLO-derived UVR irradiance/cumulative radiant exposure measures, using quasi-likelihood models accounting for underdispersion, adjusted for age, sex, racial/ethnic group and other county-level socioeconomic variables. Results: There were 30,349 cases of ALL and 8062 of NHL, with significant increasing trends of ALL with UVR irradiance (relative risk (RR) = 1.200/mW/cm2 (95% CI 1.060, 1.359, p = 0.0040)), but significant decreasing trends for NHL (RR = 0.646/mW/cm2 (95% CI 0.512, 0.816, p = 0.0002)). There was a borderline-significant increasing trend of ALL with UVR cumulative radiant exposure (RR = 1.444/MJ/cm2 (95% CI 0.949, 2.197, p = 0.0865)), and significant decreasing trends for NHL (RR = 0.284/MJ/cm2 (95% CI 0.166, 0.485, p &lt; 0.0001)). ALL and NHL trend RR is substantially increased among those aged 0–3. All-age trend RRs are most extreme (increasing for ALL, decreasing for NHL) for Hispanics for both UVR measures. Conclusions:Our more novel finding, of excess UVR-related ALL risk, is consistent with some previous studies, but is not clear-cut, and in need of replication.</p