Transitional labour markets : a social investment and risk mitigation strategy for social policy

Drawing on transitional labor market (TLM) theory, this introductory chapter highlights major themes, overviews the contributions to this volume and suggests a future agenda for policy makers. The focus of applied research projects has been the impact of post-modem social transformations on systems of social protection, looking through the lens of the labor market and shifts in household and family structure. The Transitional Labor Market project uses the TLM model as a means of developing new thinking on how flexibility and innovation might be paired with social investment and new forms of social protection. TLM theory emphasizes the importance of institutions and of the links between different institutions which frequently operate as policy silos, rather than integrated systems to buffer risks and support capability and enhance employability. The great advantage of the TLM model is that it draws attention to the right places for strategic reform. It does not offer a standard set of institutions to facilitate transitions however.<br /

Thinking Outside the Box? Applying Design Theory to Public Policy

Design involves an account of expertise which foregrounds implicit, heuristic skills. Most models of policy making have a stronger interest in structural and exogenous pressures on decision making. Research suggests that high-level experts develop unique capacities to process data, read a situation, and see imaginative solutions. By linking some of the key attributes of a design model of decision making to an account of expertise, it is possible to formulate a stronger model of public policy design expertise. While other approaches often concern themselves with constraints and structural imperatives, a design approach has a focus upon the capacities of individual actors such as policy experts. Such an approach rests upon central propositions in regard to goal emergence, pattern recognition, anticipation, emotions engagement, fabulation, playfulness, and risk protection. These provide a starting point for further research and for the professional development of policy specialists

Combination GLP-1 and Insulin Treatment Fails to Alter Myocardial Fuel Selection Versus Insulin Alone in Type 2 Diabetes

Context Glucagon-like peptide-1 (GLP-1) and the clinically available GLP-1 agonists have been shown to exert effects on the heart. It is unclear whether these effects occur at clinically used doses in vivo in humans, possibly contributing to CVD risk reduction. Objective To determine whether liraglutide at clinical dosing augments myocardial glucose uptake alone or in combination with insulin compared to insulin alone in metformin-treated Type 2 diabetes mellitus. Design Comparison of myocardial fuel utilization after 3 months of treatment with insulin detemir, liraglutide, or combination detemir+liraglutide. Setting Academic hospital Participants Type 2 diabetes treated with metformin plus oral agents or basal insulin. Interventions Insulin detemir, liraglutide, or combination added to background metformin Main Outcome Measures Myocardial blood flow, fuel selection and rates of fuel utilization evaluated using positron emission tomography, powered to demonstrate large effects. Results We observed greater myocardial blood flow in the insulin-treated groups (median[25th, 75th percentile]: detemir 0.64[0.50, 0.69], liraglutide 0.52[0.46, 0.58] and detemir+liraglutide 0.75[0.55, 0.77] mL/g/min, p=0.035 comparing 3 groups and p=0.01 comparing detemir groups to liraglutide alone). There were no evident differences between groups in myocardial glucose uptake (detemir 0.040[0.013, 0.049], liraglutide 0.055[0.019, 0.105], detemir+liraglutide 0.037[0.009, 0.046] µmol/g/min, p=0.68 comparing 3 groups). Similarly there were no treatment group differences in measures of myocardial fatty acid uptake or handling, and no differences in total oxidation rate. Conclusions These observations argue against large effects of GLP-1 agonists on myocardial fuel metabolism as mediators of beneficial treatment effects on myocardial function and ischemia protection

Feasibility of Development of Flood Resiliency Clearinghouse Program

[Introduction] House Bill 2187i, introduced by Delegate Keith Hodges in the 2021 session of the Virginia General Assembly, directed the Commonwealth Center for Recurrent Flooding Resiliency (CCRFR), a partnership between Old Dominion University, the Virginia Institute of Marine Science (VIMS) and the William & Mary Law School’s Virginia Coastal Policy Center (VCPC) established by Virginia Chapter 440 of the 2016 Acts of Assembly (HB 903), to evaluate the development of a Flood Resiliency Clearinghouse Program (henceforth Clearinghouse). The bill stipulated that the Center should work with the Department of Conservation and Recreation (DCR) to evaluate solutions that manage both water quality and flooding and emphasize naturebased solutions. Further, it states that the CCRFR and DCR shall evaluate solutions that include both “approved and not-yet-approved stormwater best management practices”. The intent of HB 2187 to provide an easily accessible resource to aid policymakers, state agencies, localities, businesses, and the public in implementing flood protection practices that are protective of water quality is clear. Less clear is the geographic and the programmatic/jurisdictional scope of the best management practices (BMPs) to be considered and the specific roles that the Clearinghouse would play beyond being a repository for information on existing BMPs ranging from shoreline erosion control to stormwater management. This report takes the approach of assuming that the intent of the bill is for the Clearinghouse to be a statewide resource, but much of the analysis is focused on the coastal zone where jurisdictional and regulatory structures include additional levels of complexity. While there are currently best management practices (BMPs) approved in the Commonwealth for the management of stormwater quantity and quality, these practices were not designed to withstand flooding impacts and have not been evaluated for flood control in the riparian and littoral zones. There is a need in Virginia for innovative shoreline strategies that manage water quality and flooding and protect the coastline from erosion related to rising sea levels and storm surge. A Flood Resiliency Clearinghouse could be a resource to promote resilient shoreline solutions and could provide the cross-agency collaboration needed to evaluate and approve solutions that manage both water quality and flooding. The Clearinghouse could fill the need in the Commonwealth for a one-stop location to identify BMPs for a particular activity intended to provide flood protection while being protective of water quality

From Entitlement to Experiment: Industry Report on Case Studies of high performing providers

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Three-dimensional food printing: Its readiness for a food and nutrition insecure world

Three-dimensional (3D) food printing is a rapidly emerging technology offering unprecedented potential for customised food design and personalised nutrition. Here, we evaluate the technological advances in extrusion-based 3D food printing and its possibilities to promote healthy and sustainable eating. We consider the challenges in implementing the technology in real-world applications. We propose viable applications for 3D food printing in health care, health promotion and food waste upcycling. Finally, we outline future work on 3D food printing in food safety, acceptability and economics, ethics and regulations. .

Challenges of developing robust AI for intrapartum fetal heart rate monitoring

Background: CTG remains the only non-invasive tool available to the maternity team for continuous monitoring of fetal well-being during labour. Despite widespread use and investment in staff training, difficulty with CTG interpretation continues to be identified as a problem in cases of fetal hypoxia, which often results in permanent brain injury. Given the recent advances in AI, it is hoped that its application to CTG will offer a better, less subjective and more reliable method of CTG interpretation. Objectives: This mini-review examines the literature and discusses the impediments to the success of AI application to CTG thus far. Prior randomised control trials (RCTs) of CTG decision support systems are reviewed from technical and clinical perspectives. A selection of novel engineering approaches, not yet validated in RCTs, are also reviewed. The review presents the key challenges that need to be addressed in order to develop a robust AI tool to identify fetal distress in a timely manner so that appropriate intervention can be made. Results: The decision support systems used in three RCTs were reviewed, summarising the algorithms, the outcomes of the trials and the limitations. Preliminary work suggests that the inclusion of clinical data can improve the performance of AI-assisted CTG. Combined with newer approaches to the classification of traces, this offers promise for rewarding future development

Body Mass Index, percent body fat, and regional body fat distribution in relation to leptin concentrations in healthy, non-smoking postmenopausal women in a feeding study

BACKGROUND: The relationship between BMI and leptin has been studied extensively in the past, but previous reports in postmenopausal women have not been conducted under carefully controlled dietary conditions of weight maintenance using precise measures of body fat distribution. The aim of the present study was to examine the association between serum leptin concentration and adiposity as estimated by BMI and dual energy x-ray absorptiometry (DEXA) measures (percent body fat, central and peripheral fat, and lean mass) in postmenopausal women. METHODS: This study was conducted as a cross-sectional analysis within the control segment of a randomized, crossover trial in which postmenopausal women (n = 51) consumed 0 (control), 15 (one drink), and 30 (two drinks) g alcohol (ethanol)/d for 8 weeks as part of a controlled diet. BMIs were determined and DEXA scans were administered to the women during the 0 g alcohol treatment, and a blood sample was collected at baseline and week 8 of each study period for leptin analysis. RESULTS AND DISCUSSION: In multivariate analysis, women who were overweight (BMI > 25 to ≤ 30 kg/m(2)) had a 2-fold increase, and obese women (BMI > 30 kg/m(2)) had more than a 3-fold increase in serum leptin concentrations compared to normal weight (BMI ≤25 kg/m(2)) women. When the models for the different measures of adiposity were assessed by multiple R(2), models which included percent body fat explained the highest proportion (approximately 80%) of the serum leptin variance. CONCLUSION: Under carefully controlled dietary conditions, we confirm that higher levels of adiposity were associated with higher concentrations of serum leptin. It appears that percent body fat in postmenopausal women may be the best adiposity-related predictor of serum leptin

Leptin concentrations in response to acute stress predict subsequent intake of comfort foods

Both animals and humans show a tendency toward eating more “comfort food” (high fat, sweet food) after acute stress. Such stress eating may be contributing to the obesity epidemic, and it is important to understand the underlying psychobiological mechanisms. Prior investigations have studied what makes individuals eat more after stress; this study investigates what might make individuals eat less. Leptin has been shown to increase following a laboratory stressor, and is known to affect eating behavior. This study examined whether leptin reactivity accounts for individual differences in stress eating. To test this, we exposed forty women to standardized acute psychological laboratory stress (Trier Social Stress Test) while blood was sampled repeatedly for measurements of plasma leptin. We then measured food intake after the stressor in 29 of these women. Increasing leptin during the stressor predicted lower intake of comfort food. These initial findings suggest that acute changes in leptin may be one of the factors modulating down the consumption of comfort food following stress