Stepfamilies and older people: evaluating the implications of family change for an ageing population

The changing nature of family life has become a major issue in contemporary Britain. Concerns that change will bring moral decline and social fragmentation are countered by a more optimistic view which focuses on a future of more equitable and flexible family ties. Research drawing on area-based data in Luton amongst older, middle-aged and younger people with experience of family change suggests that so far as inter-generational relations, caring, and transfers of family wealth are concerned, traditional attitudes towards blood ties, household independence and care and support survive alongside new step relationships. The research also suggests that although several respondents had more than one generation of experience of family change, the language of step relationships is still one which is not yet completely accepted, or one with which people feel completely at ease

Significance of Driver and Vehicle Key Performance Indicators on Organisational Performance and Customer Satisfaction: Case of Bulk Fuel Supply Chain in Zimbabwe

Fuel supply is classified under critical and dangerous goods distribution. Truck Drivers (TD) and trucks are the two components involved in every stage of fuel road-distribution hence a focus on driver and vehicle key performance indicator measurements. The study examines the significance of driver key performance indicators and vehicle performance indicators on organisational performance and on customer satisfaction in the bulk fuel supply chain. A quantitative research methodology was conducted with 91 respondents drawn from the fuel sector. SMART PLS 3.3.3 was utilised for data analysis. The study found that there are positive and significant relationships between Vehicle KPIs and Driver KPIs; Driver KPIs and Organisational Performance (OP); Vehicle KPIs and OP; Driver KPIs and Customer service (CS), and OP and CS. The study also noted that Driver KPIs have significant mediating impact on OP. The mediating role of OP on CS was found to be insignificant

Clopidogrel discontinuation and platelet reactivity following coronary stenting.

Aims: Antiplatelet therapy with aspirin and clopidogrel are recommended for 1 year after drug-eluting stent (DES) implantation or myocardial infarction. However, the discontinuation of antiplatelet therapy has become an important issue as recent studies have suggested a clustering of ischaemic events within 90 days of clopidogrel withdrawal. The objective of this investigation was to explore the hypothesis that there is a transient \u22rebound\u22 increase in platelet reactivity within three months of clopidogrel discontinuation. Methods and Results: In this prospective study, platelet function was assessed in patients taking aspirin and clopidogrel for at least 1 year following DES implantation. Platelet aggregation was measured using a modification of light transmission aggregometry in response to multiple concentrations of adenosine diphosphate (ADP), epinephrine, arachidonic acid, thrombin receptor activating peptide and, collagen. Clopidogrel was stopped and platelet function was reassessed 1 week, 1 month and 3 months later. Thirty-two patients on dual antiplatelet therapy were recruited. Discontinuation of clopidogrel increased platelet aggregation to all agonists, except arachidonic acid. Platelet aggregation in response to ADP (2.5, 5, 10, 20 μM) and epinephrine (5, 20 μM) was significantly increased at 1 month compared to 3 months following clopidogrel withdrawal. Thus, a transient period of increased platelet reactivity to both ADP and epinephrine was observed 1 month after clopidogrel discontinuation. Conclusions: This study demonstrates a transient increase in platelet reactivity 1 month after clopidogrel withdrawal. This phenomenon may, in part, explain the known clustering of thrombotic events observed after clopidogrel discontinuation. This observation requires confirmation in larger populations

ICT policies relating to privacy, freedom of expression and access to information : a briefing paper

Meeting: International Workshop on the Nexus between ICTs and Human Rights in Africa, 2-4 April, 2009, Kampala, UGICTs have made access to information and freedom of expression easier for those with less resources, and expanded the capacity for mass distribution of information. At the same time, ICTs allow for automated censorship and pose new threats to privacy. This document is a brief primer on some key issues in Africa in areas of privacy, freedom of expression and access to information, and how they relate to ICT policy. The digital divide is a significant problem in many African countries, limiting access to information. The document was prepared for the International Workshop on ‘The Nexus Between ICTs and Human Rights in Africa.

Understanding and responding to the transit needs of women in Canada

The historical practices of transportation planning are known to be gender-neutral and as a result have marginalized the experiences of a large sub-section of the population, namely women. Identifying the motives behind women’s travel behaviours works to inform equitable data collection methods, transportation planning, and public transit policy. Correspondingly, understanding how public transit services and policies (curated with gender-neutral data and transportation planning principles) impact women’s travel can reveal barriers to public transit usage. An inductive literature review of Global North grey and academic documents regarding women’s travel behaviour (mode choice, travel route, time of travel and distance) and needs was conducted. The synthesis reveals that gender roles which lead to disparities in caregiving, income, employment, and security result in women being more likely (as compared to men) to complete trip chains, mid-day or off-peak trips, and shorter distance trips. A systematic policy review of 18 public transit systems from Canada’s eight largest Census Metropolitan Areas (CMAs) and a webinar discussing public transit policy with female industry leaders reveals that the majority of public transit systems assessed do not explicitly account for gender differences when drafting actionable policy, service standards and data collection methodology. The identification of opportunities for gender inclusivity informs future research and policies regarding women’s travel. Applying a gender lens to the creation of service standards, the introduction of new public transit technologies, the collection of real-time data, the creation of customer satisfaction surveys, and the evaluation of business cases and planning processes can result in the equitable consideration of women’s travel needs in public transit service and delivery

The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of prostate carcinoma.

Prostate cancer is the most commonly diagnosed malignancy and second leading cause of cancer death among men in the United States. In recent years, several new agents, including cancer immunotherapies, have been approved or are currently being investigated in late-stage clinical trials for the management of advanced prostate cancer. Therefore, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel, including physicians, nurses, and patient advocates, to develop consensus recommendations for the clinical application of immunotherapy for prostate cancer patients. To do so, a systematic literature search was performed to identify high-impact papers from 2006 until 2014 and was further supplemented with literature provided by the panel. Results from the consensus panel voting and discussion as well as the literature review were used to rate supporting evidence and generate recommendations for the use of immunotherapy in prostate cancer patients. Sipuleucel-T, an autologous dendritic cell vaccine, is the first and currently only immunotherapeutic agent approved for the clinical management of metastatic castrate resistant prostate cancer (mCRPC). The consensus panel utilized this model to discuss immunotherapy in the treatment of prostate cancer, issues related to patient selection, monitoring of patients during and post treatment, and sequence/combination with other anti-cancer treatments. Potential immunotherapies emerging from late-stage clinical trials are also discussed. As immunotherapy evolves as a therapeutic option for the treatment of prostate cancer, these recommendations will be updated accordingly

Security governance and the private military industry in Europe and North America

Even before Iraq the growing use of private military contractors has been widely discussed in the academic and public literature. However, the reasons for this proliferation of private military companies and its implications are frequently generalized due to a lack of suitable theoretical approaches for the analysis of private means of violence in contemporary security. As a consequence, this article contends, the analysis of the growth of the private military industry typically conflates two separate developments: the failure of some developing states to provide for their national security and the privatisation of military services in industrialized nations in Europe and North America. This article focuses on the latter and argues that the concept of security governance can be used as a theoretical framework for understanding the distinct development, problems and solutions for the governance of the private military industry in developed countries.The United States Institute of Peace and the German Academic Exchange Service

Evolution of a novel orally bioavailable series of PI3Kδ inhibitors from an inhaled lead for the treatment of respiratory disease.

A four step process of high quality modelling of existing data, deconstruction, identification of replacement cores and an innovative synthetic re-growth strategy led to the rapid discovery of a novel oral series of PI3K δ inhibitors with promising selectivity and excellent in vivo characteristics

Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated

Wadelai, an isolated focus for onchocerciasis in northwest Uganda, was selected for piloting an onchocerciasis elimination strategy that was ultimately the precursor for countrywide onchocerciasis elimination policy. The Wadelai focus strategy was to increase ivermectin treatments from annual to semiannual frequency and expand geographic area in order to include communities with nodule rate of less than 20%. These communities had not been covered by the previous policy that sought to control onchocerciasis only as a public health problem. From 2006 to 2010, Wadelai program successfully attained ultimate treatment goal (UTG), treatment coverage of ≥90%, despite expanding from 19 to 34 communities and from 5,600 annual treatments to over 29,000 semiannual treatments. Evaluations in 2009 showed no microfilaria in skin snips of over 500 persons examined, and only 1 of 3011 children was IgG4 antibody positive to the OV16 recombinant antigen. No Simulium vectors were found, and their disappearance could have sped up interruption of transmission. Although twice-per-year treatment had an unclear role in interruption of transmission, the experience demonstrated that twice-per-year treatment is feasible in the Ugandan setting. The monitoring data support the conclusion that onchocerciasis has been eliminated from the Wadelai focus of Uganda