Changing roles for a settlement house in a New England city : 1965-1990.

Today inner city neighborhoods seem more threatened by poverty and lack of civil order than at any time since the beginning of the century. Many families confront hunger, homelessness, sickness and a lack of support on a daily basis. For over a century, settlement houses or neighborhood centers have responded to these needs while, contending with funding, staffing, and changing urban landscapes. This study investigated the transition of one settlement house located in a New England city from 1965-1990. Specifically, this investigation describes the response, during this critical time, to these challenges by the staff and leadership of Friendly House, located in Worcester, Massachusetts. An ethnomethodological approach was adopted. The data provided the history and the achievements of Friendly House and the base for possible comparison and contrasts between the Agency and other similar neighborhood centers. This descriptive case study was written by the Director who has had close and prolonged contact with Friendly House. The research questions focus upon the central theme of agency responsiveness to multiple social service requests from a rapidly challenging urban clientele. The results of the study suggest that the most effective and efficient means of delivering services to individuals and families who reside in impoverished inner city neighborhoods is through the settlement house model. Friendly House provides appropriate neighborhood-based services in a nonformalized atmosphere. The Agency affords the opportunity for an individual to be seen and talked to about his or her entire life situation in a setting close to home. Moreover, Friendly House can support at-risk families and offer a secure environment for their vulnerable children. Strategically located in a diverse, low-income neighborhood, Friendly House linked residents with central and public agencies. By continually seeking new sources of funding, Friendly House has adjusted to needs while remaining true to its settlement house roots

Green Urbanism and its Application to Singapore

Green urbanism has been applied to cities but not in Asia. Seven characteristics of green urbanism are outlined and then applied to Singapore. The Renewable City is not yet a concept for Singapore. The Carbon Neutral City is being developed for an island Palau Ubin and by some firms but not to significant sectors or parts of urban Singapore. The Distributed City is being developed around Singapore’s polycentric model but needs specific infrastructure plans similar to ones developed by Singapore for Tianjin Eco-City. The Biophillic City is being developed as a world first through its Skyrise Greenery initiative and urban landscaping. The Eco-Efficient City is also being demonstrated through Singapore closing the loop on their water and solid waste systems. The Place Based City is very evident in all its 22 sub centres. And the Sustainable Transport City is an Asian leader in integrated transport planning though there are signs of this becoming harder to achieve

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Impact of Systemic Inflammation and Autoimmune Diseases on apoA-I and HDL Plasma Levels and Functions

The cholesterol of high-density lipoproteins (HDLs) and its major proteic component, apoA-I, have been widely investigated as potential predictors of acute cardiovascular (CV) events. In particular, HDL cholesterol levels were shown to be inversely and independently associated with the risk of acute CV diseases in different patient populations, including autoimmune and chronic inflammatory disorders. Some relevant and direct anti-inflammatory activities of HDL have been also recently identified targeting both immune and vascular cell subsets. These studies recently highlighted the improvement of HDL function (instead of circulating levels) as a promising treatment strategy to reduce inflammation and associated CV risk in several diseases, such as systemic lupus erythematosus and rheumatoid arthritis. In these diseases, anti-inflammatory treatments targeting HDL function might improve both disease activity and CV risk. In this narrative review, we will focus on the pathophysiological relevance of HDL and apoA-I levels/functions in different acute and chronic inflammatory pathophysiological conditions

LEADERSHIP STYLE, CRISIS RESPONSE AND BLAME MANAGEMENT: THE CASE OF HURRICANE KATRINA

Crisis management research has largely ignored one of the most pressing challenges political leaders are confronted with in the wake of a large‐scale extreme event: how to cope with what is commonly called the blame game. In this article, we provide a heuristic to help understand political leader responses to blame in the aftermath of crises, emphasizing the crucial role of their leadership style on the political management of Inquiries. After integrating theoretical and empirical findings on crisis management and political leadership styles, we illustrate our heuristic by applying it to the Bush administration's response to Hurrican Katrina in 2005. We conclude by offering suggestions for further research on the underdeveloped subject of the blame management challenges faced by political leaders in the wake of acute crisis episodes