Who Is My Client? Client Centered Lawyering with Multiple Clients

Many lawyers face the challenge of adhering to the idealistic principles of objective client-centered lawyering. This Article examines the additional conflict of client-centered lawyering when the attorney seeks to balance not only the attorney’s ethical obligations to the attorney’s individual corporate client, but also the attorney’s competing personal obligations to a cause and a group (such as members of a particular race). When an attorney’s sense of duty to a cause or the attorney’s race rises to the level where the advocacy for those groups becomes, in essence, that attorney’s cause client and race client, how does the attorney balance these obligations? The attorney, at that point, has an individual corporate client, a cause client, and a race client. This Article examines how a lawyer’s sense of duties to these non-legal clients impacts the attorney’s implementation of the utopic ideals of client-centered lawyering. How does an attorney remain objective in counseling the individual corporate client while torn by the duties to the cause client and race client? How does an attorney prevent the pursuit of these goals from influencing the choice of entities to accept as clients? Is it possible to provide client-centered objective advice to clients when an attorney has these competing personal duties that threaten to unduly influence the attorney’s actions

Limited Equity Cooperatives: The Non-Economic Value of Homeownership

Economists have argued there are two main purposes of homeownership. The first is housing as a utility for consumption, and the second is housing as an investment vehicle. Legal scholars, on the other hand, view homeownership in more personal terms. Margaret Radin, in her watershed article, argues that homeownership is so closely imbued with the person that it is affirmatively part of one‘s self—the personhood of property. Radin suggests that one‘s home is such a part of the way a person constitutes oneself that the property becomes an element of personhood, something no longer entirely external to the person. In response, however, Stephanie Stern argues there is little to no empirical evidence to support this proposition. She argues instead that homeownership has been provided unwarranted legal and economic protection, and has no more intrinsic value to the individual than any other possession. Many Americans embrace homeownership for reasons beyond investment. This Article evaluates the meaning of homeownership, particularly when wealth creation is not the primary goal. There are non-economic values to homeownership, particularly for low- and moderate-income residents, which remain unexplored. This Article seeks to evaluate the arguments of legal scholars and economists in light of the limited equity cooperative, a form of homeownership that significantly limits equity appreciation for the owner. While the limited equity cooperative is an older form of homeownership, it has reemerged as a valued homeownership option, especially, though not exclusively, for low- and moderate-income residents. This Article works to dispel the argument that homeownership, particularly limited equity cooperative homeownership, is less valuable for a homeowner because equity appreciation is restricted or because limited equity cooperatives are a non-traditional form of homeownership. Part I of the Article will provide a brief history of the federal government‘s efforts to promote homeownership, particularly for low- and moderate-income individuals. Part II will provide a brief description of the different types of traditional homeownership models common in the United States. Part III will provide a history of and evaluate one of the alternatives to the traditional homeownership model—the housing cooperative, specifically, the limited equity cooperative. Part IV concludes with an analysis of the non-economic value of homeownership as it relates to limited equity cooperative homeownership

Potent selective inhibitors of protein kinase C

AbstractA series of potent, selective inhibitors of protein kinase C has been derived from the structural lead provided by the microbial broth products, staurosporine and K252a. Our inhibitors block PCK in intact cells (platelets and T cells), and prevent the proliferation of mononuclear cells in response to interleukin 2 (IL2)

A tale of two localities: Healthy Eating on a restricted income

Objective: To determine the availability and affordability of a healthy food basket and to model how those on low-incomes might manage. Design and methodology: After determining access and availability of key items from shops in two localities, called Deepdale and Ingol, a healthy food basket was developed. From this a week’s healthy menu was devised for a mother and two children, then availability of the ingredients was checked using data collected from the shops and costed. The baskets represented the cultural preferences of White British and South Asian families informed by participatory work with both these groups. We chose the income level for a family entitled to income support and child allowance. Results: Analysis of the availability of some healthy options such as brown bread, wholemeal pasta, and brown rice showed they were not widely available within shops in the two areas. The price of the ‘White British’ basket in the area of Ingol was £70.61 (lowest price). For comparable goods in the area of Deepdale, using the most expensive shopping basket, the price for the same basket was £42.47. A South Asian family shopping at a major supermarket outlet in Deepdale would pay £47.05. Using local shops they could pay between £38.59 and £44.28 by seeking out the best bargains in five shops (including some top-up items from a national supermarket). At the time of the research a mother with two children entitled to income support and child allowance would have to spend 28–32 per cent of her income in local shops and 34 per cent in a supermarket to buy a basket of healthy goods. This compared to the national average of 10–12 per cent of income being spent on food purchases. Conclusions: Prices varied enormously between the two areas. Local shops in one area offered a comparable price to shopping in the supermarkets. The Ingol area, with a large white working class population, was particularly poorly served for those on low incomes and the range of choices restricted. The percentages spent on food to meet the requirements of our healthy baskets and menus show that more than the national average – in both absolute and relative terms – would have to be spent to eat healthily. For the vulnerable and price dependent poor in Preston this will mean having to spend more on food and possibly more on travel to access basics, a healthy diet will cost more, while proportionally an unhealthy diet, as can be found in fast food outlets, may not be as expensive when other costs such as cooking are taken into account. An overall rise in food prices of 5 per cent will reduce living standards among high-income consumers by approximately 3 per cent; for low-income consumers this reduction in an already poor diet could be as high as 20 per cent. What we have demonstrated is the usefulness of local studies to highlight micro-differences in relatively small areas (Preston city) and the different experiences of groups in accessing healthy foods, and thus the need to refine interventions at a local level

Injuries to older users of public transport in the UK

Барнс Джо; Лоутон Клэр; Моррис Эндрю; Маршал Рус; Саммерскилл Стив; Кендрик Дениз; Логан Пип; Драмонд Аврил; Файлдс Брайан; Конрой Саймон; Белла Джули. Травмы для пожилых пользователей общественного транспорта в ВеликобританииThe increasing age of the United Kingdom (UK) population coupled with enhanced life expectancy impacts on transport-user demographics and will affect transport planning in the years ahead. Whist passenger car use is the ultimate means of personal independence, at some point the physiological and psychological impact of agerelated conditions will inevitably shift people out of their vehicles and onto public transport systems. Overall, public transport is seen to be vital for social inclusion (Lucas et al 2008, Rowntree Foundation) and it is considered a safe means of mobility. However, it is important that the public and in particular, the elderly perceive it to be so. Injuries (across a spectrum of severities) do occur during public transport use from time to time. In fact, over 5,000 people are injured on UK buses each year alone with over 300 bus-users killed/seriously injured (Department for Transport, 2012). This study was designed to examine the nature of injuries and their causes to older bus-users with the aim being to establish where design countermeasures may be indicated. The study uses linked (accident and injury) data involving a sample of older bus-users. Most incidents in the linked dataset were non-collisions (62 per cent) resulting in 1,381 recorded injuries in those aged 60+ years, of which 46 per cent were 'slight' and 54 per cent 'serious'

A tale of two cities: A study of access to food, lessons for public health practice

Objectives: To map food access in the city of Preston in the north-west of England in order to determine access, availability and affordability of healthy food options. Design and methodology: The research design employed a number of distinct methods including: surveys of shops; interviews with local people and shopkeepers; a cost and availability survey of shops in two deprived areas of Preston —Deepdale and Ingol — the former with a majority South Asian population; and the use of geographical information systems to map access and availability. Results: • Preston had more fast food outlets (186) [not including restaurants who operate takeaways] than general groceries outlets (165). • There were more local shops selling affordable food in the area with the high South Asian population than in Ingol with its white working class population. There were clear gaps in provision and access in the white working class area (Ingol), with shops being more than 500 metres away from where people lived. Shops in this area stocked more familiar ‘British foods’ and less specialist or fresh produce. • Analysis of the availability of some healthy options such as brown bread, wholemeal pasta and brown rice showed that they were not widely available within shops in the two areas. • The price of the ‘White British’ basket in Ingol was £70.61 (cheapest price). For comparable goods in Deepdale, using the most expensive shopping basket, the price for the same basket was £42.47. • A South Asian family shopping at a major national supermarket outlet in Deepdale would pay £47.05. Using local shops they could pay between £38.59 and £44.28 by seeking out the best bargains in five shops (including some top-up items from a national supermarket). • At the time of the research a mother with two children, entitled to income support and child allowance, would have to spend 28—32 per cent of her income in local shops and 34 per cent in a supermarket to buy a basket of healthy goods. Conclusions: There is a need to engage proactively with the location of shops in urban areas, to ensure they offer a healthy range of options and are sited near to where people live. The number of fast food outlets needs to be controlled and the food they offer improved.This latter issue of the number of outlets and quality of fast food contributes to an overall obesogenic environment. Access to food is heavily dependent on having access to a car; local shopping and the quality of food on offer are important for key groups such as those on benefits, the elderly, single parents and others with limited access to a car. Proactive policy solutions may lie with the engagement of health agencies with the planning processes in local authorities to ensure that the food retail environment reflects a healthy choice. Local area agreements between health agencies and local authorities offer a way forward, in that they can take into account the expressed needs of local residents

Occurrence of Anti-Drug Antibodies against Interferon-Beta and Natalizumab in Multiple Sclerosis: A Collaborative Cohort Analysis

Immunogenicity of biopharmaceutical products in multiple sclerosis is a frequent side effect which has a multifactorial etiology. Here we study associations between anti-drug antibody (ADA) occurrence and demographic and clinical factors. Retrospective data from routine ADA test laboratories in Sweden, Denmark, Austria and Germany (Dusseldorf group) and from one research study in Germany (Munich group) were gathered to build a collaborative multi-cohort dataset within the framework of the ABIRISK project. A subset of 5638 interferon-beta (IFN beta)-treated and 3440 natalizumab-treated patients having data on at least the first two years of treatment were eligible for interval-censored time-to-event analysis. In multivariate Cox regression, IFN beta-1a subcutaneous and IFN beta-1b subcutaneous treated patients were at higher risk of ADA occurrence compared to IFN beta-1a intramuscular-treated patients (pooled HR = 6.4, 95% CI 4.9-8.4 and pooled HR = 8.7, 95% CI 6.6-11.4 respectively). Patients older than 50 years at start of IFN beta therapy developed ADA more frequently than adult patients younger than 30 (pooled HR = 1.8, 95% CI 1.4-2.3). Men developed ADA more frequently than women (pooled HR = 1.3, 95% CI 1.1-1.6). Interestingly we observed that in Sweden and Germany, patients who started IFN beta in April were at higher risk of developing ADA (HR = 1.6, 95% CI 1.1-2.4 and HR = 2.4, 95% CI 1.5-3.9 respectively). This result is not confirmed in the other cohorts and warrants further investigations. Concerning natalizumab, patients older than 45 years had a higher ADA rate (pooled HR = 1.4, 95% CI 1.0-1.8) and women developed ADA more frequently than men (pooled HR = 1.4, 95% CI 1.0-2.0). We confirmed previously reported differences in immunogenicity of the different types of IFN beta. Differences in ADA occurrence by sex and age are reported here for the first time. These findings should be further investigated taking into account other exposures and biomarkers

Occurrence of Anti-Drug Antibodies against Interferon-Beta and Natalizumab in Multiple Sclerosis: A Collaborative Cohort Analysis

Immunogenicity of biopharmaceutical products in multiple sclerosis is a frequent side effect which has a multifactorial etiology. Here we study associations between anti-drug antibody (ADA) occurrence and demographic and clinical factors. Retrospective data from routine ADA test laboratories in Sweden, Denmark, Austria and Germany (Dusseldorf group) and from one research study in Germany (Munich group) were gathered to build a collaborative multi-cohort dataset within the framework of the ABIRISK project. A subset of 5638 interferon-beta (IFN beta)-treated and 3440 natalizumab-treated patients having data on at least the first two years of treatment were eligible for interval-censored time-to-event analysis. In multivariate Cox regression, IFN beta-1a subcutaneous and IFN beta-1b subcutaneous treated patients were at higher risk of ADA occurrence compared to IFN beta-1a intramuscular-treated patients (pooled HR = 6.4, 95% CI 4.9-8.4 and pooled HR = 8.7, 95% CI 6.6-11.4 respectively). Patients older than 50 years at start of IFN beta therapy developed ADA more frequently than adult patients younger than 30 (pooled HR = 1.8, 95% CI 1.4-2.3). Men developed ADA more frequently than women (pooled HR = 1.3, 95% CI 1.1-1.6). Interestingly we observed that in Sweden and Germany, patients who started IFN beta in April were at higher risk of developing ADA (HR = 1.6, 95% CI 1.1-2.4 and HR = 2.4, 95% CI 1.5-3.9 respectively). This result is not confirmed in the other cohorts and warrants further investigations. Concerning natalizumab, patients older than 45 years had a higher ADA rate (pooled HR = 1.4, 95% CI 1.0-1.8) and women developed ADA more frequently than men (pooled HR = 1.4, 95% CI 1.0-2.0). We confirmed previously reported differences in immunogenicity of the different types of IFN beta. Differences in ADA occurrence by sex and age are reported here for the first time. These findings should be further investigated taking into account other exposures and biomarkers

Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe:A descriptive study of test results

Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFNβ) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, considering the number of ADA tests performed and type of ADA assays used, and to determine the frequency of ADA testing against the different drug preparations in different countries. A common database platform (tranSMART) for querying, analyzing and storing retrospective data of MS cohorts was set up to harmonize the data and compare results of ADA tests between different countries. Retrospective data from six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFNβ preparations was confirmed in this large dataset. Decreased usage of the more immunogenic preparations IFNβ-1a subcutaneous (s.c.) and IFNβ-1b s.c. in favor of the least immunogenic preparation IFNβ-1a intramuscular (i.m.) was observed. The median time from treatment start to first ADA test correlated with time to first positive test. Shorter times were observed for IFNβ-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFNβ-1a i.m. (1.41 and 2.27 years), IFNβ-1b-Betaferon s.c. (2.51 and 1.96 years) and IFNβ-1a s.c. (2.11 and 2.09 years) which were available years before routine testing began. A higher rate of anti-IFNβ ADA was observed in test samples taken from older patients. Testing for ADA varies between different European countries and is highly dependent on the policy within each country. For drugs where routine monitoring of ADA is not in place, there is a risk that some patients remain on treatment for several years despite ADA positivity. For drugs where a strategy of ADA testing is introduced with the release of the drug, there is a reduced risk of having ADA positive patients and thus of less efficient treatment. This indicates that potential savings in health cost might be achieved by routine analysis of ADA