Macroeconomic impact from extending working lives (WP95)

This report presents findings from research, conducted by the National Institute of Economic and Social Research (NIESR) and funded by the Department for Work and Pensions (DWP). NIESR were commissioned to use their global econometric model, NiGEM, in order to model various scenarios involving extending working lives, and to quantify the macroeconomic effects therein. The core scenario is a one year increase in working life for the UK population that is gradually phased in over the period 2010-14. In addition to this, NIESR carried out a series of counterfactual analyses which modelled the loss to the economy from older people leaving the labour market early

The Youth Proceedings Advocacy Review: Final Report

This review considered the quality of advocacy in youth proceedings and the core components of effective advocacy, with a view to informing the Bar Standard Board's consideration of whether regulatory interventions are required to improve standards of youth advocacy. The research activities comprised a survey of 215 advocates; interviews with 96 stakeholders, including advocates, young people, youth court magistrates, and court-based YOT workers; and observations in four youth courts and five Crown Courts across England and Wales. The report concluded that the work of advocates in youth proceedings cannot be viewed in isolation from its wider legal, institutional and cultural context, and presents recommendations aimed at promoting more effective advocacy. These recommendations are focused on systems and structures of youth proceedings which could support better advocacy; court-based facilitators of advocacy; and training and learning opportunities for advocates

Organizing the Organizational Communication Course: Content and Pedagogical Recommendations

Organizational communication extends beyond communication that takes place in an organizational context to the ways communication is used to organize and facilitate activity. This article is designed to enhance organizational communication pedagogy practices by highlighting foundational concepts and content areas that should be included in undergraduate organizational communication courses. Additionally, four active learning assignments, including case studies, applied organizational communication theory papers, organizational audits, and media assignments, are described to enhance student engagement with class material and to assess student learning. Finally, the article includes common issues to help educators anticipate concerns and plan effective classroom strategies

Reka bentuk untuk kestabilan struktur

Buku ini mengandungi beberapa bab iaitu kandungan: kata penghantar, prakata, tatatanda, bab 1 tabii ketakstabilan, pengenalan, bab 2 ketakstabilan sesatah bagi tiang, pengenalan, lengkokan euler keseluruhan, tiang berhujung-cemat sempurna – pendekatan klasik, lengkungan awal dalam tiang berhujung-cemat tiang dikenakan beban sisi-tiang rasuk, tiang berbeban sipi, tegasan di dalam tiang bergeometri taksempurna, tegasan baki, tiang terpencil sebenar dan kod rekabentuk, keadaan hujung tiang, fungsi kestabilan, anggota prisma tanpa huyung, anggota prisma berhuyung, anggota tak-prisma, perembat, bibliografi, bab 3 lengkokan sisi bagi rasuk, pengenalan, piuhan keratan-i, lengkokan rasuk, runtuhan rasuk ‘nyata’, penggunaan teori lengkokan sisi terhadap rekabentuk rasuk, kesan dari momen tak-segaya, kegunaan faktor–m di dalam rekabentuk, kesan tahap pengenaan beban melintang, kesan dari keadaan sokong hujung, kelakuan rasuk selanjar, halangan sisi berkesan, rasuk jalur, kesan lengkokan tempatan, rasuk selain dari keratan-i seragam berbebibir-sama, bibliografi, bab 4 beban genting anjal bagi kerangka satah, pengenalan, kelakuan kerangka dan ketakstabilan kerangka, beban genting anjal bagi kerangka kerja tanpa huyung: teknik corak momen, beban genting anjal bagi kerangka kerja tanpa huyung: teknik santaian winter, beban genting anjal bagi kerangka kerja tanpa huyung: teknik kerangka gantian bolton, beban genting anjal bagi kerangka kerja tanpa huyung: portal terembat, pendekatan ‘agihan kekukuhan’ wood, beban genting anjal bagi kerangka kerja huyung: fungsi tiada-ricih n dan o, beban genting anjal bagi kerangka kerja huyung: teknik corak momen, beban genting anjal bagi kerangka kerja huyung: teknik santaian winter, beban genting anjal bagi kerangka kerja huyung: kaedah wood, beban genting anjal bagi kerangka kerja huyung: kaedah horne, beban genting anjal dan rekabentuk kerangka, bibliografi, lampiran serta indeks

Patient-Centric Medicine Design: Key Characteristics of Oral Solid Dosage Forms that Improve Adherence and Acceptance in Older People

Older people represent a very heterogeneous patient population and are the major user group of medication. Age-related changes mean that this population can encounter barriers towards taking medicines orally. The aim of this study was to investigate the characteristics of oral solid dosage forms that contribute to an age appropriate dosage design, with an aim to improve overall medication adherence and acceptance in older people. Fifty-two semistructured interviews were conducted with older people, informal (family) carers, and health and social care professionals. Formulation characteristics impacted three stages of the medication taking process: (1) medication identification and memorability, (2) medication handling and (3) swallowability. Small round tablets (≤7 mm) are least accepted amongst older people and their carers and had a negative impact on all stages. The use of bright, two-coloured preparations and interesting shapes improves identification and further aids memorability of indications and the timing of tablets. Palatability, while useful to enhance swallowability, also has an impact on the visual appeal and memorability of medication. Environmental, patient, medication and disease characteristics also determine preferences for formulation. Developing an age appropriate dosage design for older people, therefore, requires a holistic, patient-centric approach to improve adherence and acceptance

A pragmatic approach for engineering porous mannitol and mechanistic evaluation of particle performance

The importance of mannitol has increased recently as an emerging diluent for orodispersible dosage forms. The study aims to prepare spray dried mannitol retaining high porosity and mechanical strength for the development of orally disintegrating tablets (ODTs). Aqueous feed of d-mannitol (10% w/v) comprising ammonium bicarbonate, NH4HCO3 (5% w/v) as pore former was spray dried at inlet temperature of 110-170°C. Compacts were prepared at 151MPa and characterized for porosity, hardness and disintegration time. Particle morphology and drying mechanisms were studied using thermal (HSM, DSC and TGA) and polymorphic (XRD) methods. Tablet porosity increased from 0.20±0.002 for pure mannitol to 0.53±0.03 using fabricated porous mannitol. Disintegration time dropped by 50-77% from 135±5.29s for pure mannitol to 75.33±2.52-31.67±1.53s for mannitol 110-170°C. Hardness increased by 150% at 110°C (258.67±28.89N) and 30% at 150°C (152.70±10.58N) compared to pure mannitol tablets (104.17±1.70N). Increasing inlet temperature resulted in reducing tablet hardness due to generation of 'micro-sponge'-like particles exhibiting significant elastic recovery. Impact of mannitol polymorphism on plasticity/elasticity cannot be ruled out as a mixture of α and β polymorphs formed upon spray drying

The role of lipid geometry in designing liposomes for the solubilisation of poorly water soluble drugs

Liposomes are well recognised for their ability to improve the delivery of a range of drugs. More commonly they are applied for the delivery of water-soluble drugs, but given their structural attributes, they can also be employed as solubilising agents for low solubility drugs as well as drug targeting agents. To further explore the potential of liposomes as solubilising agents, we have investigated the role of bilayer packaging in promoting drug solubilisation in liposome bilayers. The effect of alkyl chain length and symmetry was investigated to consider if using 'mis-matched' phospholipids could create 'voids' within the bilayers, and enhance bilayer loading capacity. Lipid packing was investigated using Langmuir studies, which demonstrated that increasing the alkyl chain length enhanced lipid packing, with condensed monolayers forming, whilst asymmetric lipids formed less condensed monolayers. However, this more open packing did not translate into improved drug loading, with the longer chain, condensed bilayers formed from long-chain, saturated lipids offering higher drug loading capacity. These studies demonstrate that liposomes formulated from longer chain, saturated lipids offer enhanced solubilisation capacity. However the molecular size, rather than lipophilicity, of the drug to be incorporated was also a key factor dominating bilayer incorporation efficiency. © 2012 Elsevier B.V. All rights reserved

CCL2 nitration is a negative regulator of chemokine-mediated inflammation.

Chemokines promote leukocyte recruitment during inflammation. The oxidative burst is an important effector mechanism, this leads to the generation of reactive nitrogen species (RNS), including peroxynitrite (ONOO). The current study was performed to determine the potential for nitration to alter the chemical and biological properties of the prototypical CC chemokine, CCL2. Immunofluorescence was performed to assess the presence of RNS in kidney biopsies. Co-localisation was observed between RNS-modified tyrosine residues and the chemokine CCL2 in diseased kidneys. Nitration reduced the potential of CCL2 to stimulate monocyte migration in diffusion gradient chemotaxis assays (p < 0.05). This was consistent with a trend towards reduced affinity of the nitrated chemokine for its cognate receptor CCR2b. The nitrated chemokine was unable to induce transendothelial monocyte migration in vitro and failed to promote leukocyte recruitment when added to murine air pouches (p < 0.05). This could potentially be attributed to reduced glycosaminoglycan binding ability, as surface plasmon resonance spectroscopy showed that nitration reduced heparan sulphate binding by CCL2. Importantly, intravenous administration of nitrated CCL2 also inhibited the normal recruitment of leukocytes to murine air pouches filled with unmodified CCL2. Together these data suggest that nitration of CCL2 during inflammation provides a mechanism to limit and resolve acute inflammation

Does the Formulation of Oral Solid Dosage Forms Affect Acceptance and Adherence in Older Patients?:A Mixed Methods Systematic Review

OBJECTIVES: Age-related changes mean that the older population can encounter barriers toward taking medication orally. Further work is needed to identify the characteristics of oral solid dosage forms that will improve patient acceptance and adherence. The aim of this systematic review was to identify if and how formulation aspects of oral solid dosage forms affect acceptance and adherence in older people. DESIGN: Mixed methods systematic review using a data-based convergent synthesis design. SETTING AND PARTICIPANTS: Articles were selected if they included participants aged 60 years and older, or included health care professionals, social care professionals, and informal carers of patients aged 60 years and older. METHODS: A systematic search of the following databases was undertaken: Web of Science, MEDLINE, Scopus, and The Cochrane Databases. The search of databases was supplemented by a search of gray literature, and reference lists of included papers were manually searched. RESULTS: A total of 16 studies were included in the final synthesis. Three themes were generated from the thematic analysis: (1) dimensions, (2) palatability, and (3) appearance. The dimensions and palatability are often modified to improve swallowability by breaking tablets in half or taste masking with food. Polypharmacy can lead to patients using the appearance to identify tablets; however, this can lead to confusion when products appear similar. No study was identified that explored formulation characteristics across all 3 categories directly in the older population. CONCLUSION AND IMPLICATIONS: Manufacturers should take into account practical problems older people may encounter when considering the dimensions, palatability, and appearance of the final drug product. These characteristics should be optimized to aid visual identification and swallowability. Medical providers and pharmacists have an important role in ensuring that these patient-centric drug products are prescribed and dispensed appropriately so that patients receive the most suitable formulation

The impact of COVID-19 on emergency medical service-led out-of-hospital cardiac arrest resuscitation: A qualitative study

Background: Following the emergence of COVID-19, there have been local and national changes in the way emergency medical service (EMS) staff respond to and treat patients in out-of-hospital cardiac arrest (OHCA). The views of EMS staff on the impact of COVID-19 and management of OHCA have not previously been explored. This study aimed to explore the views of staff, with a specific focus on communication during resuscitation, resuscitation procedures and the perception of risk.Methods: A qualitative phenomenological enquiry was conducted. A purposive sample of n = 20 participants of various clinical grades was selected from NHS EMS providers in the United Kingdom. Data were collected using semi-structured interviews, transcribed verbatim and inductive thematic analysis was applied.Results: Three main themes emerged which varied according to clinical grade, location and guidelines.Decision making: Staff generally felt supported to make best-interest termination of resuscitation decisions. Staff made informed decisions to compromise on recommended levels of personal protective equipment (PPE), since it felt impractical in the pre-hospital context, to improve communication or to reduce delays to care.Service pressures: Availability of operational staff and in-hospital capacity were reduced. Staff felt pressure and disconnect from the continuous updates to clinical guidelines which resulted in organisational change fatigue.Moral injury: The emotional impacts of prolonged and frequent exposure to failed resuscitation attempts and patient death caused many staff to take time away from work to recover.Conclusion: This qualitative study is the first known to explore staff views on the impacts of COVID-19 on OHCA resuscitation, which found positive outcomes but also negative impacts important to inform EMS systems. Staff felt that COVID-19 created delays to the delivery of resuscitation, which were multi-faceted. Staff developed new ways of working to overcome the barriers of impractical PPE. There was little impact on resuscitation procedures. Moving forwards, EMS should consider how to limit organisational change and better support the ongoing emotional impacts on staff