Pioneering marriage for same-sex couples in the Netherlands

Why did the Netherlands become the first country to allow same-sex couples to marry? I argue that in addition to social and political factors that have been well-highlighted in the literature, the desire of Dutch activists and policy élites to burnish their international reputation as a social policy and lesbian, gay, bisexual and transgender rights pioneer played a critical role in motivating the government to adopt this controversial policy. In making this argument, the article addresses the often neglected topic of policy invention. I utilize the concept of regional policy community drawn from federalism studies to illustrate that such communities do not just facilitate the diffusion of new innovations across its constituent states, but they can also inspire pioneering states to experiment with new policy models in the first place

Corporate social responsibility in an era of economic crisis: Empty gesture or tool for corporate learning?

The social legitimacy of business actors in EU member states has waxed and waned over the past two decades. Levels of trust in business, as recorded in public opinion polls, tend to increase in good economic times and decrease during recessions. After the financial crisis began in 2007 and mushroomed into the Euro crisis in 2009 and a double-dip recession in 2012, the European public’s confidence in business plummeted

Mixing business with politics: does corporate social responsibility end where lobbying transparency begins?

Scholars increasingly have argued that the future effectiveness and legitimacy of firms' corporate social responsibility (CSR) activities are dependent on more transparent forms of lobbying to ensure firms' policy positions are aligned with their CSR commitments. Very little empirical work, however, has systematically analyzed firms' lobbying disclosures or examined how these firms coordinate their lobbying and CSR activities. We address these empirical questions by analyzing the CSR reports of 150 corporations from Germany, the UK and the US over an 18‐year period and by conducting interviews with the CSR managers of these firms. We find that corporations have become more transparent about their public policy advocacy over time, thus acknowledging that lobbying is a CSR issue. For most firms, however, this commitment to transparency appears to be largely ceremonial. Few firms disclose the specific policy positions they advocate or sufficiently coordinate the work of their lobbying and CSR units to foster greater alignment of these activities. These modest changes in lobbying transparency appear to be driven by legitimacy concerns and, in a few instances, by governance gaps firms perceive to be relevant to their future business interests

Engaging firms : The global organisational field for corporate social responsibility and national varieties of capitalism

This paper is the outcome of a workshop ‘The Causes and Consequences of Private Governance: The Changing Roles of State and Private Actors’ held on 6/7 November 2014 at the Mannheim Centre for European Social Research (MZES) and funded by the COST Action IS1309 ‘Innovations in Climate Governance: Sources, Patterns and Effects’ (INOGOV), MZES, and the Lorenz von Stein Foundation. The research on which the paper is based was funded by a grant from the Economic and Social Research Council in the United Kingdom (RES-062-23-3258). In addition to the participants of the Mannheim workshop, we would like to thank Jale Tosun, Sebastian Koos, Jennifer Shore, Lukas Giessen, Sarah Burns, Tim Werner, Karen Wright and the two anonymous reviewers for their constructive comments on earlier versions of this article. The remaining faults are all our own.Peer reviewedPublisher PD

When rights enter the CSR Field: British firms’ engagement with human rights and the UN Guiding Principles

The adoption of the Guiding Principles for Business and Human Rights by the United Nations (UNGPs) in 2011 created a new governance instrument aimed at improving the promotion of human rights by business enterprises. While reaffirming states duties to uphold human rights in law, the UNGPs called on firms to promote the realization of human rights within global markets. The UNGPs thus have sought to embed human rights more firmly within the field of corporate social responsibility (CSR) and to use CSR practices to improve corporate human rights accountability. In this paper, we explore how this incorporation of human rights into the CSR field has affected the business practices and public commitments British firms have made to promote human rights. We analyse the CSR reports published by the 50 largest British firms over a 20-year period starting in the late 1990s and interview senior CSR managers of these firms. We find that these firms have expanded how they articulate their responsibility for human rights over time. These commitments however remain largely focused on improving management practices such as due diligence and remediation procedures. Firms are often both vague and selective about which substantive human rights they engage with in light of their concerns about their market competitiveness and broader legitimacy. These outcomes suggest that, while firms cannot completely resist the normative pressures exerted by the CSR field, they retain significant resources and agency in translating such pressure into concrete practices

Using molecular simulation to predict solute solvation and partition coefficients in solvents of different polarity

A methodology is proposed for the prediction of the Gibbs energy of solvation (Delta(Solv)G) based on MD simulations. The methodology is then used to predict DSolvG of four solutes (namely propane, benzene, ethanol and acetone) in several solvents of different polarities (including n-hexane, n-hexadecane, ethylbenzene, 1-octanol, acetone and water) while testing the validity of the TraPPE force field parameters. Excellent agreement with experimental data is obtained, with average deviations of 0.2, 1.1, 0.8 and 1.2 kJ mol(-1), for the four solutes respectively. Subsequently, partition coefficients (log P) for forty different solute/solvent systems are predicted. The a priori knowledge of partition coefficient values is of high importance in chemical and pharmaceutical separation process design or as a measure of the increasingly important environmental fate. Here again, the agreement between experimental data and simulation predictions is excellent, with an absolute average deviation of 0.28 log P units. However, this deviation can be decreased down to 0.14 log P units, just by optimizing partial atomic charges of acetone in the water phase. Consequently, molecular simulation is proven to be a tool with strong physical basis able to predict log P with competitive accuracy when compared to the popular statistical methods with weak physical basis

Psychosocial factors and ageing in older lesbian, gay and bisexual people: a systematic review of the literature

Aims and objectives: To synthesise and evaluate the extant literature investigating the psychosocial influences on ageing as a lesbian, gay or bisexual person, in order to develop understanding about these influences and guide future research in the area. Background: Research suggests there may be specific psychological and social factors relevant to ageing for individuals with a non-heterosexual identity. Design: A systematic review was conducted on empirical research involving lesbian, gay and bisexual individuals aged 60 or above. Methods: The Cochrane Database, PsychINFO, MEDLINE, Web of Science and Google Scholar were searched and 41 studies met inclusion criteria. The majority had not been reviewed in earlier review articles. Results: Findings were within two domains: psychological, consisting of sub-themes relating to identity, mental health and body image; and social, consisting of relationships, social support, discrimination, caregiving and receiving, community, accessing services and housing. The results suggest lesbian, gay and bisexual individuals mostly adjust well to ageing identities, with mediating influences including self-acceptance and connection with peers. Challenges experienced included ageism and heteronormative health and social care services; intimate friendships, social support and respectful professionals mitigated such threats and facilitated successful ageing. Methodological issues related to sampling procedures, such as purposive sampling through the gay community and limited generalisability due to the homogeneity of participants. Additionally, there was a widespread lack of heterosexual control groups. However, most studies used appropriate measures and acknowledged inherent limitations. Conclusion: Psychosocial influences included the challenge of societal stigma, but also resilience individuals demonstrate through a positive attitude. These factors must continue to be investigated for services to best meet the needs of this population. Relevance to clinical practice: Clinicians are well placed to assist individuals draw on resilience when facing ageing challenges. Also, clinicians should be aware older people may have prior negative experiences of accessing services and try to involve ‘families of choice’ in care planning

Automated closed-loop insulin delivery for the management of type 1 diabetes during pregnancy: the AiDAPT RCT

Background There are over 2000 pregnancies annually in women with type 1 diabetes in the UK. Despite recent improvements in diabetes technology, most women cannot achieve and maintain the recommended pregnancy glucose targets. Thus, one in two babies experience complications requiring neonatal care unit admission. Recent studies demonstrate that hybrid closed-loop therapy, in which algorithms adjust insulin delivery according to continuous glucose measurements, is effective for managing type 1 diabetes outside of pregnancy, but efficacy during pregnancy is unclear. Objective To examine the clinical efficacy of hybrid closed-loop compared to standard insulin therapy in pregnant women with type 1 diabetes. Design A multicentre, parallel-group, open-label, randomised, controlled trial in pregnant women with type 1 diabetes. Setting Nine antenatal diabetes clinics in England, Scotland and Northern Ireland. Participants Pregnant women with type 1 diabetes and above-target glucose levels, defined as glycated haemoglobin A1c of ≥ 48 mmol/mol (6.5%) in early pregnancy. Interventions A hybrid closed-loop system compared to standard insulin delivery (via insulin pump or multiple daily injections) with continuous glucose monitoring. Outcome measures The primary outcome is the difference between the intervention and control groups in percentage time spent in the pregnancy glucose target range (3.5–7.8 mmol/l) as measured by continuous glucose monitoring from 16 weeks’ gestation until delivery. Secondary outcomes include overnight time in range, time above range (> 7.8 mmol/l), glycated haemoglobin A1c, safety outcomes (diabetic ketoacidosis, severe hypoglycaemia, adverse device events), psychosocial functioning obstetric and neonatal outcomes. Results The percentage of time that maternal glucose levels were within target range was higher with closed-loop than standard insulin therapy: 68.2 ± 10.5 in closed-loop and 55.6 ± 12.5 in the control group (mean‑adjusted difference 10.5 percentage points, 95% confidence interval 7.0 to 14.0; p < 0.001). Results were consistent in secondary outcomes, with less time above range (−10.2%, 95% confidence interval −13.8 to −6.6%; p < 0.001), higher overnight time in range (12.3%, 95% confidence interval 8.3 to 16.2%; p < 0.001) and lower glycated haemoglobin A1c (−0.31%, 95% confidence interval −0.50 to −0.12%; p < 0.002) all favouring closed-loop. The treatment effect was apparent from early pregnancy and consistent across clinical sites, maternal glycated haemoglobin A1c categories and previous insulin regimen. Maternal glucose improvements were achieved with 3.7 kg less gestational weight gain and without additional hypoglycaemia or total daily insulin dose. There were no unanticipated safety problems (six vs. five severe hypoglycaemia cases, one diabetic ketoacidosis per group) and seven device-related adverse events associated with closed-loop. There were no between-group differences in patient-reported outcomes. There was one shoulder dystocia in the closed-loop group and four serious birth injuries, including one neonatal death in the standard care group. Limitations Our results cannot be extrapolated to closed-loop systems with higher glucose targets, and our sample size did not provide definitive data on maternal and neonatal outcomes. Conclusions Hybrid closed-loop therapy significantly improved maternal glycaemia during type 1 diabetes pregnancy. Our results support National Institute for Health and Care Excellence guideline recommendations that hybrid closed-loop therapy should be offered to all pregnant women with type 1 diabetes. Future work Future trials should examine the effectiveness of hybrid closed-loop started before pregnancy, or as soon as possible after pregnancy confirmation

Beyond Genetic Factors in Familial Amyloidotic Polyneuropathy: Protein Glycation and the Loss of Fibrinogen's Chaperone Activity

Familial amyloidotic polyneuropathy (FAP) is a systemic conformational disease characterized by extracellular amyloid fibril formation from plasma transthyretin (TTR). This is a crippling, fatal disease for which liver transplantation is the only effective therapy. More than 80 TTR point mutations are associated with amyloidotic diseases and the most widely accepted disease model relates TTR tetramer instability with TTR point mutations. However, this model fails to explain two observations. First, native TTR also forms amyloid in systemic senile amyloidosis, a geriatric disease. Second, age at disease onset varies by decades for patients bearing the same mutation and some mutation carrier individuals are asymptomatic throughout their lives. Hence, mutations only accelerate the process and non-genetic factors must play a key role in the molecular mechanisms of disease. One of these factors is protein glycation, previously associated with conformational diseases like Alzheimer's and Parkinson's. The glycation hypothesis in FAP is supported by our previous discovery of methylglyoxal-derived glycation of amyloid fibrils in FAP patients. Here we show that plasma proteins are differentially glycated by methylglyoxal in FAP patients and that fibrinogen is the main glycation target. Moreover, we also found that fibrinogen interacts with TTR in plasma. Fibrinogen has chaperone activity which is compromised upon glycation by methylglyoxal. Hence, we propose that methylglyoxal glycation hampers the chaperone activity of fibrinogen, rendering TTR more prone to aggregation, amyloid formation and ultimately, disease

AiDAPT: automated insulin delivery amongst pregnant women with type 1 diabetes: a multicentre randomized controlled trial – study protocol

Background Pregnant women with type 1 diabetes strive for tight glucose targets (3.5-7.8 mmol/L) to minimise the risks of obstetric and neonatal complications. Despite using diabetes technologies including continuous glucose monitoring (CGM), insulin pumps and contemporary insulin analogues, most women struggle to achieve and maintain the recommended pregnancy glucose targets. This study aims to evaluate whether the use of automated closed-loop insulin delivery improves antenatal glucose levels in pregnant women with type 1 diabetes. Methods/design A multicentre, open label, randomized, controlled trial of pregnant women with type 1 diabetes and a HbA1c of ≥48 mmol/mol (6.5%) at pregnancy confirmation and ≤ 86 mmol/mol (10%) at randomization. Participants who provide written informed consent before 13 weeks 6 days gestation will be entered into a run-in phase to collect 96 h (24 h overnight) of CGM glucose values. Eligible participants will be randomized on a 1:1 basis to CGM (Dexcom G6) with usual insulin delivery (control) or closed-loop (intervention). The closed-loop system includes a model predictive control algorithm (CamAPS FX application), hosted on an android smartphone that communicates wirelessly with the insulin pump (Dana Diabecare RS) and CGM transmitter. Research visits and device training will be provided virtually or face-to-face in conjunction with 4-weekly antenatal clinic visits where possible. Randomization will stratify for clinic site. One hundred twenty-four participants will be recruited. This takes into account 10% attrition and 10% who experience miscarriage or pregnancy loss. Analyses will be performed according to intention to treat. The primary analysis will evaluate the change in the time spent in the target glucose range (3.5-7.8 mmol/l) between the intervention and control group from 16 weeks gestation until delivery. Secondary outcomes include overnight time in target, time above target (> 7.8 mmol/l), standard CGM metrics, HbA1c and psychosocial functioning and health economic measures. Safety outcomes include the number and severity of ketoacidosis, severe hypoglycaemia and adverse device events. Discussion This will be the largest randomized controlled trial to evaluate the impact of closed-loop insulin delivery during type 1 diabetes pregnancy. Trial registration ISRCTN 56898625 Registration Date: 10 April, 2018