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This paper examines self-employed individuals in the UK Labour market. We use an amalgamated dataset, the British Household Panel Survey, from the years 1991 to 2008, and its successor the United Kingdom Longitudinal Study, from years 2010 to 2014, following 11,657 respondents in the UK for 23 years. We explore the characteristics of different self-employed groups and create a new division that differentiates those who sustain in self-employment from those who move between self-employment and employee jobs. The sample size consists of 1146 sustained self-employed, 1149 dabbled self-employed and 9362 paid workers. We found that dabblers exhibit unique set of attributes that place them in a distinct position compared to sustained self-employed and/or employees. Dabblers seem to be 'pulled' rather than 'pushed' into self-employment, reflecting a labour market 'power' instead of deficiency. Thus, bringing key insight into a group who have not been separately identified in the labour market to date, the self-employed dabblers. [ABSTRACT FROM AUTHOR]

Abstract Background Identification of COPD patients with a rapid decline in FEV1 is of particular interest for prognostic and therapeutic reasons. Objective To determine the expression of markers of inflammation in COPD patients with rapid functional decline in comparison to slow or no decliners. Methods In COPD patients monitored for at least 3 years (mean ± SD: 5.8 ± 3 years) for lung functional decline, the expression and localization of inflammatory markers was measured in bronchial biopsies of patients with no lung functional decline (FEV1% + 30 ± 43 ml/year, n = 21), slow (FEV1% ml/year, − 40 ± 19, n = 14) and rapid decline (FEV1% ml/year, − 112 ± 53, n = 15) using immunohistochemistry. ELISA test was used for polymeric immunoglobulin receptor (pIgR) quantitation “in vitro”. Results The expression of secretory IgA was significantly reduced in bronchial epithelium (p = 0.011) and plasma cell numbers was significantly reduced in the bronchial lamina propria (p = 0.017) of rapid decliners compared to no decliners. Bronchial inflammatory cell infiltration, CD4, CD8, CD68, CD20, NK, neutrophils, eosinophils, mast cells, pIgR, was not changed in epithelium and lamina propria of rapid decliners compared to other groups. Plasma cells/mm2 correlated positively with scored total IgA in lamina propria of all patients. “In vitro” stimulation of 16HBE cells with LPS (10 μg/ml) and IL-8 (10 ng/ml) induced a significant increase while H2O2 (100 μM) significantly decreased pIgR epithelial expression. Conclusion These data show an impaired humoral immune response in rapid decliners with COPD, marked by reduced epithelial secretory IgA and plasma cell numbers in the bronchial lamina propria. These findings may help in the prognostic stratification and treatment of COPD.

Background: In 2019, the COVID-19 pandemic emerged. Variation in COVID-19 patient outcomes between hospitals was later reported. Purpose: This study aims to determine whether sustainers—hospitals with sustained high performance on Hospital Value-Based Purchasing Total Performance Score (HVBP-TPS)—more effectively responded to the pandemic and therefore had better patient outcomes. Methodology: We calculated hospital-specific risk-standardized event rates using deidentified patient-level data from the UnitedHealth Group Clinical Discovery Database. HVBP-TPS from 2016 to 2019 were obtained from Centers for Medicare & Medicaid Services. Hospital characteristics were obtained from the American Hospital Association Annual Survey Database (2019), and county-level predictors were obtained from the Area Health Resource File. We use a repeated-measures regression model assuming an AR(1) type correlation structure to test whether sustainers had lower mortality rates than nonsustainers during the first wave (spring 2020) and the second wave (October to December 2020) of the pandemic. Results: Sustainers did not have significantly lower COVID-19 mortality rates during the first wave of the pandemic, but they had lower COVID-19 mortality rates during the second wave compared to nonsustainers. Larger hospitals, teaching hospitals, and hospitals with higher occupancy rates had higher mortality rates. Conclusion: During the first wave of the pandemic, mortality rates did not differ between sustainers and nonsustainers. However, sustainers had lower mortality rates than nonsustainers in the second wave, most likely because of their knowledge management capabilities and existing structures and resources that enable them to develop new processes and routines to care for patients in times of crisis. Therefore, a consistently high level of performance over the years on HVBP-TPS is associated with high levels of performance on COVID-19 patient outcomes. Practice Implications: Investing in identifying the knowledge, processes, and resources that foster the dynamic capabilities needed to achieve superior performance in HVBP might enable hospitals to utilize these capabilities to adapt more effectively to future changes and uncertainty. [ABSTRACT FROM AUTHOR]

Background: Identification of COPD patients with a rapid decline in FEV1 is of particular interest for prognostic and therapeutic reasons.Objective: To determine the expression of markers of inflammation in COPD patients with rapid functional decline in comparison to slow or no decliners.Methods: In COPD patients monitored for at least 3 years (mean ± SD: 5.8 ± 3 years) for lung functional decline, the expression and localization of inflammatory markers was measured in bronchial biopsies of patients with no lung functional decline (FEV1% + 30 ± 43 ml/year, n = 21), slow (FEV1% ml/year, - 40 ± 19, n = 14) and rapid decline (FEV1% ml/year, - 112 ± 53, n = 15) using immunohistochemistry. ELISA test was used for polymeric immunoglobulin receptor (pIgR) quantitation "in vitro".Results: The expression of secretory IgA was significantly reduced in bronchial epithelium (p = 0.011) and plasma cell numbers was significantly reduced in the bronchial lamina propria (p = 0.017) of rapid decliners compared to no decliners. Bronchial inflammatory cell infiltration, CD4, CD8, CD68, CD20, NK, neutrophils, eosinophils, mast cells, pIgR, was not changed in epithelium and lamina propria of rapid decliners compared to other groups. Plasma cells/mm2 correlated positively with scored total IgA in lamina propria of all patients. "In vitro" stimulation of 16HBE cells with LPS (10 μg/ml) and IL-8 (10 ng/ml) induced a significant increase while H2O2 (100 μM) significantly decreased pIgR epithelial expression.Conclusion: These data show an impaired humoral immune response in rapid decliners with COPD, marked by reduced epithelial secretory IgA and plasma cell numbers in the bronchial lamina propria. These findings may help in the prognostic stratification and treatment of COPD. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article was to investigate the organizational and market-level variables associated with sustained superior hospital performance on Value-Based Purchasing total performance scores (TPS). Methodology: TPS for 2014 through 2017 was obtained from the Centers for Medicare & Medicaid Services Hospital Compare website. Market-level data were from the 2017 Area Health Resource File, and hospital-level data were from the 2014 American Hospital Association Annual Survey database. We specified a logistic regression model to identify significant predictors of hospitals with sustained superior performance on TPS, that is, "sustainers." Principal Findings: Only 8.4% of hospitals were classified as sustainers. Hospitals located in rural markets with a high Medicare Advantage penetration had a higher likelihood of being classified as sustainers. High RN staffing levels, lower Medicare share of inpatient days, not-for-profit ownership, and small size were all significant organizational predictors of sustained superior performance. Conclusions: Both modifiable characteristics, such as nurse staffing levels, and nonmodifiable characteristics, such as rural markets and small hospital size, are associated with the likelihood of hospitals sustaining superior performance over time. Practice Implications: Managers need to carefully examine their staffing levels as they pursue interventions to sustain high TPS overtime. Moreover, factors such as Medicare share of inpatient days and size need to be considered when understanding barriers to sustained performance on Value-Based Purchasing domains. [ABSTRACT FROM AUTHOR]

Women occupied a central place in seventeenth- and eighteenth-century transatlantic Quakerism. They acted as prophets, missionaries, authors and spiritual leaders of their communities. Recent scholarship has offered important insights into the unparalleled public roles available to women within the early Quaker community. But little is known about the networks of hospitality that developed across the British Atlantic that made itinerant missionary service possible. The generosity of countless female Quakers to unknown “Friends” remains an underexplored aspect of early Quaker history. Using printed spiritual testimonies and correspondence exchanged between Quaker missionaries and their female hosts, this article shows how ministers were “sustained” during their travels. Active religious service did not have to equate to ministerial work, and networks of female hospitality provided an important accompaniment to the national and transatlantic Quaker mission. [ABSTRACT FROM AUTHOR]