In a recent paper we showed that there is less variation in later life careers than one would expect based on the popularity of terms like 'phased retirement', 'bridge jobs', and 'un-retirement'. These concepts seemed more topical than typical, at least in the UK. In this paper we assess why this is the case by going more in depth quantitatively and investigating five qualitative case studies; Transport, Hospitality, Local Government, Manufacturing, and Mining. We will place special attention on what individuals say they want in later working life as well as investigate actual and perceived barriers. By combining strengths of quantitative and qualitative research we are in a unique position of being able to provide policy advice based on general patterns as well as a deeper understanding of why we see these patterns. We also provide employers with insight on what could extend older workers' labour force attachment.
Rationale: Increasing digitalization and automation is expected to significantly change the transport system, mobility and settlement structures. A decade ago automated, self-driving vehicles were nothing more than an unrealistic (boyhood) dream. But today the concept of highly and fully automated vehicles is rapidly becoming a reality, with a series of real-world trial applications underway. Government plans and industry predictions expect automation to be introduced from the early 2020s onwards. Nevertheless, there is still a high level of uncertainty in which form and to what extent automated vehicles will enter the market. Furthermore, there are ongoing discussions concerning net effects of positive and negative aspects of automation. Background: The authors have been involved in several research projects analyzing potential impacts of automated driving. The EU funded project CityMobil (Towards Advanced Road Transport for the Urban Environment) was one of first to address automated driving on a large scale. As part of this project the System Dynamics based model MARS (Metropolitan Activity Relocation Simulator) was adapted to assess scenarios of automated driving in four European cities. Simulations demonstrated that automated vehicles integrated into public transport have a potential to reduce car kilometers travelled and improve carbon footprint. On the contrary, privately owned automated vehicles lead to an increase in car kilometers travelled and carbon footprint, unless propulsion technology is changed. While the focus of CityMobil was on the urban scale, the nationally funded Austrian project Shared Autonomy (Potential Effects of the Take-up of Automated Vehicles in Rural Areas – own translation) focused on rural areas. The findings of Shared Autonomy show potential contributions of automated cars to improve the environmental situation and social inclusion in rural areas. Finally, the nationally funded Austrian project SAFiP (System Scenarios Automated Driving in Personal Mobility) takes a look at the national territory of Austria. Method: The relationship between vehicle automation, travel demand and environmental effects consists of a multitude of complex cause-effect-chains. The toolbox of System Dynamics offers appropriate methods to tackle such complexities. Causal Loop Diagrams are used to analyze and discuss relevant cause-effect-chains and are used to adapt an existing Stock-Flow-Model of the Austrian land use and transport demand system. The modified Stock-Flow-Model is used for a quantitative impact assessment. Sensitivity analysis in form of Monte-Carlo-Simulations is employed to tackle the high level of uncertainty concerning key factors. Findings, results: The key factors, influencing mode choice and travel demand, are generalized costs of travel time, weighted costs of use and availability. The automation of driving, expressed as the share of highly and fully automated vehicles in the fleet, is influencing all three key factors via different cause-effect-chains and feedback loops. In SAFiP we identified four key impact sources: automated and remote parking, road capacity and travel speed, value of in-vehicle time and widening the range of users. Sensitivity tests for each of the impact sources have been carried out. Widening the range of users has the highest impact on a national level, potentially increasing car kilometers by about 17 percent in 2050. Remote parking increases car kilometers by about 5 percent in total, ranging from about 1 percent in peripheral districts to about 17 percent in Vienna.
OBJECTIVE: To assess the levels of physical activity among young children with moderate acute malnutrition and to identify clinical, biochemical, anthropometric, and sociodemographic correlates of physical activity. STUDY DESIGN: In a cross-sectional study, 1609 children aged 6-23 months wore a triaxial accelerometer (ActiGraph GT3x+; ActiGraph, Pensacola, Florida) for 6 consecutive days, from which total physical activity were determined. Data on morbidity were collected based by history and physical examination, and serum C-reactive protein and α₁-acid glycoprotein were measured. RESULTS: A total of 1544 (96%) children had physical activity measured, of whom 1498 (97%) completed 6 consecutive days of physical activity recording with a daily median wear time of 24 hours. The mean (±SD) total physical activity was 707 (±180) vector magnitude counts per minute (cpm). Age was negatively correlated with physical activity; compared with children below 12 months of age, those 12-17 months of age, and 18-23 months of age had 51 (95% CI, 26; 75) and 106 (95% CI, 71; 141) cpm lower physical activity, respectively. Fever and malaria were associated with 49 (95% CI, 27; 70) and 44 (95% CI, 27; 61) cpm lower activity, respectively. Elevated serum C-reactive protein and α₁-acid glycoprotein were both negative correlates of physical activity, and hemoglobin was a positive correlate. CONCLUSIONS: Physical activity declines with age in children with moderate acute malnutrition and is also inversely related to infection and inflammatory status. Future studies are needed to ascertain cause and effect of these associations. TRIAL REGISTRATION: Controlled-Trials.com: ISRCTN42569496. ; Funded by the Danish International Development Assistance (DANIDA; 09-097 LIFE [to C.W.]), Médecins Sans Frontières (Denmark and Norway), World Food Program (received support from the US Agency for International Development's Office of Food for Peace), Alliance for International Medical Action, the European Union, Action Contre la Faim, and Arvid Nilsson Foundation. The authors declare no conflicts of interest.
International audience ; INTRODUCTION: Acute malnutrition (AM) is a continuum condition, arbitrarily divided into moderate and severe AM (SAM) categories, funded and managed in separate programmes under different protocols. Optimising acute MAlnutrition (OptiMA) treatment aims to simplify and optimise AM management by treating children with mid-upper arm circumference (MUAC) <125 mm or oedema with one product-ready-to-use therapeutic food-at a gradually tapered dose. Our main objective was to compare the OptiMA strategy with the standard nutritional protocol in children 6-59 months presenting with MUAC <125 mm or oedema without additional complications, as well as in children classified as uncomplicated SAM (ie, MUAC <115 mm or weight-for-height Z-score (WHZ) <-3 or with oedema). METHODS AND ANALYSIS: This study was a non-inferiority, individually randomised controlled clinical trial conducted at community level in the Democratic Republic of Congo. Children 6-59 months presenting with MUAC <125 mm or WHZ <-3 or with bipedal oedema and without medical complication were included after signed informed consent in outpatient health facilities. All participants were followed for 6 months. Success in both arms was defined at 6 months post inclusion as being alive, not acutely malnourished per the definition applied at inclusion and without an additional episode of AM throughout the 6-month observation period. Recovery among children with uncomplicated SAM was the main secondary outcome. For the primary objective, 890 participants were needed, and 480 children with SAM were needed for the main secondary objective. We will perform non-inferiority analyses in per-protocol and intention-to-treat basis for both outcomes. ETHICS AND DISSEMINATION: Ethics approvals were obtained from the National Health Ethics Committee of the Democratic Republic of Congo and from the Ethics Evaluation Committee of Inserm, the French National Institute for Health and Medical Research (Paris, France). We will submit results ...
International audience ; INTRODUCTION: Acute malnutrition (AM) is a continuum condition, arbitrarily divided into moderate and severe AM (SAM) categories, funded and managed in separate programmes under different protocols. Optimising acute MAlnutrition (OptiMA) treatment aims to simplify and optimise AM management by treating children with mid-upper arm circumference (MUAC) <125 mm or oedema with one product-ready-to-use therapeutic food-at a gradually tapered dose. Our main objective was to compare the OptiMA strategy with the standard nutritional protocol in children 6-59 months presenting with MUAC <125 mm or oedema without additional complications, as well as in children classified as uncomplicated SAM (ie, MUAC <115 mm or weight-for-height Z-score (WHZ) <-3 or with oedema). METHODS AND ANALYSIS: This study was a non-inferiority, individually randomised controlled clinical trial conducted at community level in the Democratic Republic of Congo. Children 6-59 months presenting with MUAC <125 mm or WHZ <-3 or with bipedal oedema and without medical complication were included after signed informed consent in outpatient health facilities. All participants were followed for 6 months. Success in both arms was defined at 6 months post inclusion as being alive, not acutely malnourished per the definition applied at inclusion and without an additional episode of AM throughout the 6-month observation period. Recovery among children with uncomplicated SAM was the main secondary outcome. For the primary objective, 890 participants were needed, and 480 children with SAM were needed for the main secondary objective. We will perform non-inferiority analyses in per-protocol and intention-to-treat basis for both outcomes. ETHICS AND DISSEMINATION: Ethics approvals were obtained from the National Health Ethics Committee of the Democratic Republic of Congo and from the Ethics Evaluation Committee of Inserm, the French National Institute for Health and Medical Research (Paris, France). We will submit results ...
