This article reflects on some of the major changes in the ways that people are working today, changes often driven by a preference for greater autonomy and choice, but also to work on a sharing, collaborative or networked basis. Many of the growing numbers of independent professionals are attracted by these ways of working. Developments in Information and Communication Technology have been critical, especially in enabling services, including professional services, to be delivered via internet platforms. This has created, in effect, new forms of intermediation and increasingly complex work relationships. These developments have often proved very controversial, as instanced by the disputes surrounding Uber, the international, internet-based taxi provider. Many of these changes also raise issues of accountability and work quality, along with creating new patterns of work relationships. Inevitably, the changes also highlight the role of regulation, which is the main focus of this article The topic is explored against a backdrop of much recent deregulation, challenges to so-called ‘red tape’ and laissez faire policies. The myriad of disputes and litigation involving Uber is examined and reflected upon. There are, of course, many differences between the taxi drivers of Uber and the designers, journalists, engineers and consultants, typical of independent professional working, but there are also some key parallels and experiences that provide a cautionary tale!
OBJECTIVE-High iron stores are a proposed modifiable risk factor for esophageal adenocarcinoma, but minimal human data exist. We evaluated whether iron intake and iron stores were associated with Barrett's esophagus, a metaplastic change that is a strong risk factor for esophageal adenocarcinoma.METHODS-We conducted a case-control study within the Kaiser Permanente Northern California population. We identified all persons with a new diagnosis of Barrett's esophagus (cases); they were matched to persons with GERD (without Barrett's esophagus) and to population controls. Subjects completed examinations, dietary questionnaires, and testing for serum iron stores (ferritin and transferrin saturation). Analyses used unconditional logistic regression.RESULTS-We evaluated 319 cases, 312 GERD patients, and 313 population controls. Compared with population controls, Barrett's esophagus patients had lower dietary iron intakes (4th vs 1st quartiles, odds ratio [OR] = 0.37, 95% confidence interval [CI] 0.17-0.80), similar total iron intakes (including supplement use), and lower iron stores (4th vs 1st quartiles, ferritin OR = 0.24, 95% CI 0.14-0.40;% transferrin saturation OR = 0.66, 95% CI 0.41-1.04; P value trend <0.01 and 0.03, respectively). Similar associations were observed in comparisons with GERD controls and among subjects without clear sources of blood loss on endoscopy. Specific author contributions: Douglas A. Corley: conception, study conduct, analysis, manuscript preparation; Ai Kubo: analysis, manuscript preparation; Theodore R. Levin: conception, manuscript preparation; Laurel Habel: conception, manuscript preparation; Wei Zhao: study conduct, analysis, manuscript preparation; Patricia Leighton: study conduct, manuscript preparation; Gregory Rumore MD: study conduct, manuscript preparation; Charles Quesenberry: analysis, manuscript preparation; Patricia Buffler: conception, analysis, manuscript preparation; Gladys Block PhD: conception, analysis, manuscript preparation. Financial support: United States National Institutes of Health RO1 DK63616 and K08 DK02697. Potential competing interests: The sponsor reviewed the study design, but had no role in the collection, analysis, or interpretation of the data, in the writing of the report, or in the decision to submit the report for publication. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript CONCLUSIONS-Patients with Barrett's esophagus had lower dietary iron intakes and lower serum iron stores than controls in our population. These findings do not provide support for the current hypothesis that high iron stores or a high iron intake are risk factors for Barrett's esophagus, a potential early event in the carcinogenic sequence for esophageal adenocarcinoma. NIH Public Access
T his special issue 'Working as a self-employed professional, freelancer, contractor, consultant … issues, questions …and solutions?' covers such a broad range and depth of topics that capturing the essence seems almost impossible. We, therefore, open this special edition with a snapshot from thought leaders from around the world. These snapshots cover a world view, presented by renowned British organisational theorist, consultant, and London Business School Professor Lynda Gratton, an Australian perspective from Australian Small Business and Family Enterprise Ombudsman, Kate Carnell to a UK view from Cambridge University's renowned Labour Law Professor, Simon Deakin and a EU perceptive from esteemed European Policy Centre Advisor, Hans Martens. As you will see, while they are united by being well informed of the issue, they all come to the topic from different (sometime very) perspectives. All of our contributors have written on the subject, including for policy development and have an 'expert eye' on the topic.
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