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Home News Planner urges multiple strategies to create Chilmark affordable housing
Planner urges multiple strategies to create Chilmark affordable housing
The town's homesite bylaw will not be enough, according to housing consultants.
Bill Chaisson
Consultant Jennifer Goldson presented in Oak Bluffs in December. —Barry Stringfellow
The Chilmark planning board got some sobering news on Jan. 23 when planners Jennifer Goldson of JM Goldson Community Preservation + Planning in Roslindale, and Judi Barrett of RKG Associates in Boston, presented a draft of a new town housing production plan (HPP). The proposal included 11 strategies for reaching the town's housing goals, including the construction of 20 units of affordable housing. And the housing experts rejected the town's existing zoning bylaw as a useful alternative.
Homesite housing, part of current town zoning, "is not the path to affordable housing," Ms. Goldson and Ms. Barrett explained.
"You need to create land for nonprofits to build affordable housing," Ms. Barrett said.
Ms. Goldson suggested the town consider establishing a village residential district in the vicinity of the town hall. The planners also recommended using natural resource protection zoning (NRPZ) called "flexible siting" in Chilmark's zoning bylaws, to free up land on which to build affordable housing.
Ms. Barrett displayed a map of the town, marked with three potential sites for affordable housing on town-owned parcels. The first site, on Middle Line Road, is an eight-acre lot next to the former town landfill. Ms. Barrett said there are no constraints on development at the site. She recommended that a feasibility study be done to determine how many units could fit on the parcel.
Two parcels are on Pasture Road, near a highway department storage building and a ballfield. Nine out of a total of 21.5 acres could be developed at this location. Ms. Barrett said that the Middle Line and Pasture Road sites together would not yield the 20 units of the HPP goal.
Ms. Goldson then went through the proposed action plan. Two of the strategies included moving forward with special legislation. One would increase the existing real estate transfer fee by 0.5 percent to promote creation of affordable housing, and the second would create an excise tax on seasonal rentals, similar to the existing tax on hotel rooms. Ms. Goldson recommended that the town pursue these strategies first, then tackle those that involved changes to the zoning bylaws later.
Rich Osnoss, chairman of the planning board, recommended that the town focus on meeting the requirement of 20 units of affordable housing, and not worry about development enabled by invoking Chapter 40B of Massachusetts General Law. This law allows developers to override some local zoning bylaws if less than 10 percent of the town's real estate is affordable. Affordability is defined as within reach of someone making 80 percent of the area median income (AMI), which is $59,583 in Chilmark. Mr. Osnoss described Chapter 40B and its ramifications as "not a big threat around here."
In a phone interview with The Times after the Jan. 23 meeting, Ms. Goldson said that the strongest demand for housing in Chilmark is for the seasonal home market, where there is a good profit margin. She said that developers were unlikely to attempt to build projects that required that 20 to 25 percent of the units have long-term affordability restrictions, which cut into their profit margins.
Ms. Goldson described the village residential district as a "smart growth" opportunity. Smart growth is a planning practice that encourages denser, walkable settings with a mixture of uses.
"There is already a mix of housing with institutional uses [near the town hall]," Ms. Goldson said. "Maybe they could add some small, locally owned commercial shops, but I know that's difficult out there."
The planner emphasized building houses in the town, and told the planning board that the state will not approve Chilmark's first housing plan, namely to build affordable housing in another town, paid for by Chilmark.
"Some people argue that there shouldn't be development in Chilmark, because it is so remote," Ms. Goldson said, "but they do have development in the form of large seasonal homes."
Ms. Goldson made it clear that she did not envision large-scale projects for Chilmark. Multifamily housing should consist of between four and six units, perhaps as many as eight.
"The design of these can be awful and inappropriate," she said, "but you can articulate a building in so many ways in order to minimize the impact. You could design it to look like an estate home with an outbuilding — like a gatehouse — but divide it up into several units."
Ms. Goldson said comprehensive permits are generally used strategically by communities in order to build housing that zoning does not allow, but the community wants. In Chilmark she thought that perhaps this strategy could be used to subdivide large, older single-family homes or commercial buildings to create multiunit dwellings. To do this through a comprehensive permit, a developer's plan would have to be approved by the town's board of zoning appeals.
Ms. Goldson did not think the town should choose between building in a village-like setting versus the more isolated sites like the ones she and Ms. Barrett proposed in their presentation. Rather, she thought Chilmark should pursue both approaches.
"You could do something appropriate and reasonable," she said. "You are probably going to need a car in Chilmark no matter where you live; their land-use plan is scattered." She said that because the town already owned the parcels at Midline and Pasture roads, the reduced overall cost would help make houses there affordable.
Part of an Island-wide effort
Ms. Goldson, Ms. Barrett, and their colleagues were hired by the Martha's Vineyard Commission to produce the HPPs for all six towns on the Island, and also an Island-wide plan. The project began with three workshops held in all the towns in November and December. The object of the first workshop was to create a vision for housing in a town. In the second, participants were expected to outline what kind of housing they wanted. And in the third workshop they discussed how to realize those goals. She described each workshop as a dialogue between the planners and the residents who attended the events. The planners would produce a document to share with the participants at a subsequent meeting and collect their feedback. The final report is a synthesis of the consultants' views and those of town residents.
Ms. Goldson has produced HPPs all over the state. Asked what differences she found between Island and mainland residents, her answer may surprise Islanders.
"People here have been thinking regionally all along," she said. "All the towns are already thinking Island-wide. In the mainland towns, they don't tend to. We usually have to push them to get them to do it. They have a view that they aren't as collaborative as they should be, but we kept hearing Island-wide solutions."
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Who will be the next generation of philanthropists? Where will they come from? Will they emerge on their own, or will they be mentored into existence by charitable-minded parents? Like other aspects of human literacy, religious, nonprofit, and educational organizations have an obligation to help surface the next generation of philanthropists by providing strategic opportunities of philanthro-paideia that will nurture the language of altruism in the young.
The ancient Greek term "paideia" (παιδεία) refers to the "tutoring of the ideal citizen" (member of theπόλις). It involved both practical and subject-based instruction that focused upon the socialization of the young who would mature into intelligent, moral, cultured, and physically fit adults. In this fashion, the youth were "molded" into the ideal citizen who was "beautiful and good" (kalos kagathos). In Homer's Iliad, King Peleus thus charged his son Achilles to acquire such "arete," excellence in all things exquisite (knowledge, morality, bravery, contemplation, and strength).
Approached in this fashion, Philanthro-paideia (φιλανθρωπική εκπαίδευση), may be understood as "tutoring-in-altruism." It is a methodology that entails helping the young become the next generation of "ideal" philanthropists who are willing and capable of making impactful, strategic decisions about the effective use of their resources towards charitable causes. Through the combination of hands-on experiences, insight into nonprofit operations, and understanding of social philanthropic impact, religious, nonprofit, and educational institutions can help acquire the empowering "arete" of charity, and thereby, transform the world.
The Old Testament is replete with examples of young leaders who reflected the transformative countenances of "arete." David was a teenage shepherd whose courageous character and God-trusting nature championed Israel against Goliath (1 Sam 17). Although he was sold into slavery by his jealous older brothers, young Joseph exemplified moral fortitude by rebuffing the inappropriate advances of Potiphar's unfaithful wife (Genesis 39). Together with the account of a "young maid" that boldly pioneered the healing-power of the prophet Elisha to her leprous master (2 Kings 5), Daniel and his three teen-age young friends who were thrown in a Babylonian furnace for refusing to worship their idols (Daniel 1), are examples of transformative leaders.
Although many youth-centered New Testament stories can also be highlighted, the altruistic "arete" of a "young lad" (Παιδαριον) that helped Jesus feed a multitude of people with five loaves of bread and three fish, is a valuable example of the philanthropic nature of the young (John 6:6). While the Feeding of the Five Thousand is a miracle story found in all four Gospels, it is significant that only Saint John informs his readers that the meager comestibles that precipitated the extraordinary meal were donated by a "young boy" (John 6:9).
The Feeding of the Five Thousand is a valuable pedagogical paradigm for nurturing the next generation of philanthropists. The miraculous event would have certainly influenced the rest of the young lad's philanthropic life. Consequently, the New Testament account encapsulates the primary goal of philanthro-paideia whose primary goal is the nurturing of altruistic-minded youth who are similarly inspired to share their time, talents, and resources for the benefit of others.
Research confirms Spaide's proposition that children are more likely to be kind and generous when they have at least one parent that humbly models philanthropic behavior. A study conducted by Ottoni-Wilhelm, professor of philanthropic studies at the Indiana University Lilly Family School of Philanthropy, found that adolescents were 18% more likely to donate to a charitable organization if their parents had made similar donations in the past year. More significantly, if parents were donors and also talked about giving, their children were 33% more likely to become contributors themselves. Similarly, adolescents whose parent(s) were volunteers were 27% more likely to volunteer themselves, and 47% more likely to do so if their parent also talked with them about the value of generosity.
Numerous studies can be cited that substantiate Spaide and Wilhelm's research data concerning the value of philanthro-paideia. In his article,Hyperagency and High-Tech Donors: A New Theory of the New Philanthropists (2003), Paul Schervish of the Boston College Social Welfare Research Institute asserts that, while philanthropy is an altruistic impulse, it is also a "learned behavior." In their paper, The Intergenerational Transmission of Generosity (2008), Ottoni-Wilhelm et al. (2014) provide data that confirms Schervish's assertion. According to the authors, there is a correlation between the generosity of parents and the charitable giving patterns of their adult children. Specifically, parents' religious giving is positively associated with children's secular giving. Like Spaide and Schervish, the authors suggest that young people are more likely to give and volunteer if they have been exposed to both conversations about philanthropy and role-modeling of philanthropic behaviors.
According to the National Center for Family Philanthropy's 2015 Trends in Family Philanthropy Study, nearly 56% of family foundations engage younger family members. More than 40% say they expect to add to or increase the number of younger-generation family members on their boards in the near future. The most common methods of engaging younger generations include allowing them to sit on the foundation board and participate in group discussions of core values. According to the Study, regardless of age or size, family foundations that are engaging the young strongly believe that the next generation will bring new ideas and vibrancy to their institution.
In her book, Teaching Philanthropy to Children(2002), Patricia O. Bjorhovde finds that the value of philanthropy and the actions of giving and serving are the consequences of three primary types of learning: (1) modeling, which involves seeing and hearing, (2) cognitive learning, which combines thinking and discussing, and (3) experiential engagement, which involves doing. Since altruistic behaviors can be learned and taught at all ages, from infancy onward throughout life, philanthro-paideia should include all three of Bjorhovde's instructional tactics of modeling, cognitive learning, and experiential engagement in all youth-centered contexts.
Data from the 2010 report entitled, Today's Children, Tomorrow's Philanthropists, Talk About Giving, an initiative developed by the Central Carolina Community Foundation to encourage multi-generational conversation about philanthropy, concludes that the home environment has an enormous impact on the development of future donors. According to the report, 71% of children with philanthropic parents go on to be philanthropic themselves while only 47% of children who have parents that don't give go on to be philanthropists.
While the home is the best setting for learning caring and empathy in relationships, the school environment is valuable for integrating service-learning opportunities and voluntarism. The classroom may also be used to provide explicit instruction about philanthropy and its role and benefit in society. Alternatively, religious communities provide opportunities for engaging in acts of giving and serving in a safe and structured environment and with clear linkage to the religious teachings and stories of the faith. Finally, community-based service and nonprofit organizations may arrange valuable programs and initiatives that are designed to nurture an affinity for philanthropic service in the young.
The 2015 Scanning the Landscape of Youth Philanthropy Report, published by the Foundation Center, the leading source of information about philanthropy worldwide, indicates that there are more than 830 youth philanthropy programs worldwide. Since 2001, over $14 million in grants has been distributed by these programs to youth. By developing programs and strategically advancing initiatives that promote philanthro-paideia, religious, education, and nonprofit organizations can help the nation's young discover the joy and transformative power of altruism. Consequently, apart from including information concerning history, culture, and values, philanthro-paideia should include literacy of effective models of charitable giving that have high-impact, low-overhead, and are focused on root causes.
But what is the best approach to inspire the next generation of such philanthropists? While a careful review of existing initiatives provides a list of effective strategies that give youth an opportunity to (1) genuinely engage in philanthropy, (2) form meaningful connections with non-profit organizations and professionals, (3) take on real responsibility, and (4) develop useful life-skills and competencies, three distinctive models of philanthro-paideia stand out: (1) Youth Pods, (2) Giving Circles, and (3) Next-Gen Donor Programs.
The Dekko Foundation is noted as the creator of Youth Pods, groups of young people who are interested in bringing about positive community change. Located in Indiana, the foundation's grantmaking program aims to equip young people with the skills, knowledge, and character they need to be self-sufficient in adulthood. A key component of the curriculum includes youth philanthropy. Each Youth Pod operates like a mini-foundation, with $15,000 in grant money provided by the Foundation plus $2,500 for expenses.
There are currently thirteen Youth Pods in four states, Indiana, Iowa, Alabama, and Minnesota. According to Foundation's founder, Chet Dekko, since 1994, when the first Youth Pod was inaugurated, more than 800 teens have participated. The benefits for youth are reflected in a recent survey of Youth Pod alumni conducted by the Foundation. Of the respondents, 80% said they gained important skills such as decision making, leadership, communication, financial responsibility, awareness of the nonprofit sector and knowledge of formal philanthropy.
According to The Center of Philanthropy at Indiana University, a Giving Circle is a philanthropic vehicle in which individual donors pool their money and other resources and together decide where to give them away. Particularly attractive to younger people, minorities, and women, nearly half of all Giving Circle participants are under the age of forty. Similar to Youth Pods, Giving Circles include social, educational, and engagement components that aim to connect participants to the local community while increasing their understanding of philanthropy and societal issues.
The Forum of Regional Associations of Grantmakers, describes Giving Circles as groups of individuals who decide to pool their money, and sometimes their talents, to make a bigger difference in a local, national or international cause. According to a two-year study to better understand the current scope, scale, and significance of collective giving in the U.S., funded by the Gates and the Charles Stewart Mott Foundations, "Giving Circles and other forms of collective giving are changing the face of community philanthropy across the United States." More specifically, the 2017 report entitled, The State of Giving Circles Today, estimates that, since their inception in 2007, Giving Circles have given $1.29 billion combined across their lifespans to philanthropic organizations.
Giving Circles provide social networks, leadership development, peer support, and collaborative learning among its members. According to the National Giving Circle Network, apart from affording a creative and simple vehicle for youth and families to learn about and engage in philanthropy, Giving Circles provide (1) youth with knowledge and skills, (2) enable inter-generational partnerships, (3) encourage equal participation from all participants, (4) build a culture of shared learning and collaboration, (4) share the responsibility of reviewing and discussing grant applications, (5) promote collaborative decision making, (6) create engagement with community, and (7) depict philanthropy as Fun and Simple.
Members of giving circles seem to donate more than other types of donors. Plus, the more engaged they are in the process of determining what groups to give to and how much, the more they give. People who were more engaged, for longer, and who belonged to multiple giving circles all gave more than the typical donor.
Giving Circle members give more strategically. They do more research, are more willing to fund the operating expenses of charities, and consider issues of class, gender, race, and culture when making giving decisions.
Compared to givers not in a giving circle, members gave more often to groups that support women and ethnic and minority groups. They also favored the arts, culture, the environment, neighborhood development, advocacy, and international aid. Their giving was less "traditional" than usual for donors.
The more engaged people are in a giving circle, the more they express civic responsibility. They become involved in community issues and in changing government policies.
Giving Circle members have a more positive view of how philanthropy can affect the health of communities and about the role of government in making a difference. They felt more empowered to make a change themselves.
The following four key findings about Next-Gen Donors should be referenced when developing strategies for their philanthropic edification.
Driven by Values, Not Valuables. Next-Gen Donors are mindful of their family's charitable legacy and want to connect with the needs of the day. They are driven by a deep sense of responsibility and values, and acknowledge their place as a privilege. They were influenced by parents (89%), grandparents (63%), close friends (56%) and peers (47%) in their approach to philanthropy; and for most, a philanthropic mindset was instilled early on in life.
Impact is First. Next-Gen Donors want to be "strategic." They want to add to their philanthropic toolbox, enhance what has been done in the past, and develop new philanthropic strategies. There are five key strategies mentioned: (1) conducting due diligence through research; (2) determining philanthropic goals and then searching for a fit; (3) funding root causes that promote systemic solutions; (4) wanting to see measurable impact and change from an organization before funding is received; and, (5) recommending the cause to others in their network.
Time, Talent, Treasure and Ties. Next-Gen Donors want to be personally engaged and linked in. These donors "want to listen and offer their own professional or personal talents, all in order to solve problems together with those whom they support." Mutually reinforcing philanthropic connections are central to Next-Gen Donor activities.
Crafting a Philanthropic Identity. The Next-Gen Donor generation does not want to wait until the sunset of their lives to be philanthropic. In addition to wanting to do more than write a check, "they are eager to be taken seriously." They are likely to use a variety of philanthropic vehicles, including Giving Circles, Pooled, and Donor-Advised Funds.
I once overheard an outlandish response from a religious leader who was asked about his church's development program. When challenged to provide more financial transparency concerning stewardship collections, the leader stated that since he did not inquire how the donors "made their money," it was "his business alone" to know how their contributions were ultimately used. One can only imagine and lament the harmful long-term impact that such a distorted posture of "stewarding" time, talents, and resources would have on current as well as Next-Gen donors.
Instead of expressing such a misguided understanding of philanthropic arete, religious, nonprofit, and educational organizations would be wise to alternatively utilize insights gleaned from Holy Scripture, careful research, and fundraising professionals to design the curricula that will be used to strategically advance best-practice programs of philanthro-paideia. Only in such a fashion can our nation help inspire the emergence of the next generation of "ideal" philanthropists.
In the end, the instruction of Saint Paul to Timothy, his young mentee, would be far more appropriate than the aforementioned perspective of the blinkered religious leader. "Let no one despise your youth," the apostle advised. "Instead, you should be an example to the believers in speech, in conduct, in love, in faith, in purity (1 Timothy 4:12). Regardless of age, the ideal citizen should exemplify the "arete" of such mature philanthropic literacy.
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Q: Delay in loading jsp page? I am having a login jsp page, after entering all the credentials and while clicking on the login button, I am redirecting it to a servlet which does all the login processing and then dispatching to a another jsp page. Iam finding delay in opening the jsp page. What can be the problem...? Any suggestions?

A: If you are not precompiling the JSPs before deploying, your container will do that on the fly. This is probably the delay you are seeing.

redpajama_set_name: RedPajamaStackExchange


text:
Q: Fitting images with different dimensions I am building a webpage for homework purposes and I am struggling to fit in four photos with different dimensions in a grid layout. To be more specific I have to make that grid layout be responsive as a 4-grid layout on Desktop view, 2-grid layout on Tablet view, and Mobile view. I have tried a lot of advice from different articles but none of them seems to be working.
CSS code:
  .services{
    float: left;
    width: 25%;
    height:100vh;
    max-width:100%;
    object-fit:cover;
  }

  @media only screen and (max-width: 1180px) {
    .services{
      width: 50%;
    }
  }

HTML code:

Current look:

I want photos to be in a line for each occasion with certain dimensions.
Any thoughts?

A: Thanks for submitting your question! Instead of using  markup for placing your images, I would suggest using  with a background-image. Why? With background-image you can use 'background-size: cover' wich make the image cover the whole  with a custom height, so the columns are all equal.
Trying to achieve this with regular  tags needs a some sort of resizer or the images need to be the same width and height already.
Below my code! Tip: You don't have to close the  tag, you can use it without the closing image tag.
HTML

CSS
     .services{
    float: left;
    width: 25%;
    height:100vh;
    max-width:100%;
    object-fit:cover;
  }

  .services .image-box {
    width: 100%;
    height: 400px;
    background-size: cover;
  }

  @media only screen and (max-width: 1180px) {
    .services{
      width: 50%;
    }
  }

A: Try this, for grid you need to define display: grid; in the parent div
.grid{
  display: grid;
  grid-template-columns: repeat(4,1fr);
}
.services{
  height: 100%;
  width: 100%;
}
@media only screen and (max-width: 1180px) {
    .grid{
        display: grid;
        grid-template-columns: repeat(2,1fr);
    }
}

in HTML , in the place of 'level' add your image code it will work in both responsive

             level

             level

             level

             level

if you want the image to be cover add this in img class object-fit: cover;
This will work fine .


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Jamestown, Virginia: Tobacco King
You probably know about the Mayflower Pilgrims, but they weren't the first English colonists. Several years before the Pilgrims arrived, settlers arrived in Virginia.
The Pilgrims came to America for religious reasons, but others came looking for opportunity. England was a crowded, dirty place and America seemed to hold the promise of adventure and wealth. Both the wealthy and the poor came looking for a new life.
Images of Jamestown Virginia Tobacco King
In 1587, 150 English men, women, and children began a colony on Roanoke Island, off the coast of Virginia. The governor, John White, returned to England for supplies. When he came back three years later, he found the island deserted. The settlers had scratched the word, Croatoan, onto a post, but White found no other clues about what had happened to the settlers. People believed they were killed or sold as slaves by the Powhatan Indians. Recently, researchers have found European artifacts, such as coins, weapons, and jewelry, mixed with Indian artifacts. Researchers believe the settlers might have joined the Indians.
In 1607, 105 men and boys arrived in three ships. They landed on the coast of Virginia and named their settlement Jamestown, in honor of King James. These settlers were wealthy gentlemen seeking their fortune. Unfortunately, Jamestown was built on a marshy area, prone to mosquitoes, which brought disease. Drought conditions caused crop failure. Indian attacks were always a danger too. Seventy-three men died in one year.
Captain John Smith helped the colony succeed. Most of the men were unaccustomed to hard work. Smith told them that if they wanted to eat they must work. He asked the Powhatan tribe to teach them how to catch fish and grow corn. Slowly the settlement began to prosper.
King James thought smoking and tobacco was a terrible habit, but it grew well in Virginia, and many people in Europe loved it. Virginian landowners became wealthy growing tobacco.
The landowners brought indentured servants from Europe to work on the farms. These servants could earn their freedom after a few years of hard work – if they survived.
Once the servants earned their freedom, they moved further inland and farmed their own land. These poor farmers resented the wealthy tobacco growers. In 1675 and 1676, Nathanial Bacon led a group of farmers in an uprising against the landowners. The rebels burned Jamestown to the ground.
The landowners knew that poor, indentured servants could become a danger once they were free. Slaves seemed like an ideal answer.
Artifacts: Items left behind by earlier civilizations
Malaria: a disease transmitted by mosquitoes
Tobacco: a plant which is used to make cigarettes
Question: Did John Smith marry Pocahontas?
Answer: Smith and Pocahontas were friends but Pocahontas married another Englishman, John Rolfe.
Visit History is Fun for a virtual field trip of Jamestown.
Declan, Tobin. " Jamestown Virginia: Tobacco King Fun Facts ." American History for Kids, Jan 2023. Web. 30 Jan 2023. < https://www.americanhistoryforkids.com/jamestown-virginia-tobacco-king/ >.
Tobin, Declan. (2023). Jamestown Virginia: Tobacco King Fun Facts. American History for Kids. Retrieved from https://www.americanhistoryforkids.com/jamestown-virginia-tobacco-king/

redpajama_set_name: RedPajamaCommonCrawl


Did the Google walkout work?
Thousands of Google employees from around the world staged a walkout protest the company's handling of sexual misconduct claims. Jamie Yuccas reports.
KING 5's Ted Land reports.
CNBC's Aditi Roy reports on the Google employee walk-out starting in the United States after Singapore and London employees walked out earlier this morning.


There is large jump for 2 reasons. The first is consumers are taking advantage of historically low interest rates hovering in the 4% range. Second is the affordability of residential homes in Ocala, Belleview, Dunnellon, Salt Spring, Fort McCoy, Sparr, Anthony, Citra and several other areas. Mortgage application can be a future gauge of home buying reported by Mortgage Bankers Association report for the week ending Dec. 2. Applications jumped 8. % from a week earlier while refinance soared to 15.3 %.
The reports states 85.5 % were for fixed-rate 30 year loans.


text:
Enzalutamide for hormone-relapsed non-metastatic prostate cancer
Technology appraisal guidance [TA580] Published date: 15 May 2019
2 Information about enzalutamide
3 Committee discussion
4 Appraisal committee members and NICE project team
Experience of people with prostate cancer
Clinical evidence
Company's economic model
Treatment sequence in the economic model
Treatment duration in the economic model
Utility values in the economic model
Costs in the economic model
Cost-effectiveness estimates
The appraisal committee (section 4) considered evidence submitted by Astellas and a review of this submission by the evidence review group (ERG). See the committee papers for full details of the evidence.
The company places enzalutamide earlier in the treatment pathway than existing indications
3.1 The committee noted that there are different clinical circumstances in which people with prostate cancer may have treatment. These are broadly defined by whether the cancer is hormone sensitive or hormone relapsed, and whether it has spread (metastasised) or not. This appraisal focuses on enzalutamide for hormone-relapsed non-metastatic prostate cancer. The clinical experts noted that this group is small and becoming smaller. This is because improved, more sensitive, radiographic imaging means that there are fewer people with undetected metastases who would otherwise be labelled as having non-metastatic disease. NICE technology appraisal guidance already recommends enzalutamide for hormone-relapsed metastatic prostate cancer before and after treatment with docetaxel. This appraisal relates to using enzalutamide at an earlier point in the treatment pathway. The committee noted that NHS England's policy stipulates that either enzalutamide or abiraterone (another antiandrogen) is to be offered only once in the treatment of prostate cancer. Therefore, using enzalutamide at this earlier position in the treatment pathway would mean that neither it nor abiraterone would be an option later (either before or after chemotherapy) once the cancer has metastasised.
Prostate cancer causes few symptoms until metastases occur
3.2 Patient experts commented that most people with hormone-relapsed non-metastatic prostate cancer have no or few symptoms. Those who have symptoms experience mainly urinary difficulties. Symptoms increase when metastases develop. For example, bone and visceral metastases may cause pain and visceral metastases may cause site-specific symptoms. The committee noted that patients consider there to be an unmet need for treatments that delay metastasis.
Androgen deprivation therapy is the relevant comparator in this appraisal
3.3 Androgen deprivation therapy (ADT) has long been the standard of care for treating prostate cancer. The clinical experts explained that ADT is continued throughout the treatment pathway, even when the cancer becomes hormone relapsed. This is because stopping treatment may speed up metastasis. The clinical experts commented that bicalutamide and dexamethasone are sometimes used for hormone-relapsed non-metastatic disease, but that the evidence for their effectiveness is limited. The committee considered ADT to be the standard of care in patients with hormone-relapsed prostate cancer, and the relevant comparator in this appraisal.
The company's definition of high risk does not closely match what is considered high risk in clinical practice
3.4 The company's decision problem focused on the subset of people with hormone-relapsed non-metastatic prostate cancer whose disease is at 'high risk' of metastasis, defined as:
an absolute prostate-specific antigen (PSA) level of 2 ng/millilitre or more
a PSA doubling time of 10 months or less.
This definition reflects the inclusion criteria in the key trial for enzalutamide (see section 3.5) and the marketing authorisation. NICE's guideline on prostate cancer: diagnosis and management recommends starting ADT if the PSA doubling time is less than 3 months in the hormone-sensitive setting. The clinical experts commented that, when assessing risk, clinicians take into account PSA doubling time but also other factors such as the age and fitness of patients. They advised that a clinically meaningful PSA doubling time in this setting would be less than 6 months. The committee concluded that clinicians' definition of people with high-risk disease in clinical practice does not closely match the patients the company defined as having high-risk disease. Although this was a source of uncertainty, the committee did not expect it to affect the generalisability of clinical results from 1 group to the other.
The PROSPER trial provides the main clinical evidence for enzalutamide
3.5 The main evidence for enzalutamide came from PROSPER, a double-blind randomised placebo-controlled trial. It included 1,401 patients with high-risk hormone-relapsed non-metastatic cancer, allocated to either enzalutamide plus ADT (n=933) or placebo plus ADT (n=468). The primary outcome was metastasis-free survival, defined as the time to radiographic evidence of metastasis or death, whichever occurred first. Scans were done every 16 weeks, or sooner if metastatic disease was suspected. Secondary outcomes included overall survival, quality of life, time to stopping treatment and safety.
The population in PROSPER has lower-risk disease but is otherwise similar to patients in the NHS who may have enzalutamide
3.6 The clinical experts advised that, apart from the criterion for PSA doubling time (see section 3.4), patients in PROSPER were generally like people who would be offered enzalutamide in the hormone-relapsed non-metastatic setting in clinical practice. The committee noted that some patients had a PSA doubling time greater than 10 months (which the study protocol did not allow), or a serum PSA higher than would be expected in the non-metastatic setting. The ERG commented that few patients did not meet the selection criteria and so were unlikely to have biased the results. The committee concluded that the population in PROSPER was sufficiently generalisable to NHS clinical practice.
Enzalutamide increases metastasis-free survival
3.7 The median metastasis-free survival with enzalutamide was 36.6 months compared with 14.7 months for placebo (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.24 to 0.35; p<0.0001) based on the final analysis. The committee agreed that enzalutamide was more effective than placebo at delaying metastasis.
The overall survival data are immature
3.8 The company presented 2 of 3 planned interim analyses of overall survival: the first after 135 deaths (coinciding with the final analysis for metastasis-free survival; see section 3.7), and the second after 285 deaths (about 1 year later). The company stated that it intends to do another interim analysis and a final analysis. The committee appreciated that, in its amended statistical plan, the company planned the final analysis for when 596 deaths had occurred. It agreed that the overall survival data from PROSPER presented by the company were immature and provided too few deaths to detect a statistically significant difference between treatment arms. For example, at the second interim analysis, the median overall survival had not been reached and the hazard ratio between the 2 treatment arms was not statistically significant as predefined (HR 0.83, 95% CI 0.65 to 1.06; p=0.134). In response to consultation, the company agreed that the overall survival data were immature because the study was statistically powered to detect a benefit in metastasis-free survival rather than overall survival. The committee noted this comment but agreed that overall survival was clinically important and key to populating the economic model.
Enzalutamide has not been shown to prolong life in patients with high-risk hormone-relapsed non-metastatic prostate cancer relative to placebo
3.9 The committee noted that the data did not show that enzalutamide plus ADT confers a survival benefit relative to ADT, acknowledging that the hazard ratio should be interpreted with caution because the data violate the proportional hazard assumption. The committee queried whether the lack of survival benefit could be explained by patients in the placebo arm being offered active therapies such as enzalutamide after metastasis and then 'catching up' with those randomised to enzalutamide earlier who had also progressed. The clinical experts stated that there was not enough evidence to comment on this. The committee also queried whether the effect of enzalutamide plus ADT relative to ADT alone decreased towards the end of the trial follow up, having observed that patients initially randomised to enzalutamide were more likely to stop life-extending subsequent therapies. The clinical experts suggested that this was unlikely. The committee concluded that the latest evidence available did not show a survival benefit with enzalutamide relative to placebo for hormone-relapsed non-metastatic prostate cancer. In response to consultation, the company suggested that it was difficult to show a statistically significant benefit in this population because, over time, people may die from causes other than prostate cancer. However, the committee agreed that, in a randomised trial, mortality from causes other than prostate cancer would be similar in both treatment arms. In the absence of new evidence, the committee did not change its conclusions about enzalutamide's survival benefit compared with placebo.
Enzalutamide may be less effective in terms of overall survival, both absolutely and relatively, when used earlier in the treatment pathway
3.10 The committee discussed whether the relative effectiveness of enzalutamide at later points in the treatment pathway could provide insight into its survival benefit in the hormone-relapsed non-metastatic setting. In this setting (see section 3.8), the hazard ratio for overall survival was 0.83 (95% CI 0.65 to 1.06). This compared with hazard ratios later in the treatment pathway (that is, for hormone-relapsed metastatic disease) of 0.76 (95% CI 0.66 to 0.88) in the pre-chemotherapy setting and 0.62 (95% CI 0.52 to 0.73) in the post-chemotherapy setting. Assuming that the hazard ratio of 0.83 was a valid estimate (see section 3.9), the committee queried the differences in absolute benefit with enzalutamide along the treatment pathway. The clinical experts explained that, for hormone-sensitive prostate cancer, there was some evidence that abiraterone and docetaxel may provide greater benefit if used earlier in the pathway, but there was no such evidence for enzalutamide. For hormone-relapsed disease, they highlighted the unclear relationship between the timing of enzalutamide treatment and overall survival. However, they agreed that the absolute benefit with enzalutamide was larger after chemotherapy than before. The committee acknowledged concerns with the validity of the hazard ratio for overall survival (see section 3.8). It agreed that, if enzalutamide does prolong life, the evidence to date suggests that the benefit is lower when offered earlier than later in therapy. The committee concluded that enzalutamide may be less effective with respect to overall survival when used earlier in the treatment pathway, both absolutely and relatively.
Subsequent treatments in PROSPER confound overall survival
3.11 The company presented information on the treatments used after metastasis for each treatment arm in PROSPER. The committee noted that:
Some patients in the enzalutamide plus ADT arm had further treatment with abiraterone and enzalutamide, which would not be available in NHS clinical practice and for which there may be a survival benefit.
Some patients in both arms had treatments not used in the NHS, which may be associated with a survival benefit (for example, sipuleucel-T).
The distribution of subsequent therapies differed between treatment arms after metastasis, with a larger proportion of patients in the enzalutamide arm having no active therapies, and a larger proportion in the placebo arm having enzalutamide, abiraterone and docetaxel.
The committee agreed that the subsequent therapies used in PROSPER meant that the relative effectiveness of enzalutamide in clinical practice is unlikely to reflect the reported effect in PROSPER. The committee concluded that the company should have adjusted for the effect of both life-extending subsequent treatments not available in the NHS and of life-extending subsequent treatments available in the NHS but which were used more frequently in PROSPER. In response to consultation, the company maintained that it did not need to adjust for the sequential use of enzalutamide and abiraterone because there was no evidence of a survival benefit. Although the committee accepted this possibility, it remained concerned that the proportion of patients randomised to placebo with ADT who had subsequent therapies differed from the NHS. The committee acknowledged that there is no straightforward method to adjust for this and recognised that it would remain an area of uncertainty, which the company could explore in scenario analyses by varying its assumptions about long-term treatment effects.
The relationship between enzalutamide and quality of life is not appropriately modelled
3.12 The patient experts explained that they had no problems with any aspect of their quality of life while having enzalutamide over several years. The company presented health-related quality-of-life data from PROSPER measured after 22 months of follow up using various quality-of-life instruments. These included the Brief Pain Inventory, the European Organisation for Research and Treatment of Cancer prostate cancer module (EORTC), Functional Assessment of Cancer Therapy – Prostate (FACT‑P) and the EQ‑5D. The only statistically significant (p<0.05) differences between treatments were detected using the EORTC in hormonal-treatment related symptoms and the FACT‑P social wellbeing instruments. The committee concluded that there was not enough evidence from PROSPER to show that enzalutamide improved quality of life compared with placebo. In response to consultation, the company stated that enzalutamide increased the time until deterioration of quality of life compared with placebo rather than improving quality of life. The committee noted that data from PROSPER supported this, but that the company did not reflect this benefit in its economic model.
The model has a semi-Markov partitioned survival structure
3.13 The company developed a semi-Markov partitioned survival model to assess the cost effectiveness of enzalutamide plus ADT compared with ADT alone. The model contained 3 states: hormone-relapsed non-metastatic, hormone-relapsed metastatic and death. The company used a partitioned survival model, informed by data from PROSPER, to model the transition of patients from the non-metastatic to the metastatic state, and from the non-metastatic or metastatic state to death. Within the metastatic state, the company used a Markov model with 3 sub-states (progressed-disease states 1 to 3) to capture disease progression beyond metastasis, and associated treatment options, costs and utilities. To model the transitions of patients within this state, the company used data from other trials, namely PREVAIL (enzalutamide compared with placebo in the pre-chemotherapy metastatic setting) and TAX‑327 (docetaxel compared with mitoxantrone in the metastatic setting).
The company's model structure introduces additional uncertainty by splitting overall survival
3.14 The company chose a model structure in which overall survival needed breaking down into death before or after metastasis to align the data with the model states. However, this increased uncertainty in the model. The company stated that it chose this model structure to reflect clinical practice. The committee considered that the company did not sufficiently justify using a model structure that increased uncertainty. The company provided a scenario analysis using a single overall survival curve; however, this did not use the latest data available on overall survival. The scenario analysis was a useful approximation of the standard 3‑state partitioned survival model. However, the committee considered that the company should have at least validated the output of its model against the 3‑state partitioned survival model commonly used in oncology, and on which NICE's Decision Support Unit provides guidance. The committee concluded that the model structure chosen by the company unnecessarily introduced additional uncertainty to the model's outputs.
There is no evidence to support that enzalutamide prolongs life before disease metastasises
3.15 To model death rates before disease metastasis, the company extrapolated pre-progression survival from PROSPER beyond the follow-up period of the trial. This was based on a few patients who died before metastasis, and the diverging curves translated to a large absolute benefit for enzalutamide compared with ADT. The clinical experts explained that the death rate pre-metastasis was likely to reflect the mortality of the general population because people are unlikely to die from non-metastatic prostate cancer. The committee agreed that the company's modelling of pre-progression survival lacked face validity and was likely to bias results in favour of enzalutamide.
Post-progression survival is biased
3.16 The committee noted that the company's extrapolation of post-metastasis survival did not preserve randomisation in PROSPER because most patients in the ADT arm, but only half of those in the enzalutamide arm, developed metastasis. This introduced selection bias because the extrapolation of the enzalutamide arm was based only on patients whose disease metastasised early (relative to the median time to metastasis), whereas the extrapolation of the ADT was based on almost all patients whose disease metastasised. It also meant that the extrapolation was based on disproportionate numbers at risk between the 2 arms. The committee agreed that this approach divided immature data in inappropriate ways and introduced bias.
Survival in each progressed-disease state is likely to differ
3.17 The company used PROSPER to model the transition from the metastatic state to death. This was constant over time and so the company implicitly assumed that all modelled patients with metastatic disease had the same rate of death before, during and after docetaxel treatment for metastatic disease. The clinical experts advised that this was implausible because they would expect to see a lower death rate in early metastatic disease than after chemotherapy. The company's assumption of equal instead of lower death rates in the early metastatic sub-state disproportionately affected the survival rates of patients having ADT, who moved to the metastatic state faster than those having enzalutamide. The committee concluded that the company's model structure and assumptions biased survival in favour of enzalutamide.
It is better to use data for overall survival from the second rather than the first interim analysis
3.18 The company used results for time to death (overall survival) in its base case from the first of 4 planned analyses to coincide with the final analysis of metastasis-free survival. However, the committee preferred using overall survival from the second interim analysis (see section 3.8) because the data, although immature, were more mature than from the first interim analysis.
The lack of data on time to metastasis at the time of the second interim analysis of overall survival is a limitation of the modelling
3.19 To estimate the time patients spent before their disease metastasised and the time they spent before they died, the company presented 2 scenarios. The first (company's base case) used metastasis-free survival from the final analysis of metastasis-free survival, and overall survival from the first interim analysis of overall survival (which coincided with the final analysis of metastasis-free survival). The second scenario used time to stopping treatment (as a proxy for metastasis-free survival) and overall survival, both from the time of the second interim analysis for overall survival. The ERG commented that it was uncertain how long people stayed on treatment after metastasis. It preferred time to metastasis (only available from the time of the first interim analysis of overall survival) over time to stopping treatment to model the time patients spend before their disease metastasises. The committee agreed with this, also noting that metastasis-free survival was the protocol-defined primary outcome of the trial and reflected the health state in the model. It also recalled that it preferred overall survival from the second interim analysis (see section 3.18). However, the company, in response to consultation, noted that using time to metastasis (from the 1 analysis that analysed it) and overall survival from the second interim analysis meant that time to stopping treatment had to be used to spilt overall survival. This was because it split overall survival into pre- and post-progression survival and because PROSPER did not report time to metastasis at the time of the second interim analysis of overall survival. The committee agreed that this introduced methodological issues. It also meant the timings of the data-cuts constrained the company to forever modelling events from the time of the first interim analysis of overall survival despite ongoing data collection. The committee considered this to be irrational. It maintained its preferences for time to metastasis to model the time patients spent before their disease metastasises, and for the most mature overall survival data to model the time people spend alive. However, it appreciated the limitations of its preferences. These arose from the lack of time to metastasis data from the time of the second interim analysis of overall survival, and from having to use time to stopping treatment to split overall survival into pre- and post-progression survival.
The company's modelled output does not match what occurred in PROSPER
3.20 The company used the survival data from the first interim analysis to generate a model, which showed that the rate of death in the ADT arm differed from, and increased more quickly than, that in the enzalutamide arm. This meant that the relative effectiveness of the treatments in the enzalutamide arm on overall survival continued to improve over time (the hazard ratio decreased). This modelled survival did not correspond with the latest data for overall survival seen in PROSPER, which showed no survival benefit (see section 3.8). The ERG used data for overall survival from the second interim analysis. This resulted in the relative effectiveness for survival of the treatments in the enzalutamide arm improving for up to 8.7 years (hazard ratio decreasing), then waning over the following 8.0 years (hazard ratio increasing to 1) and then reversing (hazard ratio greater than 1). The committee appreciated that, although this was a more reasonable assumption than the company's, it still did not reflect the observed data. It concluded that there was a disconnect between observed and modelled overall survival in both the company's and ERG's models.
The economic model should include cabazitaxel and radium‑223
3.21 The company modelled a treatment sequence based on what the company's clinical expert expected in NHS clinical practice, and applied costs to these treatments. This assumed that everyone starting on enzalutamide had ADT after developing metastases (progressed-disease state 1, see section 3.12) and vice versa. In progressed-disease state 2, 40% of people in both arms of the model had docetaxel and 60% had ADT alone. In progressed-disease state 3, everyone in both arms had best supportive care (which included ADT). The committee discussed the sequence of treatments that best reflected NHS practice, appreciating that:
enzalutamide would be continued for longer in clinical practice than it was in PROSPER because radiographic progression to determine metastasis is not measured as frequently in clinical practice as it was in PROSPER, and because clinicians may offer treatment beyond metastasis in certain clinical circumstances
abiraterone and enzalutamide are used in approximately equal proportions in the pre-docetaxel setting (corresponding to the modelled progressed-disease state 1)
clinical experts consider that more than 40% of patients will be fit enough to have docetaxel when symptoms appear
about 20% of patients who have treatment in the post-docetaxel setting have cabazitaxel
radium‑223 is considered for patients with bone metastatic disease and is used only with ADT.
The committee agreed that enzalutamide is likely to be continued for longer in practice than in the trial, which would increase the cost of treatment. However, it considered that it was inappropriate to include the cost of enzalutamide based on a longer treatment. This was because longer treatment might also be associated with higher effectiveness, which would be difficult to model. In general, the committee concluded that an appropriate treatment sequence should have included cabazitaxel and radium‑223.
The modelled sequence of treatments does not match the observed sequence of treatments in PROSPER
3.22 The committee appreciated that the company modelled the costs of treatments for patients with metastatic disease. However, the therapies for metastatic disease as modelled do not reflect what happened in PROSPER. For example, only 11% of patients with progressed disease in placebo arm of PROSPER had enzalutamide at follow up, compared with 100% in the economic model. The committee concluded that dissociating costs and effectiveness in the economic model biased the estimates of cost effectiveness in favour of enzalutamide.
For people having enzalutamide, the time spent in the first progressed-disease state is unlikely to be as long as that modelled by the company
3.23 In its base case, the company assumed that patients whose cancer metastasised having had enzalutamide would remain in the first progressed-disease state (pre-chemotherapy) for 7.3 months, based on the PREVAIL trial (enzalutamide compared with placebo in the pre-chemotherapy metastatic setting). The ERG was concerned that the population of PREVAIL was not generalisable to the population of PROSPER because PROSPER included only patients with a high risk of progression to metastasis at baseline. The clinical experts agreed that 7.3 months was an implausibly long amount of time to have ADT alone in the metastatic state. The ERG proposed a scenario using the time between metastasis and first use of active treatment seen in the enzalutamide arm of PROSPER, which led to a shorter time. The committee agreed with the ERG's approach.
The utility value for the first metastatic progressed-disease state should come from PROSPER
3.24 The company used EQ‑5D data collected in PROSPER to inform the utility value in the economic model for the first progressed-disease state. The ERG considered the company's choice of utility value for this state to be lower than expected, considering people have few symptoms. It considered the baseline utility from PREVAIL, which measured utility in the metastatic pre-chemotherapy setting, to be more representative of people at this stage of the disease. The committee acknowledged the uncertainty around the utility estimate for the first metastatic progressed-disease state. However, it considered the utility value derived from PROSPER to be more appropriate because the model then used the same source for both utility and clinical data.
The costs of monitoring disease would be the same whether people have enzalutamide plus ADT or ADT alone
3.25 The company presented higher monitoring costs for people having ADT alone compared with people on enzalutamide plus ADT within the model. The clinical experts said that the frequency of monitoring would not differ, a conclusion shared by the ERG's clinical expert. The ERG presented a scenario that equalised the monitoring frequencies and costs between both arms. The committee concluded that the ERG's scenario was appropriate.
The costs of major adverse events are not included appropriately
3.26 The committee was concerned that the company's model did not fully reflect the costs of major adverse events. Significant adverse events that occurred substantially more often with enzalutamide than with placebo in the trials included hypertension, memory impairment and major adverse cardiovascular events. The clinical experts also noted that fatigue and osteoporosis are common adverse effects with enzalutamide. The ERG noted that the company did not model costs for memory impairment or explore costs associated with osteoporosis. It was also concerned that the costs of major adverse cardiovascular events were not included appropriately considering the higher incidence of these events in patients having enzalutamide. The company used the costs of non-elective short stays for all major adverse cardiovascular events, but most events were coded as long stays. The company confirmed that it did not include the costs associated with rehabilitation from strokes. The ERG presented a scenario that included the costs of the total distribution of lengths of inpatient stays, which substantially increased the costs of major adverse cardiovascular events. The company agreed with this. The committee concluded that the scenario with increased costs was appropriate.
Enzalutamide plus ADT is not cost effective compared with ADT alone
3.27 The committee considered whether enzalutamide would be a cost-effective use of NHS resources for non-metastatic hormone resistant prostate cancer, taking into account the patient access scheme (discount) associated with enzalutamide. The company presented a base-case deterministic incremental cost-effectiveness ratio (ICER) of £28,853 per quality-adjusted life year (QALY) gained. However, this value was uncertain and included several assumptions that the committee considered inappropriate, notably, that enzalutamide prolongs survival when used in non-metastatic disease. The ERG presented a base-case ICER of £56,168 per QALY gained, which included:
using data on overall survival from the second interim analysis (see section 3.17)
modelling less time spent in the first progressed-disease state for patients in the enzalutamide arm (see section 3.22) than modelled by the company
increasing baseline utility in the first progressed-disease state (see section 3.23) compared with the company's value
correcting the company's costs (see section 3.24 and section 3.25).
The committee concluded that most of the ERG's changes to the company's model were appropriate. It noted that the ERG's ICERs may even have been low because they did not include the costs of radium‑223 and cabazitaxel. Also, the ERG's model did not reflect the absence of an overall survival benefit for enzalutamide in the trial (see section 3.8). The committee noted that the ERG provided a scenario that included the costs of cabazitaxel and radium‑223, both associated with confidential discounts, which increased the ICERs. The committee reiterated that both the company's and ERG's ICERs were associated with substantial uncertainty. This mainly arose from: the immaturity of the overall survival data; the lack of evidence of a survival benefit or quality-of-life improvement by delaying metastasis; and the disconnect between the costs and benefits of subsequent treatments in the model. Furthermore, splitting survival into before and after metastasis in the model introduced an additional layer of uncertainty. It concluded that enzalutamide could not be recommended as a cost-effective use of NHS resources for hormone-relapsed non-metastatic prostate cancer.
The health benefits associated with enzalutamide are captured
3.28 The company noted that this is the first indication for a drug within the high-risk non-metastatic prostate cancer population. However, the committee agreed that this was not associated with additional gains in health-related quality of life over those already included in the QALY calculations.


text:
Рід налічує 1 видів риб родини цихлові.

Види

 Ectodus descampsii Boulenger 1898

Переглянуті (старі) назви

 Ectodus albini див. Xenotilapia albini (Steindachner 1909)
 Ectodus foae див. Cyathopharynx furcifer (Boulenger 1898)
 Ectodus longianalis див. Xenotilapia melanogenys (Boulenger 1898)
 Ectodus melanogenys див. Xenotilapia melanogenys (Boulenger 1898)
 Ectodus ornatipinnis див. Callochromis melanostigma (Boulenger 1906)

Джерела

Тварини, описані 1898
Pseudocrenilabrinae

redpajama_set_name: RedPajamaWikipedia


Celebrate your occasions like engagement party. Then you have to get some variety of cakes online Auranagabad along with flowers to make your party a fulfilling one – right? Don't worry because we are here with a huge collection of cakes to Auranagabad and you can easily get online cake delivery in Auranagabad with the same day delivery also.


text:
Q: CSS inner shadow without box-shadow property I have some clip-path polygon elements, some are more complex but I'll use a hexagon here.

.hex{
    width: 120px;
    aspect-ratio: 1.1547005 / 1;
    display: flex;
    align-items: center;
    text-align: center;
    justify-content: center;
    clip-path: polygon(
                    0 50%,
                    25% 0,
                    75% 0,
                    100% 50%,
                    75% 100%,
                    25% 100%
    );
    background: #000;
    color: #FFF;
}

I have
five sides.

Clarification: inset shadow
Box-shadow won't work because it sticks to the bounding box, not the clip-path.
Even with a simple shape like the hexagon, I cannot figure out how to get the box-shadow property to handle the angles, I don't think it's possible.
filter:drop-shadow doesn't handle inset and also can't work outside the clip-path.
Short of replicating my clip-paths on child elements and offsetting them with a background color/gradient... is there a straightforward CSS solution for this I'm missing?

A: Yes, it is possible if you wrap your element to a parent div and add a drop-shadow to it.
html:

I have
five sides.

css:
.hex{
    width: 120px;
    aspect-ratio: 1.1547005 / 1;
    display: flex;
    align-items: center;
    text-align: center;
    justify-content: center;
    clip-path: polygon(
                    0 50%,
                    25% 0,
                    75% 0,
                    100% 50%,
                    75% 100%,
                    25% 100%
    );
    background: #000;
    color: #FFF;
}

.shadow {
  filter: drop-shadow(-1px 6px 3px rgba(50, 50, 0, 0.5));
}

Fiddle: https://jsfiddle.net/kongallis/0uajpbs8/2/
For more read: https://css-tricks.com/using-box-shadows-and-clip-path-together/


Audiences in the digital world demand consistent, easy to use business interfaces. James is passionate about helping his client's websites deliver an intuitive user experience, whilst meeting business needs.
James crafts digital interfaces and experiences which are easy to use and deliver business objectives.
We craft digital interfaces and experiences which are easy to use and deliver business objectives.


30 January 2014: Following a meeting with UNISON Stewards today, the Regional Officer and Branch Secretary met with Philip Barr, Head of Organisational Development (City of Edinburgh Council) for urgent discussions regarding the fact that non contracted members would not participate in the Winter Rota after 31st January 2014.
"In the meantime I must caution you not to withdraw from the Winter Rota on the 31st of January and put yourself in a position of risk." Andrew Barnett, Douglas Black.
As you are aware negotiations have been ongoing in seeking to reach an agreement for all members for this rota and for subsequent years and whilst we have managed to improve the variable working hours payment and have an offer of a one off payment of £200 for each member, the employer has insisted that those members who are not contractually bound to undertake the rota now should be. The offer as it stands would be backdated to the start of the winter rota last year. This reflects the final position of the employer.
If however non contracted members do not agree to the change in contract then on an individual basis the employer would not compel them to do so. That individual would then not participate on any future rotas nor receive the financial elements of the offer. However the employer would then recruit to that position on a contractual basis.
If non contracted members refuse to participate in the rota after 31st January, the employer would view this as these members undertaking unofficial industrial action. This is on the basis that the non contracted members have been operating the Winter Rota since October and by doing so becomes the normal working arrangement. This potentially leaves our members in a difficult situation as the employer could move towards disciplinary action and possible dismissal if the action continued. This is clearly a situation that UNISON wants to avoid.
We understand very clearly the urgency of this matter and we have agreed a meeting with the employer on Wednesday 5th February at 3pm to look at how we can resolve this situation. It has been suggested by the employer that non contracted members may be able to withdraw from the rota this year subject to a period of due notice being agreed. This we will bottom out on Wednesday and come back to you with their proposal.
In the meantime I must caution you not to withdraw from the Winter Rota on the 31st of January and put yourself in a position of risk.
UNISON's FE Alert for further education staff is out now.
UNISON and Jimmy Reid Foundation joint report into funding local government.


text:
Experts Answer: How Will Industries Change After Covid? (Podcast)
COVID-19 has caused the world to change more rapidly than anything we've seen—and likely will see—in our lifetimes.
For entrepreneurs, it's been an uncertain few months. Many businesses have had to make drastic changes to stay afloat while others have already fallen by the wayside. We've seen dramatic changes across entire industries such as healthcare, education, retail, and entertainment—all in a matter of weeks.
And this is just the start! We haven't even gotten to "after COVID." (But don't worry, it's not all bad.)
Entrepreneurs have nothing to fear.
I recently recorded a podcast with my good friend Peter Diamandis where we did our best to answer one simple question: How will industries change after COVID?
One thing we both agreed on right off the bat is that entrepreneurs should not be afraid, even if their industry is being affected or will be affected by COVID. From an entrepreneurial standpoint, you can be as successful with a disrupted industry as you can with a multiplying industry. There will be winners and losers regardless of how poorly an industry is faring on the whole. It all comes down to changing your business and finding ways to provide more value than your competitors.
There's a joke about two men walking in the forest that I think encapsulates this perfectly. One of them stops and says, "I hear a bear!" He sits down, takes a pair of running shoes out of his backpack, and starts to put them on. The other one says, "What are you doing? You can't outrun a bear!" The first man replies, "I don't have to outrun the bear."
So forget about outrunning the bear. As industries continue to change after COVID, the winners will be the ones that are able to keep their competitors between them and the bear.
Change doesn't have to be bad.
There tends to be a lot of doom and gloom involved when people talk about how industries will change after COVID. The airline industry is one that comes up frequently. After all, how can you pack people onto a plane while maintaining physical distancing? It's just not possible—and for an industry that needs to fill every seat to turn a profit, that's frightening.
But let's look at the other side of the coin. As airlines struggle to fill their planes, they'll need to adapt and change their service to set themselves apart from their competitors. Everyone is going to have to up their game in the experience economy—they're going to have to find ways to provide far more value than they did previously to keep their customers happy. That means a better experience for everyone.
And not only that, but as plane tickets continue to climb in price, private flying will become more feasible for many people. The idea of buying a plane or chartering a plane is already becoming more realistic.
There are also thousands of small airports around North America compared to the 27 major airports we tend to use today with jumbo jets. All of a sudden, flying goes from something scary and inaccessible to a new, exciting opportunity. Look out for new businesses in the aviation space—there is a tremendous opportunity to provide value after COVID that the big airlines simply can't compete with.
So this question, "How will industries change after COVID?" does not need to be met with doom and gloom. Airlines are just one example, but the reality is that for every negative change, there will be many more positive changes—and we have entrepreneurs to thank for that, because they're going to be the ones making the changes.
Technology will advance at a rapid pace.
I've been amazed at how quickly businesses around the world have transitioned to remote work. At Strategic Coach, we've been holding virtual workshops with Zoom and the experience so far has been remarkable. Not only are they easier for our team to manage, but our clients are loving the experience and we're able to reach many more people than we were able to with in-person workshops.
Video conferencing technologies like Zoom and other remote productivity tools will continue to improve rapidly during and after COVID, but that's just the beginning. Other industries are going to see massive changes and technological advancements as well.
Much like the airline industry, restaurants have been the focus of doom and gloom over the past few months. And for good reason, of course, as virtually all restaurants have been forced to close down or drastically limit their capacity. It raises the question: What positive change could possibly come out of this for restaurants?
Well, restaurants are in a unique position to help people right now. They have different supply chains than grocery stores, and many restaurants are realizing they can sell their inventory to their customers as groceries. So not only are they able to add an entirely new revenue stream to their business, but they're helping people who are having trouble finding groceries at their local stores. I think this will be something we continue to see from restaurants after COVID.
Takeout has also become the new normal, and I'm excited to see what changes this brings to the restaurant industry. As much as I love going out to eat, I think there is a huge opportunity for "ghost kitchens" to pop up, where restaurants are operating out of an industrial location with only takeout or delivery options.
Peter also points out how these new restaurant operations could lead the way for drone delivery systems. Imagine if you could order your favorite dish from a local restaurant and have it delivered to your doorstep via drone within a matter of minutes! I am confident that restaurants will still come back after COVID in their traditional capacity, but there will be many additional capabilities that come out of this pandemic that never would have occurred otherwise.
And this is just one example. We'll be seeing positive changes, new technology, and increased value across thousands of industries after COVID.
Want to hear more of Dan's thoughts on entrepreneurship and business? Check out all of our Strategic Coach podcasts and our partner podcasts at StrategicPodcasts.com.
We've experienced the solution.
One of the most interesting byproducts of this situation we find ourselves in is that we're currently experiencing solutions to problems that were previously thought to be infeasible or unrealistic.
All major cities around the world have been facing the same problems for decades: traffic, congestion, pollution, overcrowding, high real estate prices …
But look at them now! Nearly all of those problems have disappeared as people are working remotely and traveling less.
One of the reasons people generally can't solve a problem is because they don't know what the solution feels like. But now, we all know what the solution feels like. We know what it's like to not have traffic congestion. We know what it's like to have clear skies and no pollution in our cities.
This new way of living is going to speed up the solutions to many of these problems after COVID. The fact that we've now had this experience will encourage us to find real solutions to these problems.
No one will want to go back to rush hour traffic and polluted air after experiencing this. Many of these problems were seen as "necessary evils" or there was no clear solution in sight, yet in a matter of weeks, we've solved them almost by accident. No one can say that these solutions are impossible to solve anymore, and that brings a lot of exciting possibilities.
Entrepreneurs are poised to thrive after COVID.
How will industries change after COVID? Well, that's up to the entrepreneurs of the world.
There's an incredible opportunity for entrepreneurs to thrive after COVID. Even if your industry appears to be failing, now is the time where you can reinvent yourself, adapt, make changes, provide more value, and come out the other side stronger than ever.
Entrepreneurs are resilient, and these scary times are putting our resiliency to the test. But we've had tests like this before, and we will pass them with flying colors.
Time Management Strategies For Entrepreneurs (Effective Strategies Only)
Time management is so important for entrepreneurs. Discover a few effective time management strategies for entrepreneurs — plus some simple systems, tools, & tips.
How To Overcome Entrepreneurial Challenges And Deal With Setbacks
Being an entrepreneur is challenging & has unique entrepreneurial hardships. Discover how to overcome entrepreneurial challenges & deal with setbacks in business.


I've painted a few walls in my time. I'm pretty good at it to be honest. But having wielded a few paintbrushes to slap bulk colour on a wall doesn't make me Picasso.
In many ways, I feel the same way when people compare our approach to design with art. While I fully appreciate that there is a intrinsic link, there is a difference between an artist and a designer.
It's also important for me to add at this point, that I don't consider myself a designer either! I leave that to the experts. I'm more like Steven Spielberg than a star of the silver screen!
For me, this is the key difference. The motivation.
You see, we design many things that personally don't appeal to me. They don't really hit my button or make me go "Oh YEAH!" But that's ok…because those designs are aimed at a market that isn't me!
If we're trying to appeal to a 70yr old man or a 16yr old girl, I'm pretty sure it's not important if it appeals to me! It's only important if we're matching our design communication with the target market for our client.
While design (and art for that matter) will always be subjective, having a strong strategic foundation and serious rationale shifts the subjectiveness significantly. This is critical to our design process (especially in terms of Brand Architecture) and enables us to use science and research along with many decades of experience to develop design that communicates our clients message.
As I said earlier, my particular role is much more like a film director. It's about the vision and the connection between the strategic direction and the design communication. I have the wonderful job of collaborating with talented strategists and designers to develop the work that you see in our case studies.
Like conducting a symphony, there is a huge about of satisfaction that comes from an orchestrated approach and working with talented individuals that form a strong team.
But I am not an artist. This is about commercial outcomes. This is about our clients. It's about achieving results.


text:
Sweet, Sweet Victory: Kings Snap Seven-Game Skid With Win Over Nets
Feb 2, 2022, 9:51 PM | Updated: 9:51 pm
(Photo by Thearon W. Henderson/Getty Images)
BY FRANKIE CARTOSCELLI
Sacramento Kings Beat Writer
The losing-streak has finally come to an end for the Sacramento Kings
After 19 days, the Sacramento Kings have done it.
It took seven games and a brutal five-game road-trip, but the Kings are finally back in the win column.
Davion Mitchell continued to shine in a starting role, Buddy Hield caught fire from the bench and Tyrese Haliburton posted another double-double as Sacramento was able to snap a seven-game losing streak on Wednesday night during a 112-101 win over the Brooklyn Nets.
With just over a minute remaining in regulation and the game out of reach for Brooklyn, fans in attendance at Golden 1 Center rose to their feet to give the Kings an ovation that hadn't been heard in quite some time as Sacramento put the finishing touches on the win.
Sacramento (19-34) snapped a seven-game losing-streak and defeated the Nets for the first time since March 1, 2018, snapping a six-game skid against Brooklyn in that time-span.
Golden 1 Center got LOUD tonight 🗣 pic.twitter.com/gUo6NWyifi
— Kings on NBCS (@NBCSKings) February 3, 2022
Thanks to strong play from star guard Kyrie Irving (10 points) and center Nic Claxton (11 points), the Nets were able to end the first quarter on an 11-0 run to take a 32-23 lead into the second.
Sacramento was able to create consistent offense during the second quarter, but the defense continued to lay down as Brooklyn was able to maintain an eight-to-10-point lead for a majority of the period.
Harrison Barnes led all Kings scorers with 12 points (four-of-seven from the field) during the first half, but the Nets took a 62-54 lead into the break as Sacramento was unable to convincingly trim the deficit.
Claxton nearly established a new career-high in the first half alone on Wednesday as the center scored 17 points on six-of-eight shooting from the field–just one point shy of tying the highest scoring output of his career.
Tyrese with the steal ✔
Buddy hits the open three ✔ pic.twitter.com/CtiOZegnJ5
Davion Mitchell was the driving force behind a solid third quarter from the Kings as the Brooklyn lead was reduced to 86-83 entering the fourth period. The rookie guard topped the 15-point mark for the fourth-straight game to help bring Sacramento to within striking distance.
During the opening 99 seconds of the fourth quarter, Tyrese Haliburton and Buddy Hield combined to score eight-straight points to give the Kings its first lead since the early minutes of the game at 91-86 with 10:21 remaining.
Thanks to strong play from Haliburton and Hield down the closing stretch, Sacramento was able to finally pick up a win–the team's first since January 14th–as they turned the tables to hand Brooklyn its sixth-straight loss (how the tables have turned).
Sacramento outscored the Nets 29-15 in the fourth quarter as the closing lineup of Tyrese Haliburton, Davion Mitchell, Buddy Hield, Moe Harkless and Damian Jones completely shut down a Brooklyn offense that normally scores 111.6 points per game.
The presence of Harkless and Jones in particular helped the Kings out in-and-around the paint as the Kings were able to slow down Claxton late and completely take James Harden out of the game.
Davion steal -> Damian 🔨 pic.twitter.com/vESWMANuED
Mitchell also had a hand in slowing down the former MVP as Harden's four-point night was the lowest scoring output that the guard has had since January 19, 2011.
The Kings won't have much time to relish tonight's win as they will travel to the Bay Area on Thursday to complete the second-game of a back-to-back against the Golden State Warriors.
Still, it feels good to be on the positive side of things–even if it was just for one night.
Rounding Out The Box Score
Tyrese Haliburton posted his 13th double-double of the season on Wednesday, scoring 12 points to go along with 11 assists and four steals over 39 minutes of play. The second-year guard didn't turn the ball over once en route to another double-double.
Only Chris Paul, James Harden, Trae Young, Dejounte Murray, Luka Doncic and Darius Garland have more point-assist double-doubles this season.
BUDDY BUCKETS 🎯 pic.twitter.com/PtPeYsJDmk
Buddy Hield scored 18 points in the win, while Harrison Barnes led all Kings scorers with 19 points while only taking nine shots.
For the fourth-consecutive game, Davion Mitchell scored 15 points or more as the rookie guard looks better on a daily basis in his starting role.
Over 35 minutes, Mitchell scored 18 points, grabbed five rebounds and dished out three assists in the win. Mitchell said postgame that he enjoys playing with Tyrese Haliburton in the backcourt, stating that Haliburton helps make things easier for him on both ends of the floor.
Chimezie Metu notched his fifth double-double of the season during the win, scoring 11 points to go along with 12 rebounds. Damian Jones scored 12 points and grabbed eight boards, while Moe Harkless finished with 10 points to round out Sacramento's key contributors.
Injury Updates
After being listed as questionable prior to Wednesday night's game, De'Aaron Fox was labeled as a game-time decision by head coach Alvin Gentry. Shortly before tip-off, Fox was ruled out for the sixth-consecutive game.
Marvin Bagley III missed his second-straight game due to a sprained left ankle. Bagley is considered day-to-day.
Terence Davis underwent successful surgery to repair a right wrist ECU tendon injury on Tuesday and will be re-evaluated in approximately three months.
Sacramento will play the second game of a back-to-back on Thursday night when they travel down I-80 to face Klay Thompson and the Golden State Warriors.
The Warriors have defeated the Kings in both meetings thus far this season, with the most recent matchup taking place on December 20th at Chase Center–a 113-98 blowout win for the Warriors.
Be sure to get all of your Kings vs Warriors coverage right here on Sports 1140 KHTK beginning at 5:30pm PST on Game Night with Scott Marsh and Henry 'The High Flyer' Turner prior to a 7:00pm PST tip-off from downtown San Francisco.
Upcoming Sacramento Kings Schedule
February 3rd @ Golden State Warriors
February 5th vs Oklahoma City
February 8th vs Minnesota Timberwolves
February 10th: NBA Trade Deadline – 12:00pm PST
February 12 @ Washington Wizards
Follow @FCartoscelli3
Kevin Huerter on his goal of being in All-Star Weekend's 3-Point Contest
Sacramento Kings guard Kevin Huerter joined The Carmichael Dave Show with Jason Ross on Friday morning to talk about his goal of participating in NBA All-Star Weekend's Three-Point Contest, share what it was like to win his first Defensive Player of the Game chain, and discuss the upcoming seven-game road trip that tips off on […]
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Whistle is the high-end brand from Atala Spa with carbon fiber road bikes and mountain bikes.
Evaluation means transforming , change, researching the best or the most adaptable solution.
It is an uphill path where each step is taller than the previous one, that is what nature has shown us and taught us.
Evolution is often unperceivable, at times it is a feeling, each step is a step forward leading to something new, more suitable and appropriate.
This has always been the vision and the philosophy underlying Whistle, step a little higher systematically search for improvement, never forget your emotions.
Our emotions are the cornerstone of our daily work and of our passion for bikes.
The new Whistle bike range fully and strongly conveys our willpower and our ongoing quest for new materials, design, solutions and ideas than can lead to real.
The WFM project was born and has developed completely in Italy where safety and reliability, apart from having permeated throughout the project, from the selection of materials right through to the production process, the definition of geometries and cycling solutions, are constantly checked.
All frames from the WFM range comply with the new European CEN Standards on the safety of bicycles published on 1/12/2006 in the Official Journal of the European Union: Standard EN 14781 for Racing bicycles and Standard EN 14766 for MTB's.
These standards define the levels of quality to be satisfied (such as duration and resistance), the relative methods of control and they interpret the general safety obligation defined by the measure 2001/95/CE "General safety of products". The frames are subject to two fatigue tests in order to check resistance, for at least 10 years, to normal pressure in various conditions of use. Alternating pedalling is simulated in order to put the bottom bracket under pressure. Furthermore, alternating pressure is applied to the fork in order to test the level of stress to the head tube. Impact tests are very important for carbon frames: norms indicate two. One is carried out by subjecting the fork to front impact; the other, by rising up the frame (loaded with distributed weight) and let it fall down with the fork drop- outs on a rigid surface.
Finally, in order to guarantee maximum impartiality and constant controls, our normal internal tests are systematically supported by tests carried out in collaboration with primary external independent authorities and university structures.
Performance cannot exist without safety and reliability.
This is the philosophy of Whistle!


Ways To Ensure The Safety Of Your Workplace Employees?
As a student, you will hate the face that you have go through a lot of assessments. You might prefer a lot of practical presentations but this all depends on the type of course you are following. Written coursework is something that no student likes. Every student feels that it is the daunting part of university or even college. Some students are capable of writing while others are not able to write quickly or fluently after doing the required reading….