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The rights-based approach is particularly associated with pro-poor development and the agency of the poor. At the centre of the approach is an understanding that successful development requires political analysis and action. Rather than development being reliant on charitable goodwill to meet the basic needs of very poor people, the rights-based approach emphasises that development should be based on a recognition of the equal rights of all citizens to the resources required for material well-being and social inclusion. Within such a conceptualisation of development, the contribution of the state is given prominence. Their role is that of provider, through equal access to essential services, and regulator, through a legal system that ensures equal rights for all. It is anticipated that under such conditions, the poor will experience a more supportive and less discriminatory context, and will be able to take advantage of new opportunities. Despite this emphasis, SDI, an international group of grassroots organisations and their support NGOs seeking pro-poor urban development (notably secure tenure, basic services and housing), have struggled to work within the rights-based approach. While these groups believe in redistribution, social justice and people's empowerment, they have been criticised by rights-based groups for being 'too close' to the state. The discussion below considers the reasons for this tension, and focuses particularly on two related themes. First, women, who make up the majority of members in the local organisations (savings schemes), do not believe that an openly aggressive and critical campaign against this state is likely to be a successful strategy, given the present imbalance in power. While on occasion, savings schemes may be openly critical of the state, in general they seek to negotiate with local and national government around shelter, service and livelihood issues. Second, the women believe that there is no simple answer to their needs for tenure, basic services and housing that the ...

Collaboration in the freight industry has not been widely adopted mainly due to the perceived barriers in competition resulting in a lack of trust among fleet operators. Collaboration in this sector has significant benefits, including the reduction of empty running, operating costs (OPEX) and greenhouse gas emissions (GHG) resulting in greater utilisation of existing logistics assets. A review of the literature to establish the critical aspects of freight collaboration was undertaken, as well as analyses of published case studies and European Union (EU)-funded projects. The critical aspects and barriers identified include: revenue sharing; compliance with competition law; process synchronization; organisational and systems interoperability; different forms of collaboration from a physical and coordination structure perspective; and strategies for collaboration. To facilitate collaboration a freight collaborative business model (FCBM) framework that highlights problematic areas in freight collaboration is proposed to support standardizing collaborative practices in the freight industry. Three published freight industry collaboration business cases were evaluated against the model. The business model framework is intended as a tool to be used to compare different business models and identify the best innovations to help facilitate collaborative practices. The freight collaboration business model was applied to the Freight Share Lab research project in order to demonstrate the concept and investigate whether efficiency can be unlocked through deployment of a dynamic data and asset sharing platform to enable route and load optimization across multiple fleets of freight vehicles, rail freight wagons and containers.

The paper reports a study into set‐up time reduction and mistake proofing methods in a small company involved in the machining of precision components in small batches with high variety for the aerospace industry. The company has made some set‐up reductions mainly using work study related methods and in one manufacturing cell by the use of the Single Minute Exchange of Die (SMED) methodology. Mistake proofing devices in the form of fouling pins and offset holes have been developed for the family of components manufactured in this cell. Until recently the set‐up times were not measured and worse still were considered as productive hours. As a consequence, there was a lack of awareness and motivation amongst operational personnel to reduce set‐up times and knowledge of SMED was limited to a small group of individuals. This, along with the lack of investment in mechanisms to aid set‐up time reductions and prevent errors, has restricted the use of this type of methods and technology. However, there is evidence that the demands made by the company's major customer will lead to increased efforts to put into place these types of changes.

Copyright © The Author(s) 2021. Around 6 million tonnes of edible food are being wasted (post-farm gate) in the UK each year. This fraction of edible wasted food is known as avoidable food waste. In a circular economy food is a valuable resource that must be captured at all stages of the food supply chain and, where possible, redistributed for consumption. This can prevent avoidable food waste generation, and dissipation of food's multidimensional value that spans environmental, economic, social, technical and political/organisational impacts. While the importance and benefits of surplus food redistribution have been well documented in the global literature, there are still barriers that prevent perfectly edible food from being wasted. This study looks at the main stages of the food supply chain, and amasses the opportunities, challenges and trade-offs associated with surplus food redistribution to the UK economy. It highlights points in the food system where interventions can be made, to improve food's circularity and sustainability potential. Stakeholder interrelations, regulatory and socio-economic aspects are discussed in relation to their influence on decreasing avoidable food waste. The main output from this work is a diagrammatic depiction of where challenges and trade-offs occur along the food supply chain, and how policy and socio-economic reforms are needed to maximise avoidable food waste prevention, and the surplus avoidable food redistribution in the food supply chain for social benefit.

Background Contradicting assumptions have been made about the effectiveness of SARS-CoV-2 vaccines in patients with multiple sclerosis (MS) receiving immunomodulatory disease-modifying therapies (DMTs) based on the quantification of humoral and cellular immune responses. This study aimed to understand changes in the risk of SARS-CoV-2 infection among the total population of patients receiving MS DMTs in England following mass vaccination. Methods This is a retrospective analysis of national data collected prospectively and longitudinally. National Health Service (NHS) England and NHS Improvement (NHSE/I) hold prescribing data on all commissioned MS DMTs in England. United Kingdom Health Security Agency (UKHSA) has been collecting data on all registered SARS-CoV-2 test results, including polymerase chain reaction and rapid antigen tests. All patients receiving MS DMTs were identified using NHSE/I datasets. All patients receiving MS DMTs with SARS-CoV-2 infection (i.e., positive test) from March 2020 to August 2021 were identified by merging NHSE/I and UKHSA datasets. Similar data for the general population were captured using publicly available datasets of the United Kingdom government. The incidence rate ratios (IRR) of SARS-CoV-2 infection among patients receiving MS DMTs compared to the general population during the pre-vaccination (November 2020 to January 2021) and post-vaccination (June to August 2021) periods were calculated. Results A mean (standard deviation) of 41,208 (4,301) patients received an MS DMT in England during each month from March 2020 to August 2021. The IRR (95% confidence interval) of infection in patients taking ocrelizumab versus the general population increased from 1.13 (0.97–1.31) during the pre-vaccination period to 1.79 (1.57–2.03) during the post-vaccination period. For patients on fingolimod, it increased from 0.87 (0.73–1.02) to 1.40 (1.20–1.63) during the same periods. There were no significant changes for patients on other MS DMTs. Conclusion SARS-CoV-2 vaccines offer less protection against infection to patients taking ocrelizumab or fingolimod, who have an impaired immune response to vaccines, than the general population. These findings will have implications for vaccination policies.

ABSTRACTObjectivesThis study assessed the oral health status, dental utilization and dental needs of the homebound elderly (HBE) care patients within the Mount Sinai Visiting Doctor program.MethodsOf the 334 eligible patients, 57% agreed to participate and 95.4% completed the clinical examinations, the Dental Utilization and Needs survey and Geriatric Oral Health Assessment Index conducted in each subject's home by a trained research team.ResultsAmong 75% who were dentate subjects, 40% needed restorative dental care, 45.6% needed dental extractions, and 33% complained of current oral pain. Overall, 92.0% needed some type of dental care and 96% stated that they had not seen a dentist since they became homebound (mean number of years in program = 3.2 ± 2.58).ConclusionFindings show the oral health status of these homebound elderly was poor and their quality of life was significantly affected by the lack of basic dental care.

Therapeutic options for the treatment of malignant brain tumors have been limited, in part, because of the presence of the blood-brain barrier. For this reason, the Sixth Annual Meeting of the Blood-Brain Barrier Disruption Consortium, the focus of which was the "Importance of Dose Intensity in Neuro-Oncology Clinical Trials," was convened in April 2000, at Government Camp, Mount Hood, Oregon. This meeting, which was supported by the National Cancer Institute, the National Institute of Neurological Disorders and Stroke, and the National Institute of Deafness and Other Communication Disorders, brought together clinicians and basic scientists from across the U.S. to discuss the role of dose intensity and enhanced chemotherapy delivery in the treatment of malignant brain tumors and to design multicenter clinical trials. Optimizing chemotherapy delivery to the CNS is crucial, particularly in view of recent progress identifying certain brain tumors as chemosensitive. The discovery that specific constellations of genetic alterations can predict which tumors are chemoresponsive, and can therefore more accurately predict prognosis, has important implications for delivery of intensive, effective chemotherapy regimens with acceptable toxicities. This report summarizes the discussions, future directions, and key questions regarding dose-intensive treatment of primary CNS lymphoma, CNS relapse of systemic non-Hodgkin's lymphoma, anaplastic oligodendroglioma, high-grade glioma, and metastatic cancer of the brain. The promising role of cytoenhancers and chemoprotectants as part of dose-intensive regimens for chemosensitive brain tumors and development of improved gene therapies for malignant gliomas are discussed.