SARA LEE FOODS TAKES FLIGHT: AN ECONOMIC IMPACT ANALYSIS OF A TURKEY PLANT CLOSURE

In 1998, the Sara Lee Corporation implemented a corporate strategy of deverticalization. Bil Mar Foods, Inc., a subsidiary of Sara Lee responsible for the processing of packaged meat products, followed the strategy by shutting down its turkey slaughter facility in Zeeland, Michigan. As a consequence, turkey growers in Michigan were left with no viable outlet for live bird slaughter and the potential end of live bird production in the region. This study analyzes the economic impact associated with the cessation of live bird slaughter at the Bil Mar Foods plant. The economic consequences may be as high as an $81 million loss in total industry output, a$29 million loss in income, and a total employment loss of nearly 800 jobs. Faced with these economic consequences, turkey growers in the region joined forces to form a valued-added cooperative.impact analysis, plant closure, turkey industry, Community/Rural/Urban Development, Livestock Production/Industries,

FACTORS AFFECTING REGIONAL SHIFTS OF U.S PORK PRODUCTION

The U.S. pork industry in the recent past has transferred into fewer, larger and specialized operations. Inputs availability, developments of transportation systems, technological changes, government regulations and the consumer preferences have been driving changes in the pork industry. Spatial inequalities affect the competitiveness of one region relative to other regions. This paper is focused on how these forces affect the regional competitiveness of the pork industry and movement towards larger, specialized and geographically concentrated operations. A mathematical programming model is used to analyze the effect of market forces on the pork industry structure. The results of this study show that although raising hogs in larger operations is less costly, small-sized operations in some regions still need to produce hogs to meet the demand for consumption and export. Environmental compliance cost is considered one of the major factors of industry relocation; the analysis showed that the effect of such costs was minimal. Feed costs and transportation costs play a greater role in location of production and processing. Pork operations tend to locate near the populous areas to meet the consumer demand and to minimize the transportation cost. Pressures from current and future environment regulations, moratoria and scarcity of agricultural land for manure management tend to keep the hog operations away from high population areas. A future scenario analysis suggested that the Western region of the U.S. would experience higher growth in pork production. The current trend of fewer and larger production units and location change in the pork industry will continue.Livestock Production/Industries,

Protocol for an open label: phase I trial within a cohort of foetal cell transplants in people with Huntington’s disease

Huntington’s disease is a progressive neurodegenerative disorder characterised by motor, cognitive and psychiatric symptoms. Currently, no disease-modifying therapies are available to slow or halt disease progression. Huntington’s disease is characterised by relatively focal and specific loss of striatal medium spiny neurons, which makes it suitable for cell replacement therapy, a process involving the transplantation of donor cells to replace those lost due to disease. TRIDENT (TRIal DEsigns for delivery of Novel Therapies in neurodegeneration) is a phase I Trial Within a Cohort (TWiC) designed to assess safety and feasibility of transplanting human fetalstriatal cells into the striatum of people with Huntington’s disease. A minimum of 18 participants will be enrolled in the study cohort, and up to five eligible participants will be randomly selected to undergo transplantation of 12-22 million fetal cells in a dose escalation paradigm. Independent reviewers will assess safety outcomes (lack of significant infection, bleeding or new neurological deficit) four weeks after surgery, and ongoing safety will be established before conducting each subsequent surgery. All participants will undergo detailed clinical and functional assessment at baseline, 6 and 12 months. Surgery will be performed one month after baseline, and transplant participants will undergo regular clinical follow-up for at least 12 months. Evaluation of trial processes will also be undertaken. Transplant participants and their carers will be interviewed approximately one month before and after surgery. Interviews will also be conducted with non-transplanted participants and healthcare staff delivering the intervention and involved in the clinical care of participants. Evaluation of clinical and functional efficacy outcomes and intervention costs will be carried out to explore plausible trial designs for subsequent randomised controlled trials aimed at evaluating efficacy and cost-effectiveness of cell replacement therapy. TRIDENT will enable the assessment of the safety, feasibility, acceptability and cost of fetalcell transplants in people with Huntington’s disease. The data collected will inform trial designs for complex intracranial interventions in a range of neurodegenerative conditions and facilitate the development of stable surgical pipelines for delivery of future stem cell trials

Monitoring and managing lifestyle behaviours using wearable activity trackers: a mixed methods study of views from the Huntington's disease community

Background: There are early indications that lifestyle behaviors, specifically physical activity and sleep, may be associated with the onset and progression of Huntington disease (HD). Wearable activity trackers offer an exciting opportunity to collect long-term activity data to further investigate the role of lifestyle, physical activity, and sleep in disease modification. Given how wearable devices rely on user acceptance and long-term adoption, it is important to understand users’ perspectives on how acceptable any device might be and how users might engage over the longer term. Objective: This study aimed to explore the perceptions, motivators, and potential barriers relating to the adoption of wearable activity trackers by people with HD for monitoring and managing their lifestyle and sleep. This information intended to guide the selection of wearable activity trackers for use in a longitudinal observational clinical study. Methods: We conducted a mixed methods study; this allowed us to draw on the potential strengths of both quantitative and qualitative methods. Opportunistic participant recruitment occurred at 4 Huntington’s Disease Association meetings, including 1 international meeting and 3 United Kingdom–based regional meetings. Individuals with HD, their family members, and carers were invited to complete a user acceptance questionnaire and participate in a focus group discussion. The questionnaire consisted of 35 items across 8 domains using a 0 to 4 Likert scale, along with some additional demographic questions. Average questionnaire responses were recorded as positive (score>2.5), negative (score<1.5), or neutral (score between 1.5 and 2.5) opinions for each domain. Differences owing to demographics were explored using the Kruskal-Wallis and Wilcoxon rank sum tests. Focus group discussions (conducted in English) were driven by a topic guide, a vignette scenario, and an item ranking exercise. The discussions were audio recorded and then analyzed using thematic analysis. Results: A total of 105 completed questionnaires were analyzed (47 people with HD and 58 family members or carers). All sections of the questionnaire produced median scores >2.5, indicating a tendency toward positive opinions on wearable activity trackers, such as the devices being advantageous, easy and enjoyable to use, and compatible with lifestyle and users being able to understand the information from trackers and willing to wear them. People with HD reported a more positive attitude toward wearable activity trackers than their family members or caregivers (P=.02). A total of 15 participants participated in 3 focus groups. Device compatibility and accuracy, data security, impact on relationships, and the ability to monitor and self-manage lifestyle behaviors have emerged as important considerations in device use and user preferences

Unmet needs and behaviour during the Ebola response in Sierra Leone: a retrospective, mixed-methods analysis of community feedback from the Social Mobilization Action Consortium

Background: The west African Ebola epidemic (2014–15) necessitated behaviour change in settings with prevalent and pre-existing unmet needs as well as extensive mechanisms for local community action. We aimed to assess spatial and temporal trends in community-reported needs and associations with behaviour change, community engagement, and the overall outbreak situation in Sierra Leone. Methods: We did a retrospective, mixed-methods study. Post-hoc analyses of data from 12 096 mobiliser visits as part of the Social Mobilization Action Consortium were used to describe the evolution of satisfied and unsatisfied needs (basic, security, autonomy, respect, and social support) between Nov 12, 2014, and Dec 18, 2015, and across 14 districts. Via Bayesian hierarchical regression modelling, we investigated associations between needs categories and behaviours (numbers of individuals referred to treatment within 24 h of symptom onset or deaths responded to with safe and dignified burials) and the role of community engagement programme status (initial vs follow-up visit) in the association between satisfied versus unsatisfied needs and behaviours. Findings: In general, significant associations were observed between unsatisfied needs categories and both prompt referrals to treatment and safe burials. Most notably, communities expressing unsatisfied capacity needs reported fewer safe burials (relative risk [RR] 0·86, 95% credible interval [CrI] 0·82–0·91) and fewer prompt referrals to treatment (RR 0·76, 0·70–0·83) than did those without unsatisfied capacity needs. The exception was expression of unsatisfied basic needs, which was associated with significantly fewer prompt referrals only (RR 0·86, 95% CrI 0·79–0·93). Compared with triggering visits by community mobilisers, follow-up visits were associated with higher numbers of prompt referrals (RR 1·40, 95% CrI 1·30–1·50) and safe burials (RR 1·08, 1·02–1·14). Interpretation: Community-based development of locally feasible, locally owned action plans, with the support of community mobilisers, has potential to address unmet needs for more sustained behaviour change in outbreak settings

Translating cell therapies for neurodegenerative diseases: Huntington's disease as a model disorder

There has been substantial progress in the development of regenerative medicine strategies for central nervous system disorders over the last decade, with progression to early clinical studies for some conditions. However, there are multiple challenges along the translational pipeline, many of which are common across diseases and pertinent to multiple donor cell types. These include defining the point at which the preclinical data are sufficiently compelling to permit progression to the first clinical studies; scaling-up, characterization, quality control and validation of the cell product; design, validation and approval of the surgical device; and operative procedures for safe and effective delivery of cell product to the brain. Furthermore, clinical trials that incorporate principles of efficient design and disease specific outcomes are urgently needed (particularly for those undertaken in rare diseases, where relatively small cohorts are an additional limiting factor), and all processes must be adaptable in a dynamic regulatory environment. Here we set out the challenges associated with the clinical translation of cell therapy, using Huntington’s disease as a specific example, and suggest potential strategies to address these challenges. Huntington’s disease presents a clear unmet need, but, importantly, it is an autosomal dominant condition with a readily available gene test, full genetic penetrance and a wide range of associated animal models, which together mean that it is a powerful condition in which to develop principles and test experimental therapeutics. We propose that solving these challenges in Huntington’s disease would provide a road map for many other neurological conditions. This white paper represents a consensus opinion emerging from a series of meetings of the international translational platforms Stem Cells For Huntington’s Disease and the European Huntington’s Disease Network Advanced Therapies Working Group, established to identify the challenges of cell therapy, share experience, develop guidance, and highlight future directions, with the aim to expedite progress towards therapies for clinical benefit in Huntington’s disease

The quest for certainty in population screening for cervical cancer

The thesis explores the management of the certainty/uncertainty tension in the context of cervical screening programs (CSPs). In the past, the discursive making of certainty by laboratories, health educators, and promoters, has elicited a broad public perception of a simple screening test provided as a public good in answer to a common need. However, the recent litigation 'watershed' has recast CSP technologies as problematic. The quest for solutions emerging from a desire both to 'get it right', and to avoid litigation, has produced technologies of control which among other things, perform transformed answers to the question 'How should we live?' The turn to litigation is interpreted as a transforming moment in the continually unfolding CSP trajectory. The complex conditions of the Pap test's emergence as simultaneously a problem and a solution, are located and de-composed to reveal a multiplicity of performers, performances, understandings, and interpretations within the CSP arena. Problems experienced with constitutive elements of the CSPs have arisen from a disjunction between practices, representations, expectations, and perceived outcomes of screening. Early and continuing messages about screening have failed in some cases to accord with lived experience. As the workings of the CSPs have been opened to public scrutiny in the courts and the media, old certainties have been displaced by doubt, perceptions of error, and calls for improvement. Moves to manage these revealed uncertainties have issued in newly articulated and defensive strategies for building resilience and securing continuity. Such moves to regain control and restore public confidence are manifested and embodied in the processes of accreditation, regulation, registration, quality management, and automated technologies, all of which contain the promise of better ways of going on. The opening up of the CSPs to critical scrutiny in the courts and media, has meant adapting to a different discursive milieu in which the languages of cost benefit analysis, technological advantage, TQM, and zero-error, are fused with legal constructions of morality, responsibility, and certainty to perform a significant rhetorical shift. In this altered moral milieu, there is a danger that the flexible and reflective attitude which encourages multiple, and different voices to be heard, may be overcome by the rigidities expressed and performed in an overzealous quest for certainty