Developing Dry Powder Inhaler Formulations.

This section aims to provide a concise and contemporary technical perspective and reference resource covering dry powder inhaler (DPI) formulations. While DPI products are currently the leading inhaled products in terms of sales value, a number of confounding perspectives are presented to illustrate why they are considered surprisingly, and often frustratingly, poorly understood on a fundamental scientific level, and most challenging to design from first principles. At the core of this issue is the immense complexity of fine cohesive powder systems. This review emphasizes that the difficulty of successful DPI product development should not be underestimated and is best achieved with a well-coordinated team who respect the challenges and who work in parallel on device and formulation and with an appreciation of the handling environment faced by the patient. The general different DPI formulation types, which have evolved to address the challenges of aerosolizing fine cohesive drug-containing particles to create consistent and effective DPI products, are described. This section reviews the range of particle engineering processes that may produce micron-sized drug-containing particles and their subsequent assembly as either carrier-based or carrier-free compositions. The creation of such formulations is then discussed in the context of the material, bulk, interfacial and ultimately drug-delivery properties that are considered to affect formulation performance. A brief conclusion then considers the future DPI product choices, notably the issue of technology versus affordability in the evolving inhaler market.

England's food policy coordination and the Covid-19 response.

The impact of the first wave of the Covid-19 pandemic and the response of government and non-government actors, from February-September 2020, offers critical insights into the current state of England's food policy processes and operations, and in particular the coordination of national food policy approaches. This study aims to clarify and solidify the discourse around food policy coordination by differentiating between routine coordination of the activities of government, and strategic coordination of such policy activities with higher-level strategic goals, such as those associated with a healthy and sustainable food system. This framework is applied to the case study based on documentary analysis. In detailing the evidence of coordination in the response, including examples of cross-government working, and collaboration across the public, private and third sectors, the findings illustrate the breadth of actors which constituted the policy and governance response. These included public policymakers in national and local governments, and from a range of different government departments; private sector food businesses; and third sector organisations. There was a high level of routine coordination, but also instances of disconnection and delay. A lack of strategic coordination provides an explanatory device for several instances of disconnection and incoherence, including interventions which failed to prioritise nutrition-related health, and the working conditions of those employed in the food sector. The routine-strategic distinction can be deployed to inform discussions on the types of policy coordination mechanisms, such as cross-cutting taskforces or bodies, which might be instituted to support connected working on food.

Organizing for thoughtful food: a meshwork approach.

This paper provides an alternative narrative for organizing food systems. It introduces meshwork as a novel theoretical lens to examine the ontological assumptions underlying the shadow and informal dynamics of organizing food. Through a longitudinal qualitative case study, we place relationality and becoming at the centre of organizing food and food systems, demonstrating how entangled relationships can create a complex ontology through the meshwork knots, threads and weave. We show how issues of collective concern come together to form dynamic knots of interactions, how the threads within the meshwork indicate processes of movement, and how the weave suggests degrees of food system resilience-but always in flow. This theoretical approach thus provides a platform for addressing thoughtful concerns about "food matters" including the integrity of our global food system, the negative health and environmental impacts of industrialized food production, and food safety issues.

Antimicrobial & antiparasitic use and resistance in British sheep and cattle: a systematic review.

A variety of antimicrobials and antiparasitics are used to treat British cattle and sheep to ensure animal welfare, a safe food supply, and maintain farm incomes. However, with increasing global concern about antimicrobial resistance in human and animal populations, there is increased scrutiny of the use of antimicrobials in food-producing animals. This systematic review sought to identify and describe peer and non-peer reviewed sources, published over the last ten years, detailing the usage of, and resistance to, antimicrobials and antiparasitics in sheep and cattle farming systems in Britain as well as identify knowledge gaps. Applying the PRISMA review protocol and guidelines for including grey literature; Scopus, Web of Science, Medline, and government repositories were searched for relevant articles and reports. Seven hundred and seventy titles and abstracts and 126 full-text records were assessed, of which 40 scholarly articles and five government reports were included for data extraction. Antibiotic usage in sheep and cattle in Britain appear to be below the UK average for all livestock and tetracyclines and beta-lactam antibiotics were found to be the most commonly used. However, the poor level of coverage afforded to these species compared to other livestock reduced the certainty of these findings. Although resistance to some antibiotics (using Escherichia coli as a marker) appeared to have decreased in sheep and cattle in England and Wales over a five-year period (2013-2018), levels of resistance remain high to commonly used antibiotics. The small number and fragmented nature of studies identified by this review describing anthelmintic usage, and the lack of available national sales data, prevented the identification of trends in either sheep or cattle. We recommend that additional efforts are taken to collect farm or veterinary level data and argue that extraction of this data is imperative to the development of antimicrobial and antiparasitic resistance strategies in Britain, both of which are needed to reduce usage of these anti-infective agents, curb the development of resistance, and safeguard national agricultural production. Finally, metrics produced by this data should be generated in a way to allow for maximum comparability across species, sectors, and countries.

Nutrition and sustainability: an emerging food policy discourse.

It is well known that food has a considerable environmental impact. Less attention has been given to mapping and analysing the emergence of policy responses. This paper contributes to that process. It summarises emerging policy development on nutrition and sustainability, and explores difficulties in their integration. The paper describes some policy thinking at national, European and international levels of governance. It points to the existence of particular policy hotspots such as meat and dairy, sustainable diets and waste. Understanding the environmental impact of food systems challenges nutrition science to draw upon traditions of thinking which have recently been fragmented. These perspectives (life sciences, social and environmental) are all required if policy engagement and clarification is to occur. Sustainability issues offer opportunities for nutrition science and scientists to play a more central role in the policy analysis of future food systems. The task of revising current nutrition policy advice to become sustainable diet advice needs to begin at national and international levels.

Policy councils on food, nutrition and physical activity: the UK as a case study.

International experience of Policy Councils on food and nutrition has developed over recent decades but they have not received the attention that is due to them. The 1992 International Conference on Nutrition recommended that governments create Food Policy Councils but few have been created. There has been more experience in local and sub-national policy councils, particularly in North America. Developing country experience of attempting to improve food policy integration stems from the 1970s. The UK's House of Commons' (Parliamentary) Health Committee, in its 2004 report on obesity, reviewed current policy determinants of the rise in obesity, concluding that national food and health policy lacked coherence, integration and effectiveness. To address this vacuum, it proposed the creation of a new 'Council of Nutrition and Physical Activity to improve co-ordination and inject independent thinking into strategy'. The case for creating such a Council in the UK is reviewed, as are possible organisational options, functions and remit. A Council could be created under the forthcoming Public Health Act. The purpose of the new Council would be to provide independent advice and strategic advice as well as monitor the linkages between policies on food, nutrition and physical activity, noting their environmental implications.