National Authorities Research Articles

Dietary Assessment Methods in Surveillance Systems Targeted to Adults: A Literature Review

Accurate and reliable evaluation of dietary consumption is essential for understanding individual dietary profiles. Proper dietary practices should provide sufficient amounts of both macronutrients and micronutrients for leading a healthy life. Choosing the best dietary assessment method for a certain objective leads to greater evidence for effective nutrition projects, policies, and programs. This review provides a clear understanding of dietary diversity assessment methods and the problems associated with choosing the best method. The resource guide aims to improve the quality and accuracy of nutrition information and provides a description of its applications, validity, strengths, and limitations. The databases searched for relevant papers for this review were Science Direct, Google Scholar, PubMed, Hindawi, Web of Science, Cochrane Library, etc. The review focused on collecting data from the last ten years of published articles, and duplicate papers were excluded from the database. Assessment methods described and compared in this study were the 24-hour recall method, food frequency questionnaires (FFQs), food records (FRs), quantitative food frequency questionnaires (QFFQs), non-quantitative food frequency questionnaires (Non-QFFQs), semi-quantitative food frequency questionnaires (SQFFQs), weighed FRs, and estimated FRs. In conclusion, this study highlights the need for a surveillance system for adults that collects comprehensive dietary information using standardized techniques and minimizes bias. This review’s extensive information can help national authorities choose appropriate protocols for their own dietary assessment surveys.

Diagnosis and management of complications following pelvic organ prolapse surgery using a synthetic mesh: French national guidelines for clinical practice

Diagnosis and management of complications following pelvic organ prolapse surgery using a synthetic mesh: French national guidelines for clinical practice

Implementing integrated hypertension and diabetes management using the World Health Organization’s HEARTS model: protocol for a pilot study in the Guatemalan national primary care system

BackgroundThe HEARTS technical package was developed by the World Health Organization to address the implementation gap in cardiovascular disease prevention in low- and middle-income countries. Guatemala is a middle-income country that is currently implementing HEARTS. National authorities in Guatemala are interested in exploring how hypertension and diabetes management can be integrated in HEARTS implementation. The objective of this study is to conduct a feasibility and acceptability pilot trial of integrated hypertension and diabetes management based on HEARTS in the publicly funded primary care system in Guatemala.MethodsA single-arm pilot trial for 6 months will be carried out in 11 Ministry of Health primary care facilities starting in September 2023. A planned sample of 100 adult patients diagnosed with diabetes (n = 45), hypertension (n = 45), or both (n = 10) will be enrolled. The intervention will consist of HEARTS-aligned components: Training health workers on healthy-lifestyle counseling and evidence-based treatment protocols, strengthening access to medications and diagnostics, training on risk-based cardiovascular disease management, team-based care and task sharing, and systems monitoring and feedback, including implementation of a facility-based electronic monitoring tool at the individual level. Co-primary outcomes of feasibility and acceptability will be assessed using an explanatory sequential mixed-methods design. Secondary outcomes include clinical effectiveness (treatment with medication, glycemic control, and blood pressure control), key implementation outcomes (adoption, fidelity, usability, and sustainability), and patient-reported outcome measures (diabetes distress, disability, and treatment burden). Using an implementation mapping approach, a Technical Advisory Committee will develop implementation strategies for subsequent scale-up planning.DiscussionThis trial will produce evidence on implementing HEARTS-aligned hypertension and diabetes care in the MOH primary care system in Guatemala. Results also will inform future HEARTS projects in Guatemala and other low- and middle-income countries.Trial registrationClinicalTrials.gov ID NCT06080451. The trial was prospectively registered on October 12, 2023.

Carbon Dioxide Uptake Estimation for Spanish Cement-Based Materials.

The Intergovernmental Panel on Climate Change (IPCC), which is the United Nations body for assessing the science related to climate change, has recently recognized the natural carbonation process as a way of carbon offsetting with mortar and concrete. Accordingly, this activity could be recognized as a carbon removal process for which certification should be granted. The aim of the certification of carbon removal is to promote the development of adequate and efficient new carbon removal processes. Therefore, the main objective of this study is to provide reliable results on carbon dioxide uptake by cement-based materials in Spain. Yearly, greenhouse gas emissions are reported to the United Nations Framework Convention on Climate Change (UNFCCC) by each country, and the natural carbonation should be added up to the carbon accounting. Therefore, natural carbonation should be included in the IPCC Guidelines for National Greenhouse Gas Inventories, and such accounting information should be made available promptly to the national regulatory authorities. This paper provides the results of carbon dioxide uptake by Spanish cement-based materials from 1990 to 2020 by using an easy method of estimating the net carbon dioxide emissions (simplified method) considering the carbon dioxide released by the calcination during clinker production (process emissions). The outcome of this study reveals that there was 93,556,000 tons of carbon dioxide uptake by the mortar and concrete manufactured in Spain from 1990 to 2020.

Impression management following investigation and prosecution scandal in Norwegian police: a review of press releases

ABSTRACT This article presents research regarding impression management following a white-collar investigation and prosecution scandal by the National Authority for Investigation and Prosecution of Economic and Environmental Crime in Norway. The authority issued 39 press releases in one year, which communicate focus on less serious crime cases combined with deterrence by taking on cases without ever bringing them to court. Deterrence strategy by investigations implies that the authority passes penalties on suspects who never have a chance to defend themselves in court. The penalty is suffering from negative public attention, lack of job opportunities, and time spent in detention and interrogation as an accused where they have to explain themselves. The authority then behaves like a court where they punish people. However, that is a role assigned to judges and not to investigators or prosecutors. The authority argues that it is difficult to obtain the necessary information without a thorough investigation. While this is certainly true, a policing principle seems forgotten that an investigation should only be launched when it is somehow obvious that crime has indeed occurred.

Assessment of the clinical and analytical performance of three Seegene Allplex SARS-CoV-2 assays within the VALCOR framework.

The coronavirus disease 2019 (COVID-19) pandemic demonstrated the need for accurate diagnostic testing for the early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the pandemic has ended, accurate assays are still needed to monitor viral spread at national levels and beyond through population and wastewater surveillance. To enhance early detection, SARS-CoV-2 assays should have high diagnostic accuracy and should be validated to assure accurate results. Three distinct SARS-CoV-2 assays were evaluated with clinical samples using the VALCOR (VALidation of SARS-CORona Virus-2 assays) framework, with the TaqPath COVID-19 assay (ThermoFisher Scientific, USA) as a comparator. We evaluated clinical sensitivity, specificity, limit of detection (LOD), and overall concordance between comparator and three index Allplex SARS-CoV-2 assays (Seegene, South Korea): Allplex-SC2, Allplex-SC2Fast (Fast PCR), and Allplex-SC2FabR (SARS-CoV-2/FluA/FluB/respiratory syncytial virus). Analytical performance and LOD of index assays were assessed using a dilution series of three synthetic SARS-CoV-2 sequence reference materials (RMs). Ninety SARS-CoV-2 positives and 90 SARS-CoV-2 negatives were tested. All Allplex assays had 100.0% sensitivity (95%CI = 95.9%-100.0%). Allplex-SC2 and Allplex-SC2Fast assays had 97.8% specificity (95%CI = 92.3%-99.7%) and 98.9% overall concordance [κ = 0.978 (95%CI = 0.947-1.000)]. Allplex-SC2FabR assay showed 100.0% specificity (95%CI = 95.9%-100.0%) and 100.0% overall concordance [κ = 1.000 (95%CI = 1.000-1.000)]. LOD assessment of index assays revealed detection down to 2.61 × 102 copies/mL in clinical samples, while the analytical LOD was 9.00 × 102 copies/mL. In conclusion, the evaluation of the three Seegene Allplex SARS-CoV-2 assays showed high sensitivity and specificity and an overall good assay concordance with the comparator. The assays showed low analytical LOD using RM and even a slightly lower LOD in clinical samples. Non-overlapping target gene sequences between SARS-CoV-2 assays and RMs emphasize the need for aligning targeted sequences of diagnostic assays and RMs.IMPORTANCEThe coronavirus disease 2019 pandemic has a significant impact on global public health, economies, and societies. As shown through the first phases of the pandemic, accurate and timely diagnosis is crucial for disease control, prevention, and monitoring. Though the pandemic phase of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has concluded, diagnostic assays remain in demand to monitor SARS-CoV-2 at the individual patient level, regionally, and nationally, as well as to remain an infectious disease preparedness instrument to monitor any new SARS-CoV-2 dissemination across borders using population and wastewater surveillance. The anticipation by WHO and central health care policy entities such as the Center for Disease Control, EMA, and multiple national health authorities is that SARS-CoV-2 will reside as an endemic respiratory disease for years to come. The key strategic consideration is hence shifting from combating a pandemic situation with a high number of patients to instead allowing precise diagnostics of suspected patients with the intention of correct management in a low-prevalence setting.

Prevalence and associated risk factors of postpartum depression in India: A comprehensive review.

Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords "postpartum depression," or "postnatal depression," and "prevalence," and "causes," and "risk factors," or "predisposing factors," or "predictive factors" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities.

Multinational collaboration in solving a European Salmonella Braenderup outbreak linked to imported melons, 2021.

A genomic cluster of Salmonella Braenderup ST22, a serovar of Salmonella enterica subsp. enterica which causes symptoms of gastrointestinal illness, was notified by Danish authorities to the European Centre for Disease Prevention and Control (ECDC) on 3 May 2021. By 6 July 2021, S. Braenderup outbreak cases (n=348) had been reported from 12 countries in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK), including 68 hospitalised cases. With support from affected EU/EEA countries, and in partnership with the European Food Safety Authority (EFSA), ECDC established an international outbreak investigation team to rapidly identify the source and prevent outbreak spread. Consumption information was shared with affected countries through a standard line list, revealing that 124 of 197 cases (63%) reported having eaten (any) melons within 7 days prior to disease onset. The speed and completeness of the investigation, which identified the outbreak vehicle as galia melons imported from Honduras in June 2021, was a direct result of extensive collaboration and information sharing between countries' national food safety and public health authorities. This article describes the outbreak and the benefits, successes, and challenges of multi-country collaboration for consideration in future large foodborne outbreaks across Europe.

A Quarter of a Century of Civilian Protection: Contested Concepts and the Problem of Sovereignty

ABSTRACT The protection of civilians has moved from the periphery to the core of public perceptions of what UN peacekeeping is for. At the same time, the operational and tactical arts of civilian protection have become better developed, more sophisticated, and more widely known. This turn towards protection has improved UN peacekeeping and, more importantly, saved civilian lives. This piece shows that together, the essays in this collection suggest a need to think more holistically about by situating practices of UN peacekeeping along a broader continuum of practice comprising local actors, unarmed civilian protectors at one end, a more fulsome understanding of the role of UN police and national authorities in the middle, and – at the other end – difficult questions about humanitarian intervention.

What space for the dead? The making of burial places for and by religious minorities in The Netherlands

In this article, we examine how religious minorities in the densely populated Netherlands manage burial norms in the face of scarcity of land. Using legal pluralism, we explore how local and national authorities; funeral agents; and three religious minority communities deal with the spatial and temporal dimensions of death and burial, both inside and outside the Dutch conurbation The Randstad, in a context where the Dutch tradition of consociationalism lingers on. Based on fieldwork and legal analysis, our findings show that religious burial norms have peripheral existence, both within Dutch law where they are treated as exceptions, and geographically, as religious cemeteries still remain situated outside The Randstad. Furthermore, tensions can emerge not only between communities, but also within them, as exemplified by challenges faced by non-believers. In a context of migration, Dutch cemeteries become spaces where multiple normative orders concerning emotion, (non)belief, religion, society and the state intersect. This turns the space for the dead into a place where some members of minority groups can find the rest they are longing for, while others cannot.

Национальные научные исследования в контексте общеевропейских приоритетов научного развития: опыт Норвегии

The author examines to what extent national scientific research in Norway meets the pan-European principles and priorities of scientific development. The success of the interaction between European and national research efforts is a key condition for improving the competitiveness and efficiency of research in Europe. As an associated country, Norway does not have much influence on the allocation of funds from the European budget for research, nevertheless, the country is involved in all projects implemented within the framework of the European Research Area, financing and receiving funding from the EU Framework Programs. The article examines the structure of the scientific research complex, paying special attention to the main documents and institutions that determine science policy. In addition, the author studies budget formation in the scientific field in Norway, as well as the country’s participation in the international scientific cooperation. Norway’s experience is useful for understanding how nation states organize and coordinate their participation in European programs, especially in terms of addressing current and future “great challenges”. As a result of the analysis of the scientific policy carried out in Norway, the author comes to the conclusion that R&D institutions are directly adapted to the priorities of the European level, while national authorities have limited influence on the country’s European research portfolio. The purpose of the study is to analyze the interaction of the European research policy with the national research system of Norway. Research objectives: to analyze the formation of the structure and goals of European programs; to identify changes in the instruments and goals of national scientific policy; to determine the consequences of changes in scientific policy for the Norwegian research complex; to assess the level of coincidence of the interests and practices of the national scientific community with the interests and practices of the European scientific community, which is being formed at the supranational level.

Deterrence effects despite lack of prosecution: Punishment outcomes of white-collar crime investigations in Norway

Abstract The national authority Økokrim was established several decades ago to become a policing centre of excellence in the investigation and prosecution of economic and environmental crime in Norway that is especially concerned with white-collar and corporate crime. This article focusses on deterrence effects from Økokrim investigations that never lead to prosecution or conviction. The research raises the issue of the use of law enforcement publicity regarding investigations of potential offenders, often long before possible convictions. The issue is explored by the press releases from the Norwegian body. The apparent shift in strategy and practice at Økokrim might be explained by the devastating evaluation of the national authority some years ago. The evaluation was initiated after the Transocean court scandal where all defendants were acquitted of all charges. Deterrence strategy by investigations implies that Økokrim passes negative consequences on suspects who never have a chance to defend themselves in court. In jurisdictions with criminal justice, a suspect should always have the benefit of the doubt. Conviction should only occur when guilt is proven beyond any reasonable and sensible doubt. Until eventually proven guilty, a suspect is supposed to be considered innocent. This is a basic principle of justice.

The EU Terror List and the Islamic Revolutionary Guard Corps (IRGC): About the Law as an Alleged Obstacle to Political Action

This article examines the legal requirements for a listing on the so-called European Union (EU) terror list, an aspect that remains underdeveloped in both legal scholarship and policy debates on counter-terrorism measures. The analysis elucidates the substantive requirements governing listings on the EU terror list and applies them to the case of the Islamic Revolutionary Guard Corps. It highlights the two-tiered nature of the EU terror listing process, in which an EU terror listing relies on a national authority’s decision regarding the potential target. Furthermore, an analysis of recent Court of Justice of the European Union (CJEU) case-law outlines prospective developments in the Court of Justice’s scrutiny of restrictive measures. It will be shown that the CJEU exercises judicial deference in its examination of restrictive measures adopted by the Council, particularly in cases involving threats to the EU’s legal and democratic order or international security orchestrated by foreign state actors.

Gender Pay Gap: The Protection of the Right to Equal Pay under the Pay Transparency Directive

The purpose of this article is to comprehend how and to which extent the EU Pay Transparency Directive ensures the protection of the right to equal pay for men and women and how effective it is in addressing the Gender Pay Gap. Firstly, the analysis focuses on the main provisions of the EU Treaties, to identify the legal framework at primary level establishing the right concerned, bearing in mind the case-law of the Court of Justice of the European Union and its guiding interpretation of the meanings arising from the principle of equal pay. Secondly, the article provides an analysis of the novelties introduced by the Pay Transparency Directive, to reduce the root causes of the Gender Pay Gap through transparency and enforcement mechanisms aimed at strengthening the exercise of employees’ right to bring action before national authorities against pay discrimination. Concurrently, the article incorporates a comparison between the different standards of protection established within EU Law and those in the European Social Charter. The results reveal how market-related concerns and considerations prevail in EU social policy, concealing the risk of decreasing the effective implementation of the principle of equal pay.

Global systematic review and meta-analysis on foodborne thermotole­rant Campylobacter prevalence in different species of poultry birds and associated sources of contamination

Campylobacteriosis is one of the most prevalent foodborne bacterial diseases. Infected chickens and poultry products are a possible source of this illness in people all over the world. Therefore, the objective of this current meta-analysis was to summarise the available data on the prevalence of thermotolerant Campylobacter species in poultry and their products. A systematic literature search was conducted to gather pertinent articles from 2000 to 2021, using globally recognised four electronic databases, including Google Scholar, PubMed, Science Direct, and Scopus. The mean prevalence of campylobacteriosis in poultry species and their products (meat, eggs, and offal) was 44% (95% CI: 39–50%) with the highest prevalence in Australia (67%). Among the European countries, France had the maximum prevalence rate of 76%, while Japan had recorded 61% as the peak among Asian countries. Prevalence rates of 43% and 56% were calculated in United States and Brazil representing the American region. In the species-wise results, the mean prevalence rates of Campylobacter jejuni and Campylobacter coli were 29% and 16%, correspondingly. In case of live birds, chickens and turkeys possessed maximum prevalence rates of 47% and 40%, whereas 46% and 63% were recorded from poultry meat and liver. Besides, categorising the difference sources of contamination, the maximum prevalence rate of 62% was found in the poultry processing plants followed by 54% from supermarkets and 38% from farms. According to the current meta-analysis, Campylobacter jejuni was the most common bacterium worldwide, and poultry meat – the most frequent source of human infection. The predominance of Campylobacter species is a threat for public health, and national authorities must undertake strategies to control this disease in each country with the goal of establishing adequate risk management measures.

Structural Modeling of School Managers' Competencies as a Driver for Sustainable Development

Purpose: This study focused on the structural modeling of competencies of high school managers in Tehran as a driver for sustainable development. Methodology: From the perspective of its objective, this research is developmental-applied, and in terms of data collection, given the nature of the study, it is descriptive-survey. The statistical population in the quantitative section includes high school managers from districts 2, 5, 6, and 8 in Tehran, who have experience in managing high schools and are active in executive and research activities in the field of education. Therefore, the sample size for the forthcoming research is 384 individuals, for which 384 questionnaires were used for data analysis. To measure the research variables, questionnaires by Shamsudin & Chutipattana (2012) and Wayla & Tolud (2021) were utilized. The reliability of the questionnaire was calculated based on Cronbach's alpha, and the validity of the questionnaire was based on confirmatory factor analysis. In the present research, the structural equation modeling method was used for data analysis. The software used for data analysis were SPSS-22 and SMARTPLS-4. Findings: According to the research findings, the professional competency model of school managers includes competency enablers, management competencies, ethics and professional behavior competencies, manager development, social indicators of managers, the establishment of work groups to enhance performance and green competency, attitudinal competencies, knowledge competencies, educational competencies, commercialization of knowledge-skills and technology competencies, hardworking spirit, consumption pattern modification, and participation in development towards national authority, which lead to the realization of results such as a hardworking spirit, consumption pattern modification, and participation in development. Conclusion: The professional competency model of school managers in high schools, with the expansion of professional competency, can assist managers and planners of educational systems in improving educational and training conditions.

ІНСТИТУЦІЙНЕ ЗАБЕЗПЕЧЕННЯ УПРАВЛІННЯ ПОБУТОВИМИ ВІДХОДАМИ

The article examines the main results of the legislative reform in Ukraineʼs municipal waste management sector. It identifies key issues hindering the effective implementation of new legislative norms, such as bureaucratic obstacles, insufficient funding, and the ongoing war. The roles of the national, regional, and local levels of government in the municipal waste management process are analyzed, highlighting the necessity of their interaction. The importance of coordinating actions among all stakeholders to ensure sustainable development and effective municipal waste management is emphasized. Ukraine’s Constitution, adopted in 1996, laid the foundation for a legal state and established fundamental principles of environmental safety, including the right to a safe environment and the state’s duty to maintain ecological balance. However, the previous Waste Management Law, despite being in effect for over 20 years, was ineffective due to a lack of systematic approach, poor coordination, and outdated infrastructure. In response to these challenges, the government initiated a comprehensive legislative reform to align with European standards and improve coordination. The new Waste Management Law, adopted in 2023, aims to address these issues. However, many necessary changes are still in progress, delayed by bureaucratic obstacles and the ongoing war, which has shifted government priorities towards national security. A critical challenge remains the coordination of actions between different levels of government and waste management entities. Effective waste management requires close interaction between national, regional, and local levels, encompassing infrastructure development, waste collection, transportation, and resource allocation. Such coordination is crucial for achieving sustainable development and environmental safety in Ukraine. The article underscores the need for special procedures to accelerate the approval of critically important environmental legislation. While international organizations often push necessary decisions, aligning national strategies with European integration and funding conditions, the active role of national, regional, and local authorities is essential. Improved cooperation and communication among all levels of government and stakeholders can significantly enhance the efficiency of municipal waste management systems in Ukraine.

AI and FM – a cautionary tale

Education and Medicine are two of the greatest achievements of humankind and this knowledge has been faithfully passed down by generations for millennia. Each generation builds on the knowledge of previous generations. High technological advances have also brought many advantages to humans but because they tend to be ‘owned’ by the very few, they have increasingly become commercialised and indeed weaponised. In a world of identity theft, cybercrime, scams, fraud, war and genocide, humanity needs to be very careful about trusting in the integrity of AI. Particularly, Family Medicine should always be based on the individuality of every patient within their unique circumstances. The Covid era saw a great change in the delivery of medicine and particularly in remote consultations. Telemedicine has now become entrenched in most countries, despite some limitations, and has added to the growing use of ICT in medicine. With a computer on most doctors’ desks globally, family doctors are able to take advantage of so many online facilities and sources of information. ICT has made the job easier but has also added levels of complexity and the need for added security. We already have ‘software’ as the ‘AI’ supporting many diagnostic choices. This software is a tool however, not a decision maker and the educated physician can access that tool for speed of diagnosis and recommended care. Asking a machine to make that diagnosis however is a totally different matter. Certainly national health authorities need to provide guidance and oversight of the resources doctors are using to ensure ongoing accuracy and safety. In the bigger picture should we be entrusting the world’s most valuable knowledge to competing tech platforms when the cyber world is already riddled with divisions and crime. Should not human health always be in the hands of humans, our well educated, trusted doctors who have insight into the intricacies of each individual patient’s life. Keywords: Artificial intelligence, family medicine

The economic performance of Italian olive oil companies: a comparative quantitative approach using the Anova and Tukey-Kramer methods

<p>Italian olive oil companies play a significant role in this nation's economy, which is among the top in the world for its geomorphological and meteorological characteristics. This research analyzed the performance of three profitability ratios (return on equity (R.O.E.), return on investment (R.O.I.), and return on sales (R.O.S.)) of 3184 companies from 2013 to 2022. Average ratios for each year and critical descriptive statistics were calculated. Broken lines and interpolating curves, obtained from sixth-degree polynomial equations maximizing R<sup>2</sup>, represent the trends. One-way ANOVA and Tukey-Kramer methods facilitated statistical comparisons between macro-regions. Despite the regular consumption of olive oil, the profitability of businesses has been erratic and fluctuating, probably due to the varying productivity of raw material crops. The pandemic seems to have had no impact. There are no statistically significant differences between macro-areas. The results are helpful to Italian and foreign entrepreneurs who can relate their situation to the average situation in context, highlighting possible gaps that, if negative, must be bridged with a timely management review. National and supranational political authorities can also use this study to orient the frequent support policies in the agricultural and agro-industrial sectors. So too can the bodies in charge of food education, especially for young people, can encourage the use of olive oil where it is lacking. The main limitation of this study was its focus on a small set of profitability ratios. In the future, the study should consider other profitability and asset ratios and investigate investments in sustainability, keeping in mind that all enterprises should contribute to developing eco-friendly production systems.</p>

Evaluation of good review practices in member authorities of the East African Medicines Regulatory Harmonisation initiative: strategies for alignment with African medicines agency.

The East African Community Medicines Regulatory Harmonisation (EAC-MRH) programme was established to address challenges faced by national regulatory authorities (NRAs) of the region. Work sharing through joint assessments and inspections was adopted to manage limited resources and capacity; however, NRA good review practices (GrevP) are also a key determinant to success. This study evaluated GReVP among the EAC-MRH NRAs and mapped required strategies for countries to align themselves with the African Medicines Agency (AMA). A validated questionnaire (Optimising Efficiency in Regulatory Agency-OpERA) that standardises and captures review processes was completed by the head of the medicines registration division in each NRA. A country report based on the completed questionnaire was developed for each NRA and validated by the heads of the respective authorities. The population and size of the NRAs vary and four of the countries have semi-autonomous authorities and three NRAs are autonomous. The Burundi and South Sudan authorities were fully government funded, Kenya and Uganda entirely from fees, while Rwanda, Tanzania and Zanzibar were partially funded from different sources. All authorities except South Sudan, which does not receive or review applications had backlogs. Authority fees varied based on the different application categories. Key milestones for standardised regulatory processes are implemented in all authorities. Queue times range from a few weeks to about one year. Three NRAs use internal technical agency staff for scientific assessments and three use both internal and external experts. Clock stop time varies and target timelines for review committee range from one day to three months. All the NRAs implement some best practices on quality measures, transparency and communication. Some have activities for transparency improvement but with minimal attention to training and education. Most employ some quality decision-making practices. GrevP in EAC-MRH NRAs still needs to be improved and it is imperative that these authorities streamline and harmonise their practices. Increasing human resources and an investment in training and education of staff will enable the implementation of all measures for GRevP. This is vital, as the effectiveness and efficiency of the AMA will depend on the strength of these NRAs.