Identifying Gaps in Pelvic Pain Education: A Scoping Review and Structured Analysis of Obstetrics and Gynecology Training Milestones.

OBJECTIVE: Several clinical practice guidelines on the evaluation and management (EM) of chronic pelvic pain (CPP) have been published; however, it is not known whether obstetrics and gynecology (OBGYN) educational milestones are aligned with current practice recommendations. Therefore, this scoping review and structured analysis aims to identify gaps between clinical guidelines for the EM of CPP and OBGYN training milestones published by educational authorities like the Accreditation Council for Graduate Medical Education (ACGME) and the AAGL. DATA SOURCES: The literature search was performed in MEDLINE, PubMed Central, and Bookshelf on the PubMed interface from January 2018 to September 2022. Peer-reviewed publications were included if they were a systematic review of recent practice guidelines and focused on female CPP. Publications that focused on a single pelvic pain condition or focused on a specific treatment were excluded. METHODS OF STUDY SELECTION: Two reviewers extracted the data and appraised the study quality following the Critical Appraisal Skills Programme Checklist for systematic reviews. Four articles met inclusion criteria for thematic analysis. A reflexive thematic analysis via the inductive approach was performed to develop clinical themes common to all review articles and presumed important in the EM of CPP. Pelvic pain experts and Delphi methodology was used to assess validity and relevance of each theme in OBGYN training. Validated themes were used in a strengths weaknesses opportunities threats (SWOT) analysis of the ACGME and the AAGL Milestones used for training OBGYN residents and fellows. A SWOT analysis is an organizational tool used to analyze processes in terms of strengths, weaknesses, opportunities for improvement, and threats to implementing a potential change. TABULATION, INTEGRATION, AND RESULTS: Twelve clinical themes were conceptualized and achieved ≥ 90% consensus as being important in the EM of CPP. Clinical themes pertained to pathophysiology, biopsychosocial approach, trauma-informed care, history and physical examination, diagnostic testing, multimodal/multidisciplinary management, pain education, and medical and surgical management. SWOT analysis showed that the ACGME Milestones lacked milestones specific to CPP, while the AAGL Milestones had 6 CPP-focused competencies with multiple milestones. Milestones on trauma-informed care and application of biopsychosocial assessment were notably absent. CONCLUSION: OBGYN educational milestones published by the ACGME and the AAGL are not yet aligned with current clinical guidelines for the EM of CPP.

The 15-minute city concept: The case study within a neighbourhood of Thessaloniki.

Cities, crucial cultural hubs, mould individual and group identities. The global urban expansion, with over half the population in urban areas, presents interconnected challenges such as pollution, poverty, inequality, ageing infrastructure, resource overconsumption, land use changes, biodiversity impact and climate change. Addressing these demands ambitious actions targeting political, social and economic systems for transformative change. The theoretical framework guiding city transformation centres on an interdisciplinary approach influenced by the Smart and Green Transition. The '15-minute city' concept, emphasizing human scale and urban experience, proposes that cities enable residents to meet daily needs within a short walk or bike ride. The aim of this study was the exploration of its implementation in Greek cities, particularly Thessaloniki, which reveals inherent characteristics supporting the 15-minute concept. Through an interdisciplinary approach rooted in the Smart and Green Transition framework, the research provides concrete guidance for policymakers in tailoring urban planning strategies, allocating resources effectively and crafting policies conducive to successful and sustainable urban transformations. Moreover, prioritizing public engagement highlights the significance of community involvement in shaping urban development plans, ensuring that proposed initiatives align with residents' needs and desires. In essence, this research contributes tangible insights and actionable recommendations for Greek cities, paving the way for more liveable, resilient and sustainable urban environments.

Proteogenomics in Cancer: Then and Now.

For years, the paths of sequencing technologies and mass spectrometry have occurred in isolation, with each developing its own unique culture and expertise. These two technologies are crucial for inspecting complementary aspects of the molecular phenotype across the central dogma. Integrative multiomics strives to bridge the analysis gap among different fields to complete more comprehensive mechanisms of life events and diseases. Proteogenomics is one integrated multiomics field. Here in this review, we mainly summarize and discuss three aspects: workflow of proteogenomics, proteogenomics applications in cancer research, and the SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis of proteogenomics in cancer research. In conclusion, proteogenomics has a promising future as it clarifies the functional consequences of many unannotated genomic abnormalities or noncanonical variants and identifies driver genes and novel therapeutic targets across cancers, which would substantially accelerate the development of precision oncology.

Global cancer surgery in low-resource settings: A strengths, weaknesses, opportunities, and threats analysis.

Global cancer surgery is an essential and complex component of oncologic care. This study aims to describe global cancer surgery literature since the 2015 Lancet Commission on Global Surgery and Cancer Surgery and perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis. A systematic search was performed in PubMed of global cancer surgery articles. Themes were extracted from the included studies based on the following criteria: (1) performed in low- or low-middle-income countries, (2) published during or after 2015, (3) published in peer-reviewed journals, (4) written in the English language, and (5) accessible to the authors. Themes were further grouped into strengths, weaknesses, opportunities, and threats (SWOT analysis). The search strategy identified 154 articles published from 1992 to 2022. Forty-six articles were included in the qualitative synthesis and SWOT analysis. Recurring themes included local epidemiologic studies, local innovations and feasibility studies, prioritizing quality of life outcomes, multidisciplinary team approaches, limited resources, health system gaps, lack of economic analyses, diverse cancer management strategies and priorities, inter-setting collaboration, research expansion, the coronavirus disease 2019 pandemic, and unchecked technological advancements. These strengths, weaknesses, opportunities, and threats were described and related to the themes of research, surgical systems strengthening, economics and financing, and political framing of the 2015 Lancet Commission on Global Cancer Surgery. SWOT analyses of global cancer surgery may be helpful in suggesting future strategies for this expanding field. PLAIN LANGUAGE SUMMARY: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected growth of cancer burden, the present gap in cancer surgery care in low-resource settings with stressed health care and surgical infrastructure risks further exacerbation. We present a strengths, weaknesses, opportunities, and threats analysis of recent global cancer surgery literature pertaining to low-resource settings.

Therapeutic drug monitoring in India: A strength, weakness, opportunity and threats analysis.

Over the last three to four decades, Therapeutic Drug Monitoring (TDM) has shaped itself as therapeutic drug management, an integral component of precision medicine. The practice of TDM is not extensive in India, despite being one of the fastest-growing economies in the world. It is currently limited to a few academic medical centres and teaching hospitals. Apart from the immunosuppressive drugs, several other therapeutic areas, such as anticancer, antifungal, antibiotic and antitubercular, have demonstrated great potential to improve patient outcomes in Indian settings. Factors such as the higher prevalence of nutritional deficiencies, tropical diseases, widespread use of alternative medicines, unalike pharmacogenomics and sparse population-specific data available on therapeutic ranges of several drugs make the population of this subcontinent unique regarding the relevance of TDM. Despite the impact of TDM in clinical science and its widespread application, TDM has failed to receive the attention it deserves in India. This review intends to bring out a strength, weakness, opportunity and threats (SWOT) analysis for TDM in India so that appropriate steps for fostering the growth of TDM could be envisioned. The need of the hour is the creation of a cooperative group including all the stakeholders, such as TDM professionals, clinicians and the government and devising a National Action Plan to strengthen TDM. Nodal TDM centres should be established, and pilot programmes should be rolled out to identify the thrust areas for TDM in the country, capacity building and creating awareness to integrate TDM into mainstream clinical medicine.

Roles and significance of chelating agents for potentially toxic elements (PTEs) phytoremediation in soil: A review.

Phytoremediation is a biological remediation technique known for low-cost technology and environmentally friendly approach, which employs plants to extract, stabilise, and transform various compounds, such as potentially toxic elements (PTEs), in the soil or water. Recent developments in utilising chelating agents soil remediation have led to a renewed interest in chelate-induced phytoremediation. This review article summarises the roles of various chelating agents and the mechanisms of chelate-induced phytoremediation. This paper also discusses the recent findings on the impacts of chelating agents on PTEs uptake and plant growth and development in phytoremediation. It was found that the chelating agents have increased the rate of metal absorption and translocation up to 45% from roots to the aboveground plant parts during PTEs phytoremediation. Besides, it was also explored that the plants may experience some phytotoxicity after adding chelating agents to the soil. However, due to the leaching potential of synthetic chelating agents, the use of organic chelants have been explored to be used in PTEs phytoremediation. Finally, this paper also presents comprehensive insights on the significance of using chelating agents through SWOT analysis to discuss the advantages and limitations of chelate-induced phytoremediation.

Assessing the suitability of solar dryers applied to wastewater plants: A review.

Sludge dewatering and drying are the main processes related to sludge management in wastewater treatment plants (WWTPs). Sludge disposal is a high-cost activity, and drying the sludge reduces its mass and volume, resulting in savings in storage, handling and transportation. The discoveries regarding the use of solar energy in agricultural studies provided valuable information for using in sewage sludge drying. Some studies have reported that dry sludge has met the EPA Class A requirement for biosolids using only solar energy as an energy source. The proper sludge mixture, manual or mechanical, and the dewatering process can significantly increase the drying rate, reducing drying time and the surface area needed. The environmental conditions and the sludge's type greatly influence the drying system. A solar dryer system may be suitable to dry different types of wastewater sludge. Modeling techniques can predict the behavior of the solar drying system and, thus, save time and money in experimental steps. CFD modeling of the sludge drying system is usually done by adopting specific boundary conditions and solving the Navier Stokes equations for air and sludge. There is no standard methodology for comparing solar dryers and common methodologies, such as system efficiency and thermal efficiency, disregards different dryers in different operational conditions. A SWOT (strengths, weaknesses, opportunities, and threats) analysis indicated that, in general, the chapel-type greenhouse with mixed-mode drying has higher drying rates, resulting in reduced drying time and can be scaled to any size. Thus, this type of dryer emerges as a more economical alternative to commercial solar dryers. Based on a systematic review, this work points the SWOT analysis as a useful tool for selecting solar dryers.

An analysis of governance factors influencing performance of selected smallholder dairy cooperatives in Zimbabwe.

Cooperatives are organisations owned and operated by individuals or groups that come together for mutual benefit including pooling of resources for the purchase of inputs and marketing of products. Marketing of milk is through dairy cooperatives where the milk collection centres are mandated to help integrating smallholder farmers into competitive markets. The study investigated governance structures of five smallholder dairy schemes purposively selected based on their agroecological regions in Zimbabwe. The aim of the study was to explore how the governing boards conduct their business, particularly marketing milk, and how this affects allocation of resources (milk production and deliveries to milk centres) by smallholder farmers. Qualitative data were collected using focus group discussions with 20 dairy cooperative members from each milk collection centre. Key informant interviews were conducted with chairpersons, management committee members, and dairy value chain stakeholders such as dairy associations and processors. The SWOT analysis technique was employed to identify governance structures highlighting major strengths, weakness, opportunities, and threats as a gateway to isolating strategies for enhancing centre performance. An analysis of implications of the governance structures on resource allocation decision by farmers was also performed. So focus is on how boards are discharging mandate such as marketing on behalf of farmers, price setting and negotiations, trainings, and accountability to members. Such factors if executed well will see farmers increasing milk production and deliveries to MCC yielding positive results in income and profits. The study results show that poor governance mainly caused by incompetent boards and management committees was the major factor affecting performance. Other findings were that if good governance factors were in place, then cooperatives became proficient leading to their growth. Thus, cooperatives must adopt business models based on private sector partnerships to maximise on expertise and technical support. The schemes ought to take advantage of existing opportunities, especially policies that mitigate threats and improve product diversity, value addition, and effective pricing strategies. To achieve these milestones, capacity building roadmaps ought to identify competent and efficient boards.

Assessment of the incubating environment for investment in biogas technology in Syria by using AHP and SWOT.

In light of the massive energy supply shortage due to the Syrian war since 2011, renewable energy adoption has a high potential to cover the actual energy demand. Hence, this study aims to shed light on the factors that affect investment in biogas technology. With the scarcity of research on alternative energies in Syria, this paper focused on the characteristics of the Syrian environment toward biogas technology adoption. The results show that Syrian society accepts and desires to adopt new technologies, representing an optimal strategy to stimulate biogas technology use and the need to spread awareness about its benefits. The SWOT model was applied to identify strengths, weaknesses, opportunities, and threats facing biogas technology adoption. The analytical hierarchy process model was applied to set priorities and make better decisions related to the knowledge of biogas, acceptance of biogas technology, desire for and common approach for its use, the resulting organic fertilizer, and administrative and financial aspects. The work concludes that the southern region was at the forefront in the areas studied in terms of weights of biogas technology investment criteria, subsequently, the central and later the coastal regions. By presenting a systematic and comprehensive approach, this study represents a roadmap to assist decision-makers in inking decisions related to adopting and deploying biogas technology on a larger scale and contributes to developing a criterion for selecting biogas sites in Syria.

Market potentials of robotic systems in medical science: analysis of the Avatera robotic system.

PURPOSE: To evaluate the potential opportunities and possible competitiveness of Avatera robotic system (ARS) (Avateramedical, Germany), and perform predictive cost-analysis for its implementation and dissemination. MATERIAL AND METHODS: Our study employed a projective quantitative research design. SWOT (strengths, weaknesses, opportunities, threats) analysis was used to map ARS internal competencies towards external contexts, and potential opportunities and risks in the robotic market. The ARS purchase and procedural costs were evaluated in two different scenarios. RESULTS: In the first scenario, setting the purchase cost of the Avatera at around $1.3-1.5 million, a total $400 procedural cost reduction compared to the RAS performed with the da Vinci Xi can be calculated. In the second scenario, with a purchase cos of the ARS of $700.000-800.000 and considering a 5-year period with an annual ARS volume of 500 procedures, only an additional $300 will be attributed to the robot itself. Our projections revealed that for an effective competition the purchase cost of ARS should range between $700.000 and $800.000 during the initial phase of market entry. The marketing strategy of the ARS should be oriented towards countries without any robotic system in operational use, followed by countries where the competition intensity in the marketplace is low. CONCLUSION: The introduction of new robotic systems will greatly affect and reshape the market of robotic surgery. The ARS has all the technical capacity ensuring the performance of high-quality surgical procedures. A fast spread and implementation of the ARS could be expected should the purchase and maintenance costs be kept low.

Combining Stakeholder- and Social Network- Analysis to Improve Regional Nature Conservation: A Case Study from Osnabrück, Germany.

Many nature conservation projects fail primarily not because of a lack of knowledge about upcoming threats or viable conservation concepts but rather because of the inability to transfer knowledge into the creation of effective measures. Therefore, an increase in information exchange and collaboration between theory- and practice-oriented conservation actors, as well as between conservation actors, land user groups, and authorities may enhance the effectiveness of conservation goals. By considering the interactions between conservation stakeholders as social networks, social network analysis (SNA) can help identify structural optimization potential in these networks. The present study combines SNA and stakeholder analysis (SA) to assess the interactions between 34 conservation stakeholders in the major city and district of Osnabrück in northwestern Germany and offers insights into cost/benefit optimizations of these stakeholder interactions. Data were acquired using a pile sort technique and guideline-based expert interviews. The SA, based on knowledge mapping and SWOT (strength, weaknesses, opportunities, and threats) analysis, identified individual stakeholder's complementary properties, indicating which among them would most benefit from mutual information exchange and collaboration. The SNA revealed discrepancies in information exchange and collaboration between theory- and practice-focused stakeholders. Conflicts were found predominantly between conservation associations, authorities and land user groups. Ecological research, funding, land-use conflicts, and distribution of conservation knowledge were identified as fields with high potential for increased information exchange and collaboration. Interviews also showed that the stakeholders themselves see many opportunities for increased networking in the region. The results are discussed in relation to the existing literature on nature conservation networks and used to recommend optimization measures for the studied network. Finally, the conclusion reflects upon the developed approach's implications and possibilities for conservation stakeholders and planners in general.

Sustainable development goals assessment of Erzurum province with SWOT-AHP analysis.

Sustainable development is one of the issues that many developed and developing countries focus on in the world. The sustainability of human and natural resources is of great importance for securing the world and humanity's common future. In this context, this study aims to evaluate the socio-economic structure of Erzurum with analytical hierarchy process (AHP) and digitized strengths, weaknesses, opportunities and threats analysis considering sustainable development goals (SDGs). The items included in the Agenda 21 report of the United Nations and 17 SDGs determined by the United Nations were taken into consideration in this endeavour. In line with expert opinions, the strengths, weaknesses, opportunities and threats created by the sustainable development goals for Erzurum province were analysed statistically with the AHP. Priority and weighted values of each sub-criterion were calculated. According to this analysis, "the richness of natural, cultural and historical resources for tourism potential" ranks first among the strengths of the province regarding sustainable development goals. Weaknesses include "insufficient investment and entrepreneurial culture". However, "priority region status for development" criterion stands out as the most important opportunity. Threats include "loss of labour force due to migration from agricultural areas" criterion. After the statistical analysis, the quantitative results of made for the best realization of sustainable development for the area were assessed to specify new goals and strategies. Suggestions were offered to define opportunities and strengths, threats and weaknesses with new-build strategies and to make the plans accordingly.

A mixed-method study of edible oil waste from farm to table in Iran: SWOT analysis.

The increasing trend of food waste is one of the serious challenges throughout the world. The purpose of this study is to investigate the status of edible oil waste (EOW) from farm to table using the SWOT (strengths, weaknesses, opportunities, and threats) analysis in Iran (2021). First, semi-structured, interviews were conducted with 11 experts in the edible oil industry. Then a cross-sectional study was done on 40 restaurant managers through telephone interviews about the restaurant's discarded edible oils. Finally, an online study was undertaken among 121 households regarding their waste cooking oil at home. Two categories in five themes with 20 subthemes were explored based on the participant's perspectives. Lack of up-to-date knowledge and appropriate technology were the main reasons for making waste from farm to factory. EOW is used optimally in other industries. The results showed that 92% of the restaurants sell the EOW for poultry feeds without refinement. The majority of the households [52%] throw EOW in the garbage and 21% dump their discarded oils in the sewage. By SWOT analysis, the challenges of EOW from farm to table were identified. There is no specific policy plan for collecting and recycling EOW. The waste oil used in poultry feed without refinement can enter the human body and the possible oxidation toxicity of this waste can pose public health risks. Policymakers can use the SWOT analysis for setting laws and regulations for EOW to ensure its safe disposal and promote its use for biodiesel to provide a healthy community.

Assessment of COVID-19 control strategies in a steel industry using a SWOT matrix.

According to the health regulations, industrial environments due to the gathering of people are considered as one of the highest-risk places during the COVID-19 pandemic. Thus, planning with regard to health concerns can decisively help in infection control and continuity of businesses during the pandemic. The aim of this study was to evaluate the COVID-19 control management measures in the Sepid-farab Kavir Steel Complex (SKS complex) located in Isfahan province (Iran) using strengths, weaknesses, opportunities, and threats (SWOT) matrix. After a literature review and field surveys, all weak, strong, threatening, and opportunity points were collected and were listed using the internal factor evaluation (IFE) and external factor evaluation (EFE) matrices and then were prioritized and weighted. Next, given the sum of scores of IFE and EFE, the SWOT matrix was constructed, the disease prevention and control strategies in the complex was determined, and finally, experts proposed corrective measures to improve the current situation. The results of the IFE matrix (IFE) analysis showed that in terms of corona control, there are more weaknesses than strengths within the company (the score of this matrix was 201.12). Also the score of 165 on the EFE matrix indicated that external threats were predominant, compared to external opportunities of company. SWOT analysis showed that despite some external problems and challenges, the existence of a favorable internal decision-making system had an important role in developing appropriate health strategies and implementing effective prevention measures in SKS complex against the COVID-19.

A Novel Alternative Methods for Decalcification of Water Resources Using Green Agro-Ashes.

The strategic idea in this work was to increase pH values by employing natural alkali sources (i.e., HCO3- and CO32-) from four tested agro-ashes as an alternative to chemicals (i.e., lime or soda ash). The considerable proportion of carbonates and bicarbonates in the investigated ash products had remarkable features, making them viable resources. All ash materials showed a significant ability for Ca ion elimination at high initial Ca ion concentrations. A slight quantity of ash (10 g/L) was sufficient for usage on very hard water contents up to 3000 ppm. Finally, the tested agro-ash was free of cost. Furthermore, unlike other conventional precipitants, such as NaOH, Ca(OH)2, NaHCO3, Na2CO3, and CaO, they are cost effective and ecologically sustainable. There is no need to employ any additional chemicals or modify the agro-ash materials throughout the treatment process. The benefits of the manufactured ash were assessed using a SWOT analysis.

The 2019-2023 Strategic Plan of the Spanish Society of Radiological Protection (SEPR).

The Spanish Society for Radiological Protection (SEPR) is a scientific and technical organization that aims to bring together all radioprotection professionals from all the sectors of activity where ionizing and non-ionizing radiation is produced. The development of the SEPR's Strategic Plan every 5 years is the cornerstone of all the different activities that the Society carries out. This document establishes the SEPR goals and objectives for that period, as well as the activities planned to achieve them. It is a living and open document that draws on past experiences while looking to the future. The Strategic Plan 2019-2023, approved on June 2019, is the Third Strategic Plan of the SEPR. In its preparation, account has been taken of the experience obtained in the application of the two previous Strategic Plans, as well as of the new demands of the general public and of professionals in the area of radiological protection that have become apparent during the previous period. This paper describes the development of the current Strategic Plan, as well as the Plan itself, and briefly analyzes its implementation in the Conclusion.

Status of ecotourism in Nepal: a case of Bhadaure-Tamagi village of Panchase area.

This study was conducted with an aim to assess the status of ecotourism in terms of tourism demand, tourist characteristics, and strength, weakness, opportunity, and threat (SWOT) analysis. For this, the study was conducted in Bhadaure-Tamagi village of the Panchase Protected Forest Area of Gandaki Province, which was planned to be developed as an important tourist destination for tourists visiting Pokhara because of its cultural and natural importance. Mixed-method research approach was implemented in this research for data collection and analysis. One hundred and twenty-two tourism stakeholders (30 hoteliers, 40 homestay owners, and 52 tourists) were surveyed for quantitative data collection and analysis along with seven key informant interviews (KII) for qualitative data collection and analysis. It was observed that the current demand for accommodation facilities in the Bhadaure-Tamagi village was 23,390 bed nights per annum. The tourism demand in terms of tourism revenues estimated through this study amounted to a total of US$10,763.67 per year. The occupancy rate of accommodation facilities at Bhadaure-Tamagi village was a mere 20%, which is well below the national and international average. Despite outstanding ecotourism opportunities and a necessary regulatory framework in place, the SWOT analysis revealed that the tourism sector development is not satisfactory. In the current situation, Coronavirus disease (COVID-19) had adversely affected the ecotourism in the area. So, tourism promotional activities need to be focused by following appropriate health, hygiene, and safety measures.

Cryopreservation in reproductive medicine during the COVID-19 pandemic: rethinking policies and European safety regulations.

Cryopreservation of reproductive cells and tissues represents an essential aspect of ART practices that might be particularly strategic and helpful during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergency. However, recommendations on how and when to preserve reproductive tissues and cells during a novel severe pandemic are scanty. This article uses a SWOT (strengths, weaknesses, opportunities and threats) analysis to identify favourable and unfavourable factors and to recognize challenges and obstacles related to the use of cryopreservation procedures during the spreading of a new virus. One of the strengths associated with the cryopreservation is represented by the availability of robust European guidelines on storage safety to prevent sample contamination or cross-contamination by pathogens. These recommendations should be deep-rooted in all ART laboratories. Weaknesses include uncertainties regarding the management of COVID-19 affected asymptomatic patients, the suboptimal accuracy of diagnostic tests for the disease, the nebulous prospective regarding the duration of the pandemic and the additional costs. The application of the strategy represents an opportunity to postpone pregnancy in order to avoid a severe infectious disease during gestation while concomitantly counteracting the possible detrimental effect of time. Critical threats, at present still undefined, are represented by potential adverse events for the mother and offspring due to infected gametes or embryos after thawing and, subsequently, the re-spreading of the virus.

The Program Evaluation Committee in the Adult Cardiothoracic Anesthesiology Fellowship - Harnessing Opportunities for Program Improvement.

The Program Evaluation Committee has an essential role in the quality improvement process of the adult cardiothoracic anesthesiology fellowship. The annual program evaluation presents all stakeholders with an opportunity to evolve with the changing needs and opportunities of the fellowship milieu. The active engagement of the program in this process is a high-quality approach to successful planning, preparation and conduct of the self-study and site visit that are important extensions of the annual program evaluation and the program evaluation committee.

The burden of chronic diseases across Europe: what policies and programs to address diabetes? A SWOT analysis.

BACKGROUND: Promoting the well-being at all ages and reducing premature mortality from non-communicable diseases (NCDs) is a major target of the Sustainable Development Goals. In the frame of the JA-CHRODIS, a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis was conducted to provide different countries' insights on what makes a policy/programme addressing NCDs applicable, sustainable and effective, with a focus on diabetes. METHODS: A qualitative study has been performed using a SWOT analysis on policies/programmes at the national/federal or subnational level. RESULTS: By March 2016, 14 SWOTs were conducted involving 11 European countries and 57 stakeholders and Ministries of Health, reporting and analysing a total of 44 policies. The main strengths, weaknesses, opportunities and threats have been outlined as well as and the main areas for governance improvement. A binding trans-sectoral approach is necessary to tackle the underlying risk factors of inequalities. The culture of disease prevention and health promotion is still low while the biomedical paradigm prevails. A systematic gender perspective is still missing. Sharing and exchange of best practices, as sponsored by the European Commission, is acting as a motivator. CONCLUSION: The SWOT analyses draw an overall picture of the complexity of designing and implementing good policies and programmes that are tailored to local needs. These results may apply to any context and can be used by decision-makers, managers, professionals and other stakeholders to focus on key issues, recognising areas for attention.