Examining the relationship between chain governance structures and chain performance : an empirical evidence of the dairy sector

Purpose: The purpose of this study is to analyze the influence of chain governance on chain performance among the chain members. Design/methodology/approach: The survey was conducted in a triadic context with 345 chain members (115 dairy farmers, 115 dairy cooperative managers and 115 processors) of the dairy sector in Uganda. Data collection was performed through simple random sampling by survey questionnaires with the chain executives. SEM was used for data analysis. Findings: The results revealed several chain governance structures (spot market, relational, contractual and mini integration) some confirmed the hypothesized correlations on chain performance at different chain levels. We found a positive influence of relational governance on chain performance for all the chain members, however, the effect is stronger at the first supplier chain level. Originality/value: This triadic chain approach makes an original contribution to the chain governance structures and chain performance literature. Studies analyzing all aspects of CGS and CP at three tire chain level are limited

Examining the relationship between chain governance structures and chain performance : an empirical evidence of the dairy sector

Purpose: The purpose of this paper is to analyze the influence of chain governance on chain performance among the chain members. Design/methodology/approach: The survey was conducted in a triadic context with 345 chain members (115 dairy farmers, 115 dairy cooperative managers, and 115 processors) of the dairy sector in Uganda. Data collection was performed through simple random sampling by survey questionnaires with the chain executives. SEM was used for data analysis. Findings: The results revealed several chain governance structures (spot market, relational, contractual and mini integration) confirmed the hypothesized correlations on chain performance at different chain levels. The authors found a positive influence of relational governance on chain performance for all the chain members; however, the effect is stronger at the first supplier chain level. Originality/value: This triadic chain approach makes an original contribution to the chain governance structures and chain performance literature in the supply chain context. Studies analyzing all aspects of chain governance structure and chain performance at three chain levels are limited

Editorial: Transformative food value chains for local development

Peer Reviewe

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

22 Years of Governance Structures and Performance: What Has Been Achieved in Agrifood Chains and Beyond? A Review

Although the existing literature has shown that the choice of governance structure plays a key role in inter-organizational performance, the nature of construct measurability still remains equivocal. The diversity of terminologies used means that the full potential of most studies may be lost in the confusion of indistinctive and misapplied terms. To better understand the relationship between governance structures and performance, a descriptive systematic review was conducted on the extant literature; essentially, to provide a comprehensive point of reference for researchers interested in this research area and to identify future research gaps. A simple analytical framework&mdash;Search, Appraisal, and Synthesis&mdash;was used to extract data. A total of 110 peer-reviewed journal articles were identified and analyzed. The results indicated that different governance structures are positively related to performance except for the spot market. The findings provide strong evidence that under certain circumstances, the contractual governance structure is negatively related to performance. Whereas in other circumstances, there is a positive interaction. Furthermore, the results revealed that numerous proxy indicators have been used to measure governance structures and performance. Overall, this study provides new insights on the relationship between governance structures and performance in the agrifood sector and beyond. The contribution of the study, implications, and suggestions for future research outlook are discussed in relation to governance structures and performance

Measuring chain performance beyond supplier–buyer relationships in agri-food chains

Purpose: Measuring chain performance which extends beyond supplier–buyer interface is of paramount importance in tracking and tracing the ineffectiveness and inefficiency of the entire chain. In response to chain inefficiencies, key performance indicators need to be assessed at different chain levels. Knowledge amongst chain members and evident research on the chain members’ assessment of the chain partners’ contribution to their individual chain performance is equivocal. The purpose of this study is to investigate perceived performance contribution of bilateral relationships of each chain member to its chain partners’ performance across the dairy sector. Design/methodology/approach: The research was conducted in a dairy agri-food sector in Uganda. A total of 115 triad chains (three matching chain members) were obtained during the period of January to April 2016. Using simple random sampling, the dairy farmers (first suppliers), the cooperative supply managers (second suppliers) and the processors (buyers) were surveyed. Means and standard deviations presented descriptive findings. Furthermore, Kruskal–Wallis and Mann–Whitney U tests were used to assess the differences and similarities of the perceived performance contribution of the individual chain partners. Findings: The results revealed that each chain members’ perception of chain performance contribution toward the individual chain performance is relatively high. Further, it was found that there were significant differences between the chain members about the perceived chain performance contributions. However, within the internal chain analysis, no significant differences were observed. Research limitations/implications: Although limited to a single agri-food sector within the Ugandan dairy sector, the findings support evidence from similar agri-food chains worldwide. Originality/value: Literature shows shortcomings in measuring chain performance at three chain levels. Therefore, this shift from single or dyad to triad chain analysis provides new insights into the field of agri-food chains and supply chain performance in particular. It also provides important empirical results on how each chain member contributes to the chain partners’ performance.</p