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This paper links supply chain risk management to medicine supply chains to explore the role of policymakers in employing supply chain risk management strategies (SCRMS) to reduce generic medicine shortages.

Using secondary data supplemented with primary data, the authors map and compare seven countries' SCRMS for handling shortage risks in their paracetamol supply chains before and during the first two waves of the COVID-19 pandemic.

Consistent with recent research, the study finds that policymakers had implemented few SCRMS specifically for responding to disruptions caused by COVID-19. However, shortages were largely avoided since multiple strategies for coping with business-as-usual disruptions had been implemented prior to the pandemic. The authors did find that SCRMS implemented during COVID-19 were not always aligned with those implemented pre-pandemic. The authors also found that policymakers played both direct and indirect roles.

Combining longitudinal secondary data with interviews sheds light on how, regardless of the level of preparedness during normal times, SCRMS can be leveraged to avert shortages in abnormal times. However, the problem is highly complex, which warrants further research.

Supply chain professionals and policymakers in the healthcare sector can use the findings when developing preparedness and response plans.

The insights developed can help policymakers improve the availability of high-volume generic medicines in (ab)normal times.

The authors contribute to prior SCRM research in two ways. First, the authors operationalize SCRMS in the medicine supply chain context in (ab)normal times, thereby opening avenues for future research on SCRM in this context. Second, the authors develop insights on the role policymakers play and how they directly implement and indirectly influence the adoption of SCRMS. Based on the study findings, the authors develop a framework that captures the diverse roles of policymakers in SCRM.

This paper addresses access to formal health care among Cape Verdean immigrants in the Netherlands, and their transnational health‐seeking process in other European countries. Three barriers hindering Cape Verdeans' access to care have been identified: lack of information about the health services available, problems in the relationship with health providers and difficulties in dealing with the conditionality of help. These problems are deeply intertwined, and relate to two sets of factors. At the macro‐level these include the organisational and structural characteristics of the Dutch health care system. At the micro‐level, the problems concern the mismatch between users' and providers' expectations of health care provision.Despite the barriers encountered, Cape Verdeans strive to benefit from good health. The informants in this study employ two sorts of strategy to access good health care. On the one hand, they try to adapt their help‐seeking behaviour to the model prevalent in the Netherlands. On the other, they resort to transnational health care use in other European countries, including Portugal and France. These strategies prove Cape Verdeans' resilience in finding the care that is most appropriate to their needs.

Research investigating the experience and management of pain in people with intellectual disabilities has mainly been carried out in community services. The purpose of this baseline audit aims to examine this area in a forensic intellectual disability setting.

A baseline audit of pain management was carried out. Audit standards were derived from recent research, and the performance on each measured. Patients and nurses were interviewed. The audit included 82 patients, of which 64 were interviewed. Twelve nurses were interviewed. Health Action Plans and medication files were accessed for information.

There were interesting differences and similarities in the experience and management of pain between community and forensic intellectual disability patients. Within this sample, most patients were able to communicate their pain, and access appropriate treatment. However, a minority required further support. Nurse decision making about providing pain treatment was affected by fears of manipulation, contributing to addition and disbelieving the patient. Additionally, a number of patients appeared to have insufficient knowledge about how to best manage pain.

Results suggested that a standardised approach to pain management, incorporating policy, staff training, and health promotion and psycho-education for patients, would have benefits for both patients and staff within secure intellectual disability services.

At present, there is little research focusing on pain experience and management in forensic intellectual disability settings.

Rosemary Albinson, a staff scientist with Cambridge Consultants Ltd, discusses how biosensors are best developed and commercially exploited.

The study aimed to listen to refugee survivors of sexual and gender-based violence (SGBV) and/or torture and explore what justice meant to them in exile. This study argues that what the survivors who participated in this research wanted was “viable justice”. The research was funded by the British Academy and Leverhulme Trust.

Using a survivor-focussed justice lens combined with a trauma-informed approach, narrative interviews were held with 41 women and 20 men refugee survivors living in refugee settlements in Northern Uganda. The researchers also conducted semi-structured interviews with 37 key informants including refugee welfare councils, the UN, civil society, non-government and government organisations. Thematic analysis of the data resulted in the following themes being identified: no hope of formal justice for atrocities that occurred in South Sudan; insecurity; lack of confidence in transitional justice processes in Ugandan refugee settlements; abuse and loss of freedom in refugee settlements; and lack of access to health and justice services in refugee settlements.

This study argues that what the survivors who participated in this research wanted was “viable justice”. That is justice that is survivor-centred and includes elements of traditional and transitional justice, underpinned by social justice. By including the voices of both men and women survivors of SGBV and/or torture and getting the views of service providers and other stakeholders, this paper offers an alternative form of justice to the internationally accepted types of justice, which offer little relevance or restitution to refugees, particularly where the crime has been committed in a different country and where there is little chance that perpetrators will be prosecuted in a formal court of law.

The research findings are based on a small sample of South Sudanese refugees living in three refugee settlements in Northern Uganda. Thus, wider conclusions should not be drawn. However, the research does suggest that a “viable justice” approach should be implemented that is gender and culturally sensitive and which could also be trialled in different refugee contexts.

Improvements in refugee survivors’ dignity, resilience and recovery are dependent upon the active engagement of refugees themselves using a “survivor-focussed approach” which combines formal and community-based health services with traditional and transitional justice responses.

The provision of a “viable justice approach” ensures those who have experienced SGBV and/or torture, and their families, feel validated. It will assist them to use their internal, cultural and traditional resilience and agency in the process of recovery.

The research findings are original in that data was collected from men and women survivors of SGBV and/or torture and service providers. The empirical evidence supports this study’s recommendation for an approach that combines both formal and survivor-focussed approaches towards health and viable justice services to meet the needs of refugees living in refugee settlements. This is a response that listens to and responds to the needs of refugee survivors in a way that continues to build their resilience and agency and restores their dignity.

This review provides an overview of recent advances in electrochemical sensors for analyte detection in saliva, highlighting their potential applications in diagnostics and health care. The purpose of this paper is to summarize the current state of the field, identify challenges and limitations and discuss future prospects for the development of saliva-based electrochemical sensors.

The paper reviews relevant literature and research articles to examine the latest developments in electrochemical sensing technologies for saliva analysis. It explores the use of various electrode materials, including carbon nanomaterial, metal nanoparticles and conducting polymers, as well as the integration of microfluidics, lab-on-a-chip (LOC) devices and wearable/implantable technologies. The design and fabrication methodologies used in these sensors are discussed, along with sample preparation techniques and biorecognition elements for enhancing sensor performance.

Electrochemical sensors for salivary analyte detection have demonstrated excellent potential for noninvasive, rapid and cost-effective diagnostics. Recent advancements have resulted in improved sensor selectivity, stability, sensitivity and compatibility with complex saliva samples. Integration with microfluidics and LOC technologies has shown promise in enhancing sensor efficiency and accuracy. In addition, wearable and implantable sensors enable continuous, real-time monitoring of salivary analytes, opening new avenues for personalized health care and disease management.

This review presents an up-to-date overview of electrochemical sensors for analyte detection in saliva, offering insights into their design, fabrication and performance. It highlights the originality and value of integrating electrochemical sensing with microfluidics, wearable/implantable technologies and point-of-care testing platforms. The review also identifies challenges and limitations, such as interference from other saliva components and the need for improved stability and reproducibility. Future prospects include the development of novel microfluidic devices, advanced materials and user-friendly diagnostic devices to unlock the full potential of saliva-based electrochemical sensing in clinical practice.

This paper aims to explore the role of tramadol in pain management and the impact of regulatory measures on supply and medical access in Ghana and other African countries.

The study adopted an exploratory design and qualitative methods to explore the perspectives of different actors, including officials of regulatory agencies, law enforcement agents, health-care providers and non-medical tramadol users. Data were collected through individual and group interviews, and transcripts were subjected to thematic analysis.

Findings show that tramadol fills a critical gap in treating pain across Ghana in areas with an acute shortage of opioid analgesics due to scheduling-related barriers. This was partly due to porous borders allowing for an influx of tramadol into the countries. The study further found that most tramadol purchases in Ghana and other West African countries were made from market traders rather than from health-care settings and were mainly generic medicines categorised as “substandard/spurious/falsely-labelled/falsified/counterfeit medical products” within the World Health Organization standards.

Although the findings are instructive, there were some limitations worth noting. The study encountered several limitations, especially with the non-medical users, because the environment is highly criminalised, People who use drugs were unwilling to avail themselves for fear of law enforcement officers’ harassment. Obtaining ethical clearance had its own bureaucracy – challenges that delayed the study time frame.

Placing tramadol under the list of internationally controlled substances would create barriers to access to effective pain medications, particularly by the poor, and encourage victimisation of users by law enforcement authorities.

The study is based on empirical research on tramadol use and regulation in African countries, contributing to knowledge in an under-researched subject area on the continent. The comparative approach further adds value to the research.