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Medicine shortages have a detrimental impact on stakeholders in the pharmaceutical supply chain (PSC). Existing studies suggest that building resilience strategies can mitigate the effects of these shortages. As such, this research aims to examine whether resilience strategies can reduce the impact of medicine shortages in the United Kingdom's (UK) PSC.

A sequential mixed-methods approach that involved qualitative and quantitative research enquiry was employed in this study. The data were collected using semi-structured interviews with 23 key UK PSC actors at the qualitative stage. During the quantitative phase, 106 respondents completed the survey questionnaires. The data were analysed using partial least square-structural equation modelling (PLS-SEM).

The results revealed that reactive and proactive elements of resilience strategies helped tackle medicine shortages. Reactive strategies increased relational issues such as behavioural uncertainty, whilst proactive strategies mitigated them.

The findings suggest that PSC managers and decision-makers can benefit from adopting structural flexibility and proactive strategies, which are cost-effective measures to tackle medicine shortages. Also engaging in strategic alliances as a proactive strategy mitigates relational issues that may arise in a complex supply chain (SC).

This study is the first to provide empirical evidence of the impact of resilience strategies in mitigating medicine shortages in the UK's PSC.

This study aims to determine the factors and dynamic systems behaviour of essential medicine stockout in public health-care supply chains. The authors examine the constraints and effects of mental models on medicine stockout to develop a dynamic theory of medicine availability towards saving patients’ lives.

This study uses a mixed-method approach. Starting with a survey method, followed by in-depth interviews with stakeholders within five health-care supply chains to determine the dynamic feedback leading to stockout and conclude by developing a network mental model for medicines availability.

The authors identified five constraints and developed five case mental models. The authors develop a dynamic theory of medicine availability across cases and identify feedback loops and variables leading to medicine availability.

The need to include mental models of stakeholders like manufacturers and distributors of medicines to understand the system completely. Group surveys are prone to power dynamics and bias from group thinking. This survey’s quantitative output could minimize the bias.

This study uniquely uses a mixed-method of survey method and in-depth interviews of experts to assess the essential medicine stockout in Nigeria. To improve medicine availability, the authors develop a dynamic network mental model to understand the system structure, feedback and behaviour driving stockouts. This research will benefit public policymakers and hospital managers in designing policies that reduce medicine stockout.

This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked.

The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title.

A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively.

In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.

In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

Many psychiatrists and trainees in Aotearoa New Zealand used telepsychiatry during COVID-19 lockdowns, despite minimal experience and training in the area. Research on a culturally safe telepsychiatry framework is lacking in Aotearoa. This study aims to provide a better understanding of telepsychiatry in the Aotearoa context and identify potential gaps with the current practice, with a focus on exploring telepsychiatry use with Maori, Pacific peoples and Asians.

This qualitative study was guided by the principles of the Kaupapa Maori methodology and the “Give Way Rule” from Pan-Pacific studies, to ensure culturally appropriate analysis and outcomes. Semi-structured interviews were conducted with a sample of psychiatrists and trainees recruited from Aotearoa members of the Royal Australian and New Zealand College of Psychiatrists. The qualitative data were then analysed using general inductive thematic analysis to identify the major themes.

In total, 18 participants were interviewed. Three key themes were identified: cultural safety such as preparation for a telepsychiatry session, cultural practices and equity issues; clinical practice such as continuity of care, patient selection and limitations; and process of running a telepsychiatry service.

The analysis of the main themes gives both practical ideas for providing a culturally safe telepsychiatry appointment, as well as a wider base for developing a telepsychiatry service that works particularly for Maori, Pacific and Asians mental health users. Issues around resources and expertise in the field are lacking and further frameworks to support infrastructure and training are needed.

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

Illicit drug use is a well-known global problem that has been noticed to be increased significantly among medical students. This study aims to assess the prevalence and consequences of illicit drug use among medical students in the country of Jordan using the validated Drug Abuse Screening Test-10 (DAST-10).

The authors used a cross-sectional, descriptive design to conduct this study. A total of 2,104 participants from six medical schools were included. A structured online-based English self-administered questionnaire was used for data collection.

Out of 2,104 included participants, 242 (11.5%) reported using illicit drugs in the past year. More than three-quarters (77%) of the drug users suffer from various degrees of problems related to drug use, ranging from risky (41%) to severe risk (6%). Drug use was found to be associated with gender, planned specialty and exposure to psychiatry training.

The cross-sectional design prevents from drawing cause-and-effect relationships and confirming how the tendency toward substance use is affected by the psychological state, sleep quality and exposure to psychiatry. Also, although it is important to measure the subjective observation of distress and sleep, objective estimates of psychological distress and sleep including actigraphy and sleep diary could be helpful to strengthen the findings. Also using an online survey with convenience sampling are some inevitable limitations with the present COVID-19 restrictions. Also, the nature of DAST-10 closed-ended questions precluded from accurately exploring the consequences of substance abuse.

Appropriate screening to identify medical students at risk for substance abuse and provide them with treatment referrals are strongly recommended in this study. In addition, medical schools should provide a comfortable environment that encourages a healthy lifestyle with a responsible attitude toward using drugs.

There is a dearth of information about illicit drug use among medical students, especially in the country of Jordan. The nature of their studies, the different stresses they experience and the impact imposed by other factors such as sociocultural all are likely to make medical students more susceptible to drug abuse. To the best of the authors’ knowledge, this is the first cross-national study of its kind in Jordan with a representative sample of 2,104 participants. We assessed the prevalence and consequences of self-reported illicit drug use and the sleep quality of medical students from all schools of medicine in Jordan.

The purpose of the paper is to showcase the significant achievements of Egypt's scientists in the 20th century across various fields of study such as medicine, physics, chemistry, biology, math, geology, astronomy and engineering. The paper highlights the struggles and successes of these scientists, as well as the cultural, social and political factors that influenced their lives and work. The aim is to inspire young people to pursue careers in science and make their own contributions to society by presenting these scientists as role models for hard work and dedication. Ultimately, the paper seeks to promote the importance of science and its impact on society.

The purpose of this review is to present the scientific biographies of Egypt's most distinguished scientists, primarily in the field of Natural Sciences, in a balanced and comprehensive manner. The work is objective, honest and abstract, avoiding any bias or exaggeration. The author provides a clear and concise methodology, including a brief introduction to the scientist and their field of study, an explanation of their major contributions, the impact of their work on society, any challenges or obstacles faced during their career and their lasting legacy. The aim is to showcase the important achievements of these scientists, their impact on their respective fields and to inspire future generations to pursue scientific careers.

The group of outstanding scientists in 20th century Egypt were shaped by various factors, including familial upbringing, education, society, political and cultural atmosphere and state support for scientific research. These scientists made significant contributions to various academic disciplines, including medicine, physics, chemistry, biology, mathematics and engineering. Their impact on their communities and cultures has received international acclaim, making them role models for future generations of scientists and researchers. The history of these scientists highlights the importance of educational investments and supporting scientific research to foster innovation and social progress. The encyclopedia serves as a useful tool for students, instructors and education professionals, preserving Egypt's scientific heritage and honouring the scientists' outstanding accomplishments.

The encyclopedia preserves Egypt's scientific heritage, which has been overlooked for political or other reasons. It is a useful tool for a variety of readers, including students, instructors and education professionals, and it offers insights into universally relevant scientific success factors as well as scientific research methodologies. The encyclopedia honours the outstanding scientific accomplishments of Egyptian researchers and their contributions to the world's scientific community.

The practical implications of this paper are several. First, it highlights the importance of education, family upbringing and societal support for scientific research in fostering innovation and social progress. Second, it underscores the need for continued funding and support for scientific research to maintain and build upon the accomplishments of past generations of scientists. Third, it encourages young people to pursue scientific careers and make their own contributions to society. Fourth, it preserves the scientific heritage of Egypt and honors the contributions of its outstanding scientists. Finally, it serves as a useful tool for students, instructors and education professionals seeking to understand the factors underlying scientific success and research methodologies.

The social implications of the paper include promoting national pride and cultural identity, raising awareness of the importance of education and scientific research in driving social progress, inspiring future generations of scientists and researchers, reducing socioeconomic disparities and emphasizing the role of society, politics and culture in shaping scientific researchers' personalities and interests.

The paper's originality/value lies in its comprehensive documentation of the scientific biographies of Egypt's most prominent scientists in the 20th century, providing unique insights into the factors that contributed to their development and their impact across various academic disciplines. It preserves Egypt's scientific heritage and inspires future generations of scientists and researchers through the promotion of educational investments and scientific research. The encyclopedia serves as a useful tool for education professionals seeking to understand scientific success factors and research methodologies, emphasizing the importance of supportive and inclusive environments for scientific development.

The purpose of this paper is to illuminate the ethical concerns associated with the use of artificial intelligence (AI) in the medical sector and to provide solutions that allow deriving maximum benefits from this technology without compromising ethical principles.

This paper provides a comprehensive overview of AI in medicine, exploring its technical capabilities, practical applications, and ethical implications. Based on our expertise, we offer insights from both technical and practical perspectives.

The study identifies several advantages of AI in medicine, including its ability to improve diagnostic accuracy, enhance surgical outcomes, and optimize healthcare delivery. However, there are pending ethical issues such as algorithmic bias, lack of transparency, data privacy issues, and the potential for AI to deskill healthcare professionals and erode humanistic values in patient care. Therefore, it is important to address these issues as promptly as possible to make sure that we benefit from the AI’s implementation without causing any serious drawbacks.

This paper gains its value from the combined practical experience of Professor Elhassan gained through his practice at top hospitals worldwide, and the theoretical expertise of Dr. Arabi acquired from international institutes. The shared experiences of the authors provide valuable insights that are beneficial for raising awareness and guiding action in addressing the ethical concerns associated with the integration of artificial intelligence in medicine.

The purpose of this paper is to report on the dynamics of “identity leadership” with a quality improvement project undertaken by an International Medical Graduate (IMG) from Sri Lanka, on a two year Medical Training Initiative (MTI) placement in the National Health Service (NHS) [Academy of Medical Royal Colleges (AoMRC), 2017]. A combined MTI rotation with an integrated Fellowship in Quality Improvement (Subedi et al., 2019) provided the driver to implement the HEART score (HS) in an NHS Emergency Department (ED) in the UK. The project was undertaken across ED, Acute Medicine and Cardiology at the hospital, with stakeholders emphasizing different and conflicting priorities to improve the pathway for chest pain patients.

A social identity approach to leadership provided a framework to understand the insider/outsider approach to leadership which helped RH to negotiate and navigate the conflicting priorities from each departments’ perspective. A staff survey tool was undertaken to identify reasons for the lack of implementation of a clinical protocol for chest pain patients, specifically with reference to the use of the HS. A consensus was reached to develop and implement the pathway for multi-disciplinary use of the HS and a quality improvement methodology (with the use of plan do study act (PDSA) cycles) was used over a period of nine months.

The results demonstrated significant improvements in the reduction (60%) of waiting time by chronic chest pain patients in the ED. The use of the HS as a stratified risk assessment tool resulted in a more efficient and safe way to manage patients. There are specific leadership challenges faced by an MTI doctor when they arrive in the NHS, as the MTI doctor is considered an outsider to the NHS, with reduced influence. Drawing upon the Social Identity Theory of Leadership, NHS Trusts can introduce inclusion strategies to enable greater alignment in social identity with doctors from overseas.

More than one third of doctors (40%) in the English NHS are IMGs and identify as black and minority ethnic (GMC, 2019a) a trend that sees no sign of abating as the NHS continues its international medical workforce recruitment strategy for its survival (NHS England, 2019; Beech et al., 2019). IMGs can provide significant value to improving the NHS using skills developed from their own health-care system. This paper recommends a need for reciprocal learning from low to medium income countries by UK doctors to encourage the development of an inclusive global medical social identity.

This quality improvement research combined with identity leadership provides new insights into how overseas doctors can successfully lead sustainable improvement across different departments within one hospital in the NHS.