Disruptions, recovery strategies and the pharmaceutical supply chain; empirical evidence from first tier customers in the United Kingdom

yesPurpose: The aim of this research therefore is to explore the causes of drug shortages within the pharmaceutical supply chain and assess the adopted mitigation strategies. Research Approach: The study is carried out from an inductive perspective where we seek to understand the phenomenon by a detailed review of extant literature followed by a series of semi-structured interviews with first tier consumers within a case study framework. The respondents were chosen using purposive sampling as those best to comment on the phenomenon under scrutiny. Data was analysed using thematic analysis, where a dual focus was adopted; 1) the preliminary focus was on the identification of system themes (where the system was impacted and the responds e.g. complexity, disruptions and product alternatives) and 2) the secondary focus was the impact on the patient as system recipient and product user (where themes such as stress, anxiety, and adverse drug reactions emerged). Findings and Originality: The analysis show that drug shortages within the pharmaceutical supply chain in the UK occur as a result of stringent regulatory frameworks, faults in the manufacturing processes, lack of Active Pharmaceutical Ingredients, monopolistic wholesaler markets; lack of information dissemination, offshore trading and price manipulations for profit. The impact on the consumers is reported to be extensive and can endure long after the disruptive event occurs. The findings indicate that existing recovery strategies are however cumbersome, add complexity to the supply chain and in extreme cases facilitate the infiltration of counterfeits. The study is innovative as it explores disruptive events and associated recovery strategies which have not been adequately addressed in supply chain management studies to date. Research Impact: This research contributes to existing literature by extending discussions on supply chain disruptions within a dynamic supply chain whilst focusing on product service supply chain recovery strategies and mechanisms. Practical Impact: This study provides Operations/Supply Chain Managers and Pharmaceutical companies and professionals with strategies that can be adopted can adopt in reducing and recovering in a more resilient manner to disruptive events. This thus presents the bedrock for resilient practice and systems design and development, thus reducing system vulnerability and ultimately leading to improved product availability and patient care

Discursive Narrative Analysis: A Study of Online Autobiographical Accounts of Self-Injury

This article offers an innovation in narrative analysis afforded by incorporating analytic concepts from discourse analysis. We share some examples from our study of online autobiographical accounts of non - suicidal self - injury (NSSI) to illustrate the various aspects of a discursive narrative approach to research. We show how the participants construct events and experiences as sequentially linked and temporarily related using a range of discursive practices and devices, including producing contrasting descriptions of emotional states, using figurative language, vivid or vague descriptions, and extreme case formulations. The specific way in which experience was constituted as sequentially and causally linked allows narrators to attribute relief from suffering to NSSI and to present NSSI as a reasonable and justifiable behavior to those who may read these autobiographies. This study offers insight into what may be missed when interpretation is focused solely on the content or broad structural elements of stories, as in much narrative analysis, and suggests the critical role of narrators’ social or interactive orientation and their reliance on the micro - details of language in the construction of stories. Methodological and theoretical implications are discusse

Crossed Module Bundle Gerbes; Classification, String Group and Differential Geometry

We discuss nonabelian bundle gerbes and their differential geometry using simplicial methods. Associated to any crossed module there is a simplicial group NC, the nerve of the 1-category defined by the crossed module and its geometric realization |NC|. Equivalence classes of principal bundles with structure group |NC| are shown to be one-to-one with stable equivalence classes of what we call crossed module gerbes bundle gerbes. We can also associate to a crossed module a 2-category C'. Then there are two equivalent ways how to view classifying spaces of NC-bundles and hence of |NC|-bundles and crossed module bundle gerbes. We can either apply the W-construction to NC or take the nerve of the 2-category C'. We discuss the string group and string structures from this point of view. Also a simplicial principal bundle can be equipped with a simplicial connection and a B-field. It is shown how in the case of a simplicial principal NC-bundle these simplicial objects give the bundle gerbe connection and the bundle gerbe B-field

Energy Transition Dynamics; Understanding Policy Resistance in the Dutch Energy System

Contains fulltext : 127511pre.pdf (preprint version ) (Open Access)Various countries seek to establish an energy transition, a structural change towards a more sustainable energy system. Countries implement a combination of energy policies aimed at establishing an energy transition, but these policies frequently result in unintended negative consequences. This study provides an attempt to unravel the complexity of the Dutch energy transition. We present a model of the Dutch energy transition, showing its various components and their interrelations. The model is based on eight group model building workshops in which a total of 96 stakeholders in the Dutch energy transition participated. In each workshop, a variety of stakeholders engaged in the collaborative construction of a model that explains the current progress of the energy transition. In this paper, we aggregate these eight models into one overarching model, which we lay out step by step. The model shows how technological, ecological, social, economic, and political aspects of the energy transition influence each other either directly or indirectly. We discuss several policy implications, with a focus on reducing unintended negative consequences.32nd International Conference of the System Dynamics Societ