scholarly journals Looking Beyond the Provision of Injecting Equipment to People Who Use Anabolic Androgenic Steroids: Harm Reduction and Behavior Change Goals for UK Policy

2021 ◽  
pp. 009145092199870
Author(s):  
Geoff Bates ◽  
Jim McVeigh ◽  
Conan Leavey
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Public Health Intervention ◽  
Anabolic Androgenic Steroids ◽  
Public Health Response ◽  
Health Response ◽  
Wide Range ◽  
Reduction Strategies ◽  
The Uk ◽  
Androgenic Steroids

Understanding of the choices and motivations of people who use anabolic androgenic steroids (AAS) for muscular enhancement has increased greatly in the past thirty years, along with understanding of a wide range of health harms associated with this form of drug use in the community. During this period the predominant public health intervention for this population in the UK has consistently remained the provision of injecting equipment to prevent blood borne virus (BBV) transmission. The study explored the health professionals’ and other stakeholders’ perceptions on: whether the current UK public health response is sufficient to address the needs of people who use AAS, and if not, what other needs they might have. This included an exploration of whether there were gaps in harm reduction strategies or other behavioral outcomes and interventions that were needed. Interviews with 27 stakeholders who provide support to people who use AAS in a variety of roles established consensus on the need for a range of interventions to reduce harm and risk in those that choose to use AAS, to prevent initiation, to motivate and support cessation, and to prevent relapse. Study findings indicate that while providing sterile injecting equipment remains essential, it should be considered a bare minimum. The challenge is to develop and deliver a range of harm reduction interventions that look beyond BBV prevention to provide appropriate support to who choose to use AAS at all points in their cycles of use and ultimately for those choosing the temporary or permanent cessation of use.

A tale of two epidemics: drugs harm reduction and tobacco harm reduction in the United Kingdom

2016 ◽  
Vol 16 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Gerry V. Stimson
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Tobacco Harm Reduction ◽  
Public Health Response ◽  
Content Type ◽  
Drug Of Choice ◽  
The United Kingdom ◽  
Health Response ◽  
Wide Range ◽  
Hiv Aids

Purpose The purpose of this paper is to compare the response to HIV/AIDS and drug use (drugs harm reduction) with tobacco harm reduction. Design/methodology/approach Analysis of historical and contemporary sources, combined with personal knowledge of key stakeholders in the history and development of both fields. Findings Both drugs harm reduction and tobacco harm reduction share a similar objective – to reduce health risks for people who are unwilling or unable to stop using their drug of choice. Both also share a broader public health aim of helping people to make healthier decisions. Drugs harm reduction – as a response to HIV/AIDS – included the adoption of a wide range of radical harm reduction interventions and was a public health success. It became an established part of the professional Public Health agenda. In contrast the Public Health response to e-cigarettes and tobacco harm reduction has ranged from the negative to the cautious. A recent Public Health England report is exceptional for its endorsement of e-cigarettes. Originality/value Highlights contradictions in Public Health responses to drugs and tobacco; and that public health interventions can be implemented without and despite the contribution of professional Public Health.

scholarly journals Event-Based Surveillance of Poisonings and Potentially Hazardous Exposures over 12 Months of the COVID-19 Pandemic

2021 ◽  
Vol 18 (21) ◽  
pp. 11133
Author(s):  
Meghan A. Cook ◽  
Nicholas Brooke
Keyword(s):  
Public Health ◽  
Information Service ◽  
Herbal Remedies ◽  
Public Health Response ◽  
International Media ◽  
Industrial Sites ◽  
Health Response ◽  
Media Reports ◽  
The Uk ◽  
Event Based

The COVID-19 pandemic has seen people and governments utilise an array of chemical and pharmaceutical substances in an attempt to prevent and treat COVID-19 infections. The Centre for Radiation, Chemicals and Environmental Hazards (CRCE) at Public Health England (PHE) routinely undertakes Event-Based Surveillance (EBS) to monitor public health threats and incidents related to chemicals and poisons. From April 2020, EBS functions were expanded to screen international media for potentially hazardous exposures associated with the COVID-19 pandemic. Media sources reported that poisons centres were experiencing increased enquiries associated with the use and misuse of household cleaners and alcohol-based hand sanitiser (HS). There were also media reports of people self-medicating with over-the-counter supplements and traditional or herbal remedies. Public figures who directly or indirectly facilitated misinformation were sometimes reported to be associated with changes in poisoning trends. Border closures were also believed to have been associated with increasingly toxic illicit drug supplies in Canada, and record numbers of opioid-related deaths were reported. In other countries, where the sale of alcohol was banned or limited, home-brewing and methanol-based supplies resulted in a number of fatalities. At least two chemical incidents also occurred at industrial sites in India, after sites were left unattended or were closed and reopened due to lockdown measures. Reports of poisoning identified in the international media were provided to the UK National Poisons Information Service (NPIS) and contributed to the UK COVID-19 public health response.

scholarly journals 4.C. Round table: Recovering from the COVID-19 Pandemic: Identifying and Acting Upon Lessons Learned

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Lessons Learned ◽  
European Countries ◽  
Scientific Uncertainty ◽  
Health Practice ◽  
Public Health Response ◽  
The Public ◽  
Health Response ◽  
Wide Range

Abstract   The COVID-19 pandemic has revealed many gaps and vulnerabilities in health systems and pandemic preparedness in European countries. It has also led to innovation and rapid improvements in certain elements of public health practice. One defining characteristic of the COVID-19 pandemic has been the rapid advance of scientific knowledge, accompanied by high degrees of scientific uncertainty. Each phase (or “wave”) of the pandemic has presented unique challenges. This workshop involves public health practitioners from multiple European countries. They will reflect upon some over-arching lessons learned through their experiences in the field, while also alluding to important innovations in public health that should be safeguarded for the future. The panellists will also discuss how lessons learned can be systematically identified and acted upon, through approaches such as after-action reviews (AARs), in order to optimise the public health response to the ongoing COVID-19 pandemic as well as to future ones. The panel discussion format of this workshop adds value to EUPHA 2021 participant through hearing, in a relatively informal format, the experiences from senior staff at national public health agencies from a variety of European countries and contexts. This approach keeps a coherence between speakers will also highlighting the unique challenges posed by specific national contexts. This workshop will also consider how processes such as AARs can be formalised to become routine aspects of public health practice. Particular attention will be paid to challenges and solutions that are similar across national boundaries. During the workshop, the moderator will ensure that the panelists responses are short and succinct. The final 15 minutes will be dedicated to questions from the audience. Speakers/Panelists Flavia Riccardo ISS, Rome, Italy Ute Rexroth RKI, Berlin, Germany Tanya Melillo Directorate of Health Promotion and Disease Prevention, MSIDA, Malta Mario Fafangel National Institute of Public Health, Ljubljana, Slovenia Key messages In order to guide the public health response to the COVID-19 pandemic as well as to future pandemics, it is essential to systematically identify lessons learned as well as innovative good practices. Identifying lessons learned, however, is only a first step as it is essential to develop action plans that are supported and endorsed across a wide range of stakeholders.

scholarly journals Oral fluid testing facilitates understanding of hepatitis A virus household transmission

2019 ◽  
Vol 147 ◽  
Author(s):  
Becky Haywood ◽  
Richard S. Tedder ◽  
Kazim Beebeejaun ◽  
Koye Balogun ◽  
Sema Mandal ◽  
...  
Keyword(s):  
Public Health ◽  
Hepatitis A ◽  
Oral Fluid ◽  
Hepatitis A Virus ◽  
Public Health Intervention ◽  
Immunoglobulin M ◽  
Public Health Response ◽  
Recent Infection ◽  
Household Transmission ◽  
Health Response

AbstractThe public health response to sporadic hepatitis A virus (HAV) infection, hepatitis A, can be complex especially when the index case is a child and no obvious source is identified. Identifying an infection source may avoid mass immunisation within schools when transmission is found to have occurred within the household. Screening of asymptomatic contacts via venepuncture can be challenging and unacceptable, as a result non-invasive methods may facilitate public health intervention. Enzyme-linked immunoassays were developed to detect HAV immunoglobulin M (IgM) and immunoglobulin G (IgG) in oral fluid (ORF). A validation panel of ORF samples from 30 confirmed acute HAV infections were all reactive for HAV IgM and IgG when tested. A panel of 40 ORF samples from persons known to have been uninfected were all unreactive. Two hundred and eighty household contacts of 72 index cases were screened by ORF to identify HAV transmission within the family and factors associated with household transmission. Almost half of households (35/72) revealed evidence of recent infection, which was significantly associated with the presence of children ⩽11 years of age (odds ratio 9.84, 95% confidence interval: 2.74–35.37). These HAV IgM and IgG immunoassays are easy to perform, rapid and sensitive and have been integrated into national guidance on the management of hepatitis A cases.

scholarly journals COVID-19 pandemic and its impact on social relationships and health

2021 ◽  
pp. jech-2021-216690
Author(s):  
Emily Long ◽  
Susan Patterson ◽  
Karen Maxwell ◽  
Carolyn Blake ◽  
Raquel Bosó Pérez ◽  
...  
Keyword(s):  
Public Health ◽  
Social Interactions ◽  
Social Relationships ◽  
Public Health Policy ◽  
Public Health Response ◽  
The Public ◽  
Health Response ◽  
The Social ◽  
The Uk ◽  
Key Aspects

This essay examines key aspects of social relationships that were disrupted by the COVID-19 pandemic. It focuses explicitly on relational mechanisms of health and brings together theory and emerging evidence on the effects of the COVID-19 pandemic to make recommendations for future public health policy and recovery. We first provide an overview of the pandemic in the UK context, outlining the nature of the public health response. We then introduce four distinct domains of social relationships: social networks, social support, social interaction and intimacy, highlighting the mechanisms through which the pandemic and associated public health response drastically altered social interactions in each domain. Throughout the essay, the lens of health inequalities, and perspective of relationships as interconnecting elements in a broader system, is used to explore the varying impact of these disruptions. The essay concludes by providing recommendations for longer term recovery ensuring that the social relational cost of COVID-19 is adequately considered in efforts to rebuild.

Using Surveillance With Near–Real-Time Alerts During a Cluster of Overdoses From Fentanyl-Contaminated Crack Cocaine, Connecticut, June 2019

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 18S-23S
Author(s):  
Peter Canning ◽  
Suzanne Doyon ◽  
Sarah Ali ◽  
Susan B. Logan ◽  
Aliese Alter ◽  
...  
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Real Time ◽  
Crack Cocaine ◽  
State Department ◽  
Poison Control ◽  
Opioid Overdose ◽  
Public Health Response ◽  
Mapping Tool ◽  
Health Response

In 2019, Connecticut launched an opioid overdose–monitoring program to provide rapid intervention and limit opioid overdose–related harms. The Connecticut Statewide Opioid Response Directive (SWORD)—a collaboration among the Connecticut State Department of Public Health, Connecticut Poison Control Center (CPCC), emergency medical services (EMS), New England High Intensity Drug Trafficking Area (HIDTA), and local harm reduction groups—required EMS providers to call in all suspected opioid overdoses to the CPCC. A centralized data collection system and the HIDTA overdose mapping tool were used to identify outbreaks and direct interventions. We describe the successful identification of a cluster of fentanyl-contaminated crack cocaine overdoses leading to a rapid public health response. On June 1, 2019, paramedics called in to the CPCC 2 people with suspected opioid overdose who reported exclusive use of crack cocaine after being resuscitated with naloxone. When CPCC specialists in poison information followed up on the patients’ status with the emergency department, they learned of 2 similar cases, raising suspicion that a batch of crack cocaine was mixed with an opioid, possibly fentanyl. The overdose mapping tool pinpointed the overdose nexus to a neighborhood in Hartford, Connecticut; the CPCC supervisor alerted the Connecticut State Department of Public Health, which in turn notified local health departments, public safety officials, and harm reduction groups. Harm reduction groups distributed fentanyl test strips and naloxone to crack cocaine users and warned them of the dangers of using alone. The outbreak lasted 5 days and tallied at least 22 overdoses, including 6 deaths. SWORD’s near–real-time EMS reporting combined with the overdose mapping tool enabled rapid recognition of this overdose cluster, and the public health response likely prevented additional overdoses and loss of life.

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