scholarly journals Having a voice and saving lives: a qualitative survey on employment impacts of people with lived experience of drug use working in harm reduction

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tamar Austin ◽  
◽  
Jade Boyd
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Lived Experience ◽  
Large Scale ◽  
Structural Changes ◽  
Workplace Discrimination ◽  
Structural Factors ◽  
The Everyday ◽  
The Impact ◽  
Overdose Deaths

Abstract Background Ongoing legal and social discrimination, and stigmatization of people with lived experience of drug use (PWLE) continues to contribute to overdose-related deaths in Canada. The involvement of PWLE working in harm reduction services has proven effective in decreasing drug-related harms among PWLE; however, there exist unintended negative impacts. PWLE working in harm reduction services risk overextending themselves beyond employment parameters (e.g., emotional labor) with few systems in place (e.g., employment advocacy) for support. While meaningful participation of PWLE in harm reduction programs is critical to addressing the overdose crisis, their labor in Canada’s overdose response commands further investigation and recognition. This paper examines some of the benefits and negative aspects of working in harm reduction among PWLE. Methods Fifty qualitative surveys were completed by PWLE working in harm reduction services from across Canada at the National 2018 Stimulus conference held in Edmonton, Alberta. The surveys focused on the benefits and negatives of ‘peer’ employment and recommendations for organizational transformation through short answer written sections. Surveys were analyzed thematically using NVivo, informed by critical perspectives on substance use, with attention to key re-occurring themes on employment equity. Results While participants described multiple benefits of working in harm reduction services, such as the valuing of their expertise by fellow ‘peers,’ growing skill sets, countering stigma, and preventing overdose deaths, issues of workplace equity were significantly identified. Stigma, tokenism, workplace discrimination, including power and pay inequities, as well as lack of worker compensation and benefits were identified as key factors persisting in the everyday experiences of participants. Conclusion Continued exposure to stigma, workplace discrimination, and/or power imbalances, combined with the impact of high stakes employment (e.g., dealing with overdose deaths), can have significant consequences for PWLE working in harm reduction, including burn out. Policy recommendations include large-scale structural changes that address inequities of hierarchical ‘peer’ employment for PWLE, including increased leadership roles for diverse PWLE, pay equity and benefits, unionization, as well as more supportive working environments attentive to the intersecting social-structural factors (poverty, criminalization, racism, gendered violence) impacting the everyday lives of PWLE working in harm reduction.

scholarly journals Harm Reduction Interventions to Prevent Overdose Deaths

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Jonathan Harris
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Lived Experience ◽  
Public Understanding ◽  
Opioid Overdose ◽  
Current Crisis ◽  
Overdose Prevention ◽  
Prevention Interventions ◽  
Informal Supports ◽  
Overdose Deaths

Overdose deaths have been occurring at high rates in many parts of Canada. From January 2016 (when national surveillance began) to March 2019, an estimated 12,800 Canadians died of an opioid overdose.1 In addition to opioid-related harms, stimulants such as methamphetamine have re-emerged in some regions and are also contributing to the current rise in overdose deaths. COVID-19 has resulted in a more compromised illicit drug supply, and those who use drugs have had limited access to formal and informal supports because of public health measures regarding physical distancing. As a result, overdose deaths have increased during the pandemic. Harm reduction approaches provide a mechanism to prevent overdose deaths and have additional health and public safety benefits. The current crisis has been exacerbated by COVID-19; therefore, it is an appropriate time to consider the entire continuum of harm reduction approaches available to reduce preventable overdose deaths. People with lived experience of drug use should be meaningfully included in policy discussions about harm reduction and overdose prevention interventions. This would enhance the person-centredness of programs and ensure they are reflective of the lived realities of those who use drugs. Although societal attitudes about drug use are changing, harm reduction interventions remain politically contentious. Countering stigma, being prepared to engage with community concerns, and clearly articulating that harm reduction services are intended to complement and not replace drug treatment are all important in enhancing public understanding of harm reduction.

The Lived Experience of Financialization at the UK Financial Fringe

2021 ◽  
pp. 1-22
Author(s):  
LINDSEY APPLEYARD ◽  
CARL PACKMAN ◽  
JORDON LAZELL ◽  
HUSSAN ASLAM
Keyword(s):  
Lived Experience ◽  
Financial Services ◽  
Global Financial Crisis ◽  
Credit Market ◽  
Short Term ◽  
Dramatic Decline ◽  
The Everyday ◽  
The Subject ◽  
The Uk ◽  
The Impact

Abstract The financialization of everyday life has received considerable attention since the 2008 global financial crisis. Financialization is thought to have created active financial subjects through the ability to participate in mainstream financial services. While the lived experience of these mainstream financial subjects has been the subject of close scrutiny, the experiences of financial subjects at the financial fringe have been rarely considered. In the UK, for example, the introduction of High-Cost, Short-Term Credit [HCSTC] or payday loan regulation was designed to protect vulnerable people from accessing unaffordable credit. Exploring the impact of HCSTC regulation is important due to the dramatic decline of the high-cost credit market which helped meet essential needs in an era of austerity. As such, the paper examines the impact of the HCSTC regulation on sixty-four financially marginalized individuals in the UK that are unable to access payday loans. First, we identify the range of socioeconomic strategies that individuals employ to manage their finances to create a typology of financial subjectivity at the financial fringe. Second, we demonstrate how the temporal and precarious nature of financial inclusion at the financial fringe adds nuance to existing debates of the everyday lived experience of financialization.

scholarly journals Structural and cyclical factors of Serbia’s current account

2018 ◽  
Vol 63 (217) ◽  
pp. 75-97 ◽  
Author(s):  
Radovan Kovacevic
Keyword(s):  
Current Account ◽  
Structural Changes ◽  
Current Account Deficit ◽  
Current Account Balance ◽  
Full Time ◽  
Structural Factors ◽  
Crisis Period ◽  
The Impact ◽  
The Current Account

This paper examines the impact of structural and cyclical factors on Serbia?s current account. We have applied several filters to turn off the long-term (structural) component and isolate the influence of cyclical factors. In this paper, we show that structural factors were more important determinants of the current account deficit in the full-time sample (1997-2016), while cyclical factors showed a stronger impact in the post-crisis period when the deficit was reduced. Although they lost their intensity during the crisis and in the post-crisis period, the structural factors determine the trend of the current account balance in the long-term. For further improvement of the current account, measures to increase exports should be taken. The structural changes of production, the wider range of support for export financing to small and medium-sized enterprises, and the application of advanced technologies in manufacturing could help to reduce the trade deficit, making the current account deficit sustainable.

The “Drugs-Crime Nexus”

2018 ◽  
Author(s):  
Dominique de Andrade
Keyword(s):  
At Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Good Evidence ◽  
People Who Use Drugs ◽  
Correctional Institutions ◽  
Reduction Strategies ◽  
At Risk Populations ◽  
Prison Populations ◽  
The Impact

The prioritization of imprisonment as a response to drug use in many countries has led to growing prison populations, with little impact on drug use, drug-related harm, or drug-related crime. There is increased international debate around how to best manage and respond to at-risk populations, with good evidence to suggest that embracing harm reduction strategies in the community and in prison can lead to reduced rates of imprisonment, infectious disease, and other preventable harms. Despite this, evidence-based treatment and harm reduction programs have largely failed to penetrate the walls of correctional institutions in most countries. This chapter provides an overview of major drug groups and explores the impact of drug policy on international imprisonment rates, and the diversity of responses to people who use drugs in the community and prison. The potential for corrections to play a significant therapeutic role in addressing the urgent treatment and harm reduction needs of at-risk, drug-using populations in prison and during their transition back to the community is highlighted.

scholarly journals Remote sensing of the impact of flash drought events on terrestrial carbon dynamics over China

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Miao Zhang ◽  
Xing Yuan ◽  
Jason A. Otkin
Keyword(s):  
Remote Sensing ◽  
Soil Moisture ◽  
Large Scale ◽  
Structural Changes ◽  
Terrestrial Ecosystems ◽  
Northern China ◽  
Carbon Dynamics ◽  
Western China ◽  
Terrestrial Carbon ◽  
The Impact

Abstract Background Flash drought poses a great threat to terrestrial ecosystems and influences carbon dynamics due to its unusually rapid onset and increasing frequency in a warming climate. Understanding the response of regional terrestrial carbon dynamics to flash drought requires long-term observations of carbon fluxes and soil moisture at a large scale. Here, MODIS satellite observations of ecosystem productivity and ERA5 reanalysis modeling of soil moisture are used to detect the response of ecosystems to flash drought over China. Results The results show that GPP, NPP, and LAI respond to 79–86% of the flash drought events over China, with highest and lowest response frequency for NPP and LAI, respectively. The discrepancies in the response of GPP, NPP, and LAI to flash drought result from vegetation physiological and structural changes. The negative anomalies of GPP, NPP, and LAI occur within 19 days after the start of flash drought, with the fastest response occurring over North China, and slower responses in southern and northeastern China. Water use efficiency (WUE) is increased in most regions of China except for western regions during flash drought, illustrating the resilience of ecosystems to rapid changes in soil moisture conditions. Conclusions This study shows the rapid response of ecosystems to flash drought based on remote-sensing observations, especially for northern China with semiarid climates. Besides, NPP is more sensitive than GPP and LAI to flash drought under the influence of vegetation respiration and physiological regulations. Although the mean WUE increases during flash drought over most of China, western China shows less resilience to flash drought with little changes in WUE during the recovery stage. This study highlights the impacts of flash drought on ecosystems and the necessity to monitor rapid drought intensification.

Internationalization: Perspectives From University Faculty in the Republic of Ireland

2019 ◽  
pp. 102831531988846
Author(s):  
Marie Clarke ◽  
Linda Hui Yang
Keyword(s):  
Higher Education ◽  
Lived Experience ◽  
Faculty Members ◽  
National Context ◽  
Republic Of Ireland ◽  
Education Literature ◽  
The Everyday ◽  
The Republic ◽  
Professional Contexts ◽  
The Impact

This article, emerging from a wider study on internationalization in the Republic of Ireland, explores internationalization through the everyday lived experience of faculty and its impact on their professional contexts. It highlights issues that faculty members face in a national context, where internationalization is viewed as an economic goal rather than an academic goal. This aspect, which has been under-researched in higher education literature, addresses the complexities and contradictions that internationalization can create for faculty. A social realist approach using Archer’s morphogenetic framework was employed to facilitate an exploration of the variegated responses that internationalization produced. The performative response to internationalization was captured, which revealed different agential responses: from an acceptance of the instrumentalist discourse to feeling demoralized by the lack of recognition for professional commitment, the impact of non-engagement by colleagues and engagement with the process to advance other career objectives.

Impact of structural changes in product sales on the profitability of production of agricultural enterprises in the region (on the example of the Altai Krai)

2021 ◽  
pp. 26-30
Author(s):  
S.P. Vorobyov ◽  
◽  
V.V. Vorobyova ◽  
A.S. Savchenko ◽  
I.G. Mosina ◽  
...  
Keyword(s):  
Agricultural Development ◽  
Structural Changes ◽  
Specific Weight ◽  
State Regulation ◽  
Structural Factors ◽  
Agricultural Enterprises ◽  
External Conditions ◽  
Product Sales ◽  
Economic Zones ◽  
The Impact

Studies were conducted to determine the impact of structural factors on the profitability of agricultural production in the Altai Krai. It was revealed that the largest amplitude of structural fluctuations per unit of specific weight of production was observed for the products of sheep, beet, beekeeping, pig breeding. The decrease in the size of production in sheep farming is associated with the liquidation of unprofitable activities, in pig farming – with the bankruptcy of credited pig complexes. The influence of structural and qualitative indicators on the profitability of agricultural enterprises in the whole region and its natural and economic zones is shown. The directions of formation of the mechanism of balanced (proportional) development of agriculture related to the need to improve state regulation of agricultural development, the mechanism of adaptation of commodity producers to changes in external conditions are summarized.

scholarly journals Impact of drug consumption rooms on risk practices and access to care in people who inject drugs in France: the COSINUS prospective cohort study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023683
Author(s):  
Marc Auriacombe ◽  
Perrine Roux ◽  
Laélia Briand Madrid ◽  
Sébastien Kirchherr ◽  
Charlotte Kervran ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Access To Care ◽  
Social Services ◽  
People Who Inject Drugs ◽  
Drug Consumption ◽  
Risk Practices ◽  
The Impact

IntroductionThe high prevalence of hepatitis C and the persistence of HIV and hepatitis C virus (HCV) risk practices in people who inject drugs (PWID) in France underlines the need for innovative prevention interventions. The main objective of this article is to describe the design of the COSINUS cohort study and outline the issues it will explore to evaluate the impact of drug consumption rooms (DCR) on PWID outcomes. Secondary objectives are to assess how DCR (a) influence other drug-related practices, such as the transition from intravenous to less risky modes of use, (b) reduce drug use frequency/quantity, (c) increase access to treatment for addiction and comorbidities (infectious, psychiatric and other), (d) improve social conditions and (e) reduce levels of violence experienced and drug-related offences. COSINUS will also give us the opportunity to investigate the impact of other harm reduction tools in France and their combined effect with DCR on reducing HIV-HCV risk practices. Furthermore, we will be better able to identify PWID needs.Methods and analysisEnrollment in this prospective multi-site cohort study started in June 2016. Overall, 680 PWID in four different cities (Bordeaux, Marseilles, Paris and Strasbourg) will be enrolled and followed up for 12 months through face-to-face structured interviews administered by trained staff to all eligible participants at baseline (M0), 3 month (M3), 6 month (M6) and 12 month (M12) follow-up visits. These interviews gather data on socio-demographic characteristics, past and current drug and alcohol consumption, drug-use related practices, access to care and social services, experience of violence (as victims), offences, other psychosocial issues and perception and needs about harm reduction interventions and services. Longitudinal data analysis will use a mixed logistic model to assess the impact of individual and structural factors, including DCR attendance and exposure to other harm reduction services, on the main outcome (HIV-HCV risk practices).Ethics and disseminationThis study was reviewed and approved by the institutional review board of the French Institute of Medical Research and Health (opinion number: 14–166). The findings of this cohort study will help to assess the impact of DCR on HIV-HCV risk practices and other psycho-social outcomes and trajectories. Moreover, they will enable health authorities to shape health and harm reduction policies according to PWID needs. Finally, they will also help to improve current harm reduction and therapeutic interventions and to create novel ones.

scholarly journals Analysis of the prevalence and risk factors of osteoarthritis in a population

2019 ◽  
Vol 13 (2) ◽  
pp. 105-111 ◽  
Author(s):  
O. O. Portyannikova ◽  
S. M. Tsvinger ◽  
A. V. Govorin ◽  
E. N. Romanova
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Metabolic Disorders ◽  
Structural Changes ◽  
Professional Activities ◽  
Ethnic Factors ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

The review contains data from large-scale foreign and Russian studies of the epidemiology of osteoarthritis (OA). It considers the role of modifiable and non-modifiable risk factors for OA, such as age, sex, hormonal status, obesity, etc. There are data on genetic susceptibility to OA and on congenital anomalies that contribute to joint structural changes. Data on the impact of racial and ethnic factors on the development and progression of OA are analyzed. The role of metabolic disorders in the pathogenesis of this disease is highlighted. Data on the relationship of OA to patients' professional activities are summarized.

scholarly journals Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047511
Author(s):  
Katrina Bouzanis ◽  
Siddharth Joshi ◽  
Cynthia Lokker ◽  
Sureka Pavalagantharajah ◽  
Yun Qiu ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Drug Use ◽  
Infectious Diseases ◽  
Harm Reduction ◽  
Bacterial Infections ◽  
People Who Inject Drugs ◽  
Integrative Review ◽  
Future Research ◽  
Structural Factors ◽  
Health Programmes

ObjectivesPeople who inject drugs (PWID) experience a high burden of injection drug use-related infectious disease and challenges in accessing adequate care. This study sought to identify programmes and services in Canada addressing the prevention and management of infectious disease in PWID.DesignThis study employed a systematic integrative review methodology. Electronic databases (PubMed, CINAHL and Web of Science Core Collection) and relevant websites were searched for literature published between 2008 and 2019 (last search date was 6 June 2019). Eligible articles and documents were required to address injection or intravenous drug use and health programmes or services relating to the prevention or management of infectious diseases in Canada.ResultsThis study identified 1607 unique articles and 97 were included in this study. The health programmes and services identified included testing and management of HIV and hepatitis C virus (n=27), supervised injection facilities (n=19), medication treatment for opioid use disorder (n=12), integrated infectious disease and addiction programmes (n=10), needle exchange programmes (n=9), harm reduction strategies broadly (n=6), mobile care initiatives (n=5), peer-delivered services (n=3), management of IDU-related bacterial infections (n=2) and others (n=4). Key implications for policy, practice and future research were identified based on the results of the included studies, which include addressing individual and systemic factors that impede care, furthering evaluation of programmes and the need to provide comprehensive care to PWID, involving medical care, social support and harm reduction.ConclusionsThese results demonstrate the need for expanded services across a variety of settings and populations. Our study emphasises the importance of addressing social and structural factors that impede infectious disease care for PWID. Further research is needed to improve evaluation of health programmes and services and contextual factors surrounding accessing services or returning to care.PROSPERO registration numberCRD42020142947.

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