scholarly journals More evidence or stronger political will: exploring the feasibility of needle and syringe programs in Ukrainian prisons

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alexandra Dmitrieva ◽  
Vladimir Stepanov ◽  
Kateryna Svyrydova ◽  
Ievgeniia-Galyna Lukash ◽  
Svetlana Doltu ◽  
...  
Keyword(s):  
Drug Use ◽  
Injecting Drug Use ◽  
World Health ◽  
Historical Period ◽  
Research Approach ◽  
Political Will ◽  
Prison Staff ◽  
Action Research Approach ◽  
Needle And Syringe Programs ◽  
Laws And Policies

Abstract Introduction In 2007, the World Health Organization (WHO) recommended for prison authorities to introduce prison needle and syringe programs (PNSP) if they have any evidence that injecting drug use is taking place in prisons. This article presents descriptive evidence that injecting drug use takes place in Ukrainian prisons, it discusses how (denial of) access to injection equipment is regulated in the current system and what changes should be considered in order to implement PNSP. Background Ukrainian prisons still live by the laws and policies adopted in the Soviet Union. Besides laws and regulations, these legacies are replicated through the organization and infrastructure of the prison’s physical space, and through “carceral collectivism” as a specific form of living and behaving. Inviolability of the prison order over time helps the prison staff to normalize and routinely rationalize punishment enforcement as a power “over” prisoners, but not a power “for” achieving a specific goal. Methods The Participatory Action Research approach was used as a way of involving different actors in the study’s working group and research process. The data were gathered through 160 semi-structured interviews with prison health care workers, guards, people who inject drugs (PWID) who served one or several terms and other informants. Results The “expertise” in drug use among prisoners demonstrated by prison staff tells us two things—they admit that injecting use takes place in prisons, and that the surveillance of prisoner behavior has been carried out constantly since the very beginning as a core function of control. The communal living conditions and prison collectivism may not only produce and reproduce a criminal subculture but, using the same mechanisms, produce and reproduce drug use in prison. The “political will” incorporated into prison laws and policies is essential for the revision of outdated legacies and making PNSP implementation feasible. Conclusion PNSP implementation is not just a question of having evidence of injecting drug use in the hands of prison authorities. For PNSP to be feasible in the prison environment, there is a need for specific changes to transition from one historical period and political leadership to another. And, thus, to make PNSP work requires making power work for change, and not just for reproducing the power itself.

scholarly journals Drug Addiction in Sikkim: A Sociological Study

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
P. K. Mishra
Keyword(s):  
Drug Abuse ◽  
Drug Use ◽  
Drug Addiction ◽  
Injecting Drug Use ◽  
World Health ◽  
Easy Access ◽  
North East India ◽  
North East ◽  
The People ◽  
Pharmaceutical Industries

<p><em>In contemporary society, the full-fledged impact of modernization and globalization, which has led to free movement of people, goods and money across the countries of the world, can be witnessed. This has also opened the economic opportunities among the individuals and the communities in the society, which has become the new of life. Society has changed over the years and activities of the people have undergone changes. Even the substances used for inebriation have changed corresponding with the dynamics of society. Traditionally used drugs, marijuana and cannabis, have been replaced by modern synthetic drugs. The proliferation of pharmaceutical industries, which manufactures narcotic drugs, has directly and indirectly encouraged the use and the abuse of the drugs due to the easy access in the market. The epidemic of illicit drug users in the global society has increased significantly and simultaneously drug use associated crimes as well in the society.</em></p><p><em>A drug is a biological substance, synthetic or natural, that is taken primarily for non-dietary needs, and it is a substance, which affects the functioning of mind and body or both. Globally according to UNODC estimate, in 2009 between, 149 and 272 people or 3.3% to 6.1% of the population aged 15-64 has used illicit substance once in previous year. Cannabis and Amphetamine Type Stimulants [ATS] are two important drugs which are commonly used world-wide.(World Drug Report,2010;pg.123) Within Asia, ATS ranks as the main drug abuse in Thailand, Japan, Republic of Korea, Philippines and also China, Myanmar and Indonesia are in the second rank according to United Nations of Development Countries   [UNODC] in 2004.  Heroin, Cocaine and other drugs kill around 0.2 million people each year and causes health problems with incurable diseases. (Changing Drug abuse patterns and law enforcement strategies;pg.-134)  The European-Monitoring Center for Drug and Drug Addiction [EMCDDA] defines the problem of Drug use as injecting drug use as ‘injecting drug use or long duration regular use of opium, cocaine and amphetamines.’ World Health Organization [WHO] defines Drug Addiction as a ‘disease’  and the American Psychiatric Association defines drug abuse as the ‘illicit consumption of any naturally occurring of pharmaceutical substance for the purpose of changing the way, in which a person feels, thinks or behaves without understanding or taking into consideration the damaging physical and mental side effects that are caused.(World Drug Report,2012;pg.125-126).</em></p><p><em>Drug Abuse is a global phenomena and it is also abused in India. India is a diverse nation and is like many other nations afflicted by drug abuse and drug addiction among the youths in the society. Drugs like opium and cannabis were traditionally used by the people, which are taken as a pain reliever by the people. ‘Ganja was consumed to worship Hindu God, Lord Shiva, during the festival of ‘Shivratri’ in India.(B. Sundas, 2011;pg.50). According to a nation-wide survey spread over 13 states by a NGO, in collaboration with the Ministry of Women and Child Development found that 32.1% children below the age of 18had tasted bhang, ganja, heroin or other forms of narcotics. (P. Mehta, 2011) In 2008, 5.3 million Indians aged 12 and older had abused cocaine in any form and 1.1 million had abused LSD at least once in the year. In 2008,453,000 Indians aged 12 and older had abused Heroin at least once in the year. In 2008,25.8 million Indians aged 12 and older had abused marijuana at least once in the year. In 2008,850,000 Indians aged 12 and older had abused methamphetamine at least once in the year.(Ibid,pg. 34-40).</em></p><p><em>Northeast has been challenged by serious problem of Drug use by the youth. Nagaland and Manipur are the two states in Manipur are the two states in North-East India, which has the highest prevalence of Intravenous Drugs (IDUs). Even cultivation of opium is done in Manipur, Nagaland and Arunachal Pradesh, and supplied to other parts of India. These are the easy routes of drug trafficking across the common borders of Myanmar and the three North-eastern States of India (Manipur, Mizoram and Nagaland). There is illicit cultivation of opium and cannabis, the heroin and the amphetamines, and the pharmaceuticals are used as illicit drugs and trafficked in the North-east India. (Drug used in Northeastern States, India;pg.xiv).</em></p>

scholarly journals Healthcare utilisation and disclosure of injecting drug use among clients of Australia's needle and syringe programs

2013 ◽  
Vol 37 (2) ◽  
pp. 148-154 ◽  
Author(s):  
M. Mofizul Islam ◽  
Libby Topp ◽  
Jenny Iversen ◽  
Carolyn Day ◽  
Katherine M. Conigrave ◽  
...  
Keyword(s):  
Drug Use ◽  
Healthcare Utilisation ◽  
Injecting Drug Use ◽  
Needle And Syringe Programs

Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam
Keyword(s):  
Drug Use ◽  
World Health Organization ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Sectional Study ◽  
Hospital Data ◽  
Cross Sectional ◽  
Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

Beyond Findings: Conversations with Experts

2018 ◽  
Vol 47 (2) ◽  
pp. 60-62
Author(s):  
Joanne Evans ◽  
Gregory Rolan
Keyword(s):  
Home Care ◽  
Associate Professor ◽  
Research Approach ◽  
Participatory Action ◽  
Childhood Education ◽  
Out Of Home Care ◽  
Action Research Approach ◽  
Historical Justice ◽  
Protection Systems ◽  
Discovery Project

AbstractRights in Records by Design is a three-year Australian Research Council-funded Discovery Project that is running from 2017 to 2019. This project brings together an interdisciplinary research team to investigate the recordkeeping and archival needs for those whose childhoods are impacted by child welfare and protection systems. Using a participatory action research approach the team of recordkeeping, historical, social work, early childhood education and community researchers are exploring the design of Lifelong Living Archives for those who experience childhood out-of-home Care. The goal of research and in designing the Archive is to re-imagine recordkeeping frameworks, processes and systems in support of responsive and accountable child-centred out-of-home Care, and to enable historical justice and reconciliation. Chief Investigator Associate Professor Joanne Evans and post-doctoral researcher Dr. Gregory Rolan from the Faculty of Information Technology at Monash University in Australia talk to PDT&C about this project.

scholarly journals The process of transprofessional collaboration: how caregivers integrated the perspectives of rehabilitation through working with a physical therapist

2020 ◽  
Vol 8 (4) ◽  
pp. e000378
Author(s):  
Ryohei Goto ◽  
Junji Haruta
Keyword(s):  
Nursing Home ◽  
Action Research ◽  
Physical Therapist ◽  
Nursing Home Residents ◽  
Research Approach ◽  
Action Research Approach ◽  
Informal Interview ◽  
Trial Basis ◽  
Field Notes

ObjectivesTo clarify the process of how caregivers in a nursing home integrate the perspectives of rehabilitation into their responsibilities through working with a physical therapist.DesignThis study was conducted under an action research approach.SettingThe target facility was a nursing home located in Japan. The researcher, a physical therapist, worked at the nursing home once a week from April 2016 to March 2017. During the study period, he created field notes focused on the dialogue and action of caregivers regarding care, responses of caregivers to the physical therapist and reflections as a physical therapist. Caregivers were also given a short informal interview about their relationship with the nursing home residents. For data analysis, two researchers discussed the content based on the field notes, consolidating the findings.ParticipantsThe participants were caregivers who worked at the target facility. Thirty-eight caregivers agreed to participate. Average age was 39.6±11.1 years, 14 (37%) were male and average caregiver experience was 9.8 years.ResultsTwo cycles of action research were conducted during the study period. There were four stages in the process of how caregivers in the nursing home integrated the perspectives of rehabilitation through their work with the physical therapist. First, caregivers resisted having the rehabilitation programme carried out in the unit because they perceived that rehabilitation performed by a physical therapist was a special process and not under their responsibility. However, the caregivers were given a shared perspective on rehabilitation by the physical therapist, which helped them to understand the meaning of care to adapt the residents’ abilities to their daily life. They practised resident-centred care on a trial basis, although with a sense of conflict between their new and previous role, which emphasised the safety of residents’ lives and personhood. The caregivers increased their self-efficacy as their knowledge and skills were supplemented by the physical therapist and his approval of their attempted care. They were then able to commit to their newly conceived specialty of care as a means of supporting the lives of residents.ConclusionsThe process of working with a physical therapist led to a change in caregivers’ perception and behaviours, which occurred in four stages: resistance to incorporation, recapture of other perspectives, conflicts and trials in the role of caregiver and transformation to a resident-centred perspective.

scholarly journals Use of participatory action research approach to develop a self-management resource for persons living with dementia

Dementia ◽  
2021 ◽  
pp. 147130122199728
Author(s):  
Sherry Dupuis ◽  
Carrie McAiney ◽  
Lisa Loiselle ◽  
Brenda Hounam ◽  
Jim Mann ◽  
...  
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Primary Care Providers ◽  
Self Management ◽  
Research Approach ◽  
Care Providers ◽  
Participatory Action ◽  
Action Research Approach ◽  
Care Partners ◽  
Essential Components

This article describes the use of a participatory action research (PAR) approach to developing a self-management resource for persons living with dementia and care partners. Despite growing evidence that persons with dementia are able to contribute in meaningful ways to decision-making about their care and life preferences, few opportunities exist for them to participate in the design of resources and services meant for them. There is also a need to support the self-management of persons living with dementia with the provision of accurate, high quality, user-friendly information. The Living Well with Dementia resource was developed through a partnership with persons with dementia, family members, Alzheimer Society representatives, primary care providers, and researchers. The methods used in the development of this resource are outlined in six steps employed in this process, from establishment of a PAR team to final resource creation. Informed by a whole systems approach, the resource brings together essential components of self-management into a comprehensive system of care and support for living. It empowers users to be active participants in the application of new knowledge to their lives. Better self-management has important implications for access to health care and quality of life for persons with dementia and care partners.

scholarly journals 1065. Hepatitis C Virus Care Cascade Assessment–One Step Closer to Micro-Elimination

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S561-S562
Author(s):  
Jehan F Chowdhury ◽  
Anna Winston ◽  
Tanya Zeina ◽  
Hong Gi Shim ◽  
Tine Vindenes
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Use ◽  
Sustained Viral Response ◽  
The United States ◽  
World Health ◽  
Viral Response ◽  
Care Cascade ◽  
Care Gaps ◽  
Hcv Antibody

Abstract Background Hepatitis C virus (HCV) is a leading cause of advanced liver disease and death. In the United States about 3.5 million people are living with HCV, but only 50% are aware of the infection, 16% are prescribed treatment, and only 9% achieve sustained viral response. The World Health Organization published an HCV elimination goal for 2030 that strives to achieve a 65% reduction in HCV-related deaths and 90% reduction in transmission. An important step toward this goal is micro-elimination at local hospitals by addressing care gaps in the HCV care cascade. Figure 1 Methods We created a retrospective cohort of patients who tested positive for HCV antibody (HCV Ab+) between 2016 and 2018 at Tufts Medical Center in Boston, Massachusetts. We assessed achievement of care cascade steps including HCV viral load (VL) testing, linkage to care, treatment initiation, and sustained viral response (SVR). We also assessed patient demographics, clinical factors and HCV risk factors. We used STATA/IC 14.1 to conduct bivariate analysis to identify factors associated with loss to follow-up across each care cascade step. Results A total of 24,308 HCV antibody tests were done during this timeframe, of which 5% (n=1,222) were HCV Ab+. After excluding duplicate tests, 1,041 unique patients with HCV Ab+ were included. This cohort had a mean age of 47 years and were 61% male, 66% white, 72% on public insurance, 12% HIV-positive, 13% HCV treatment-experienced. The most frequent HCV risk factor was injection drug use, occurring in 64% of patients. Of patients with HCV Ab+, 76% (n=791) were tested for an HCV VL, of which 50% (n=393) had detectable VL and 50% (n=398) had undetectable VL. Of the patients with a detectable VL, 58% (n=226) were linked with care. Following care linkage, 69% (n=155) initiated treatment, of which 90% (n=139) completed treatment, of which 97% (n=135) achieved SVR (Figure 1). Factors that were significantly associated with getting a VL test and linking to care included private insurance, HIV co-infection, absence of intravenous drug use and cirrhosis; however, these factors were not significantly associated with achieving subsequent steps. Conclusion Assessment of the HCV care cascade at our hospital allowed us to identify clear care gaps and areas needing improvement towards a local micro-elimination. Disclosures All Authors: No reported disclosures

scholarly journals Tensions in Representing Behavioral Data in an Electronic Health Record

2021 ◽  
Author(s):  
Gabriela Marcu ◽  
Anind K. Dey ◽  
Sara Kiesler
Keyword(s):  
Electronic Health Record ◽  
Behavioral Health Care ◽  
Behavioral Data ◽  
Research Approach ◽  
Prototype System ◽  
Health Record ◽  
Record Keeping ◽  
Action Research Approach ◽  
Electronic Health ◽  
The Moment

AbstractTaking an action research approach, we engaged in fieldwork with school-based behavioral health care teams to: observe record keeping practices, design and deploy a prototype system addressing key challenges, and reflect on its use. We describe the challenges of capturing behavioral data using both paper and electronic records. Creating records of behaviors requires direct observation, and as a result the record keeping responsibility is challenging to distribute across a care team. Behavioral data on paper must be transferred and prepared for reporting, both inside the organization and to stakeholders outside of the organization. In prototyping a computerized working record, we targeted user needs for capturing details of a behavioral incident in the moment. Challenges persisted through the transition from paper to our prototype, and based on these empirical findings over two years of fieldwork, we present five tensions in representing behavioral data in an electronic health record. These tensions reflect the differences between entering behavioral data into the record for intraorganizational use versus interorganizational use.

scholarly journals Integrating a Sport-Based Trauma-Sensitive Program in a National Youth-Serving Organization

2021 ◽  
Author(s):  
M. Shaikh ◽  
C. Bean ◽  
L. Bergholz ◽  
M. Rojas ◽  
M. Ali ◽  
...  
Keyword(s):  
Program Development ◽  
Program Implementation ◽  
Effective Means ◽  
Academic Community ◽  
Lessons Learned ◽  
Community Context ◽  
Research Approach ◽  
Prevention Measures ◽  
Action Research Approach ◽  
Interdisciplinary Partnership

AbstractThere is a pressing need to equip youth-serving community organizations to respond to the unique needs of trauma-exposed children. Early prevention measures can be an effective means of redirecting children to self-regulatory healing, while facilitating their transition toward strength-based thriving. Sport can offer a powerful opportunity to reach these children; however there remains little information on how to effectively develop, deliver, evaluate, and sustain trauma-sensitive sport programs in a community context. The purpose of this paper is to outline a case study of integrating sport-based trauma-sensitive practices with BGC Canada’s national Bounce Back League program. An interdisciplinary partnership of academic, community, and practice experts used a community-based participatory action research approach, paired with a knowledge translational approach, to guide the process of program development. Mixed methods (e.g., surveys, logbooks, interviews, focus groups, online communications) were used to generate ongoing insights of staff’s training experiences, successes and challenges of program implementation, and potential impact of program on club members. Several stages of program development are described, including: (a) collaboratively planning the program; (b) piloting the program to three clubs; (c) adapting the program using pilot insights; (d) expanding the adapted program to ten clubs; and (e) creating opportunities to maintain, sustain, and scale-out practices throughout grant duration and beyond. Lessons learned regarding the leadership team’s experiences in terms of developing, adapting, and integrating trauma-sensitive practices in this community context are shared.

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