The impact of changes to heroin supply on blood-borne virus notifications and injecting related harms in New South Wales, Australia

BACKGROUND: In early 2001 Australia experienced a sudden and unexpected disruption to heroin availability, know as the 'heroin shortage'. This 'shortage has been linked to a decrease in needle and syringe output and therefore possibly a reduction in injecting drug use. We aimed to examine changes, if any, in blood-borne viral infections and presentations for injecting related problems related to injecting drug use following the reduction heroin availability in Australia, in the context of widespread harm reduction measures. METHODS: Time series analysis of State level databases on HIV, hepatitis B, hepatitis C notifications and hospital and emergency department data. Examination of changes in HIV, hepatitis B, hepatitis C notifications and hospital and emergency department admissions for injection-related problems following the onset of the heroin shortage; non-parametric curve-fitting of number of hepatitis C notifications among those aged 15–19 years. RESULTS: There were no changes observed in hospital visits for injection-related problems. There was no change related to the onset heroin shortage in the number of hepatitis C notifications among persons aged 15–19 years, but HCV notifications have subsequently decreased in this group. No change occurred in HIV and hepatitis B notifications. CONCLUSION: A marked reduction in heroin supply resulted in no increase in injection-related harm at the community level. However, a delayed decrease in HCV notifications among young people may be related. These changes occurred in a setting with widespread, publicly funded harm reduction initiatives

The Type 2 Diabetes Knowledge Portal: an open access genetic resource dedicated to type 2 diabetes and related traits

Associations between human genetic variation and clinical phenotypes have become a foundation of biomedical research. Most repositories of these data seek to be disease-agnostic and therefore lack disease-focused views. The Type 2 Diabetes Knowledge Portal (T2DKP) is a public resource of genetic datasets and genomic annotations dedicated to type 2 diabetes (T2D) and related traits. Here, we seek to make the T2DKP more accessible to prospective users and more useful to existing users. First, we evaluate the T2DKP's comprehensiveness by comparing its datasets with those of other repositories. Second, we describe how researchers unfamiliar with human genetic data can begin using and correctly interpreting them via the T2DKP. Third, we describe how existing users can extend their current workflows to use the full suite of tools offered by the T2DKP. We finally discuss the lessons offered by the T2DKP toward the goal of democratizing access to complex disease genetic results

Sharing, group-buying, social supply, offline and online dealers: how users in a sample from six European countries procure new psychoactive substances (NPS).

Given the multiple ways of regulations and market situations for new psychoactive substances (NPS), it is of interest how NPS users procure their drugs in different countries as well as in different user groups. Data comes from a face-to-face and online survey conducted in six EU countries, covering three groups of current (12-month) adult NPS users: (1) socially marginalized, (2) users in night life, and (3) users in online communities. While the supply situation differed considerably between countries, friends were the most prevalent source for buying, followed by online shops and private dealers. Marginalized users were more likely to buy from dealers, while online respondents showed the highest rates for buying online. While buying NPS from online or offline shops was relatively prevalent, we also found high rates for social supply and buying from dealers. A considerable part of this market may be classified as “social online supply,” with private suppliers procuring their drugs online. The market features among marginalized users resemble more those of illicit drug markets than those for other NPS users

Rationally Risking Addiction: A Two-Stage Approach

We extend the Becker-Murphy rational addiction model to account for a period before the onset of addiction. While during the first stage of recreational consumption of the addictive good does not imply negative effects, the second stage is analogous to the classical Becker-Murphy model. In line with neurological research, the onset of addiction is a random event positively related to the past consumption of the addictive good. The resulting multistage optimal control model with random switching time is analyzed by way of a transformation into an age-structured deterministic optimal control model. This enables us to analyze in detail the anticipation of the second stage, including the possible emergence of a Skiba point. A numerical example demonstrates that it is optimal to stop consuming the addictive good in case of an early onset (i.e. at a low level of cumulative consumption) of addiction. A late onset tends to lead into long-run addiction

Illicit Performance and Image Enhancing Drug Markets in the Netherlands and Belgium

This chapter explores the illicit production and supply of performance and image enhancing drug (PIED) markets in Belgium and the Netherlands. Aside from the potential health risks related to the use of these substances, a concern is that the majority of PIEDs are not legally obtained through a physician, by means of a prescription, but instead are illegally purchased on the black market. The illicit supply of PIEDs will be the focus of this chapter. This chapter provides a historical account of the development of illicit PIED markets in Belgium and the Netherlands. Next, a categorization of supplier types will be provided based on the profession of PIED suppliers. This will be followed with an examination of the methods and motives of PIED dealers, using bodybuilding as a case study. It is highlighted that many types of suppliers are involved in the trade of PIEDs and that they are driven by multiple and often overlapping reasons (financial and non-financial motives). In the final section, the link between the illicit PIED market, organized crime and professional sport is critically explored. The chapter concludes with a discussion of the overall findings

Community-Based Operations Research: Introduction, Theory and Applications

Community-based operations research is the name of a new sub-discipline within operations research and the management sciences. CBOR synthesizes previous practice and research traditions within OR/MS to address problems within the public sector that are often of a localized nature, that address the concerns of citizens affiliated through characteristics of race, ethnicity and class and other ties and that are solved using diverse qualitative and quantitative methods. Solutions to these problems are developed and implemented by formal and informal organizations, and embody a critical perspective towards traditional notions of decisionmakers, stakeholders and analytic methods. The most proximate antecedents of CBOR are the well-studied fields of community operational research, problem structuring methods and soft systems methodologies. This chapter provides a framework for understanding CBOR through key themes such as the importance of place and space, community, disadvantaged populations and multiple methods. It introduces a theory of CBOR, surveys recent literature within CBOR and assesses the presence of CBOR in OR/MS literature, education and practice. After a summary of this book‘s twelve chapters, eleven of which are newly published, the introduction concludes by summarizing the important contributions of CBOR and identifies some promising avenues for future research