It's time for Canadian community early warning systems for illicit drug overdoses

Although fatal and non-fatal overdoses represent a significant source of morbidity and mortality, current systems of surveillance and communication in Canada provide inadequate measurement of drug trends and lack a timely response to drug-related hazards. In order for an effective early warning system for illicit drug overdoses to become a reality, a number of elements will be required: real-time epidemiologic surveillance systems for illicit drug trends and overdoses, inter-agency networks for gathering data and disseminating alerts, and mechanisms for effectively and respectfully engaging with members of drug using communities. An overdose warning system in an urban area like Vancouver would ideally be imbedded within a system that monitors drug trends and overdoses by incorporating qualitative and quantitative information obtained from multiple sources. Valuable information may be collected and disseminated through community organizations and services associated with public health, emergency health services, law enforcement, medical laboratories, emergency departments, community-based organizations, research institutions and people with addiction themselves. The present paper outlines considerations and conceptual elements required to guide implementation of such systems in Canadian cities such as Vancouver

Association between Food Insecurity and Procurement Methods among People Living with HIV in a High Resource Setting

Objective: People living with HIV in high-resource settings suffer severe levels of food insecurity; however, limited evidence exists regarding dietary intake and sub-components that characterize food insecurity (i.e. food quantity, quality, safety or procurement) in this population. We examined the prevalence and characteristics of food insecurity among people living with HIV across British Columbia, Canada. Design: This cross-sectional analysis was conducted within a national community-based research initiative. Methods: Food security was measured using the Health Canada Household Food Security Scale Module. Logistic regression was used to determine key independent predictors of food insecurity, controlling for potential confounders. Results: Of 262 participants, 192 (73%) reported food insecurity. Sub-components associated with food insecurity in bivariate analysis included: < RDI consumption of protein (p = 0.046); being sick from spoiled/unsafe food in the past six months (p = 0.010); and procurement of food using non-traditional methods (p <0.05). In multivariable analyses, factors significantly associated with food insecurity included: procurement of food using non-traditional methods [AOR = 11.11, 95% CI: 4.79–25.68, p = <0.001]; younger age [AOR = 0.92, 95% CI: 0.86–0.96, p = <0.001]; unstable housing [AOR = 4.46, 95% CI: 1.15–17.36, p = 0.031]; household gross annual income [AOR = 4.49, 95% CI: 1.74–11.60, p = 0.002]; and symptoms of depression [AOR = 2.73, 95% CI: 1.25–5.96, p = 0.012]. Conclusions: Food insecurity among people living with HIV in British Columbia is characterized by poor dietary quality and food procurement methods. Notably, participants who reported procuring in non-traditional manners were over 10 times more likely to be food insecure. These findings suggest a need for tailored food security and social support interventions in this setting

Addressing the needs of young people living with perinatally-acquired HIV : promoting health through community-based research

There is a need for community-based tertiary health promoting and risk reduction programs that target the unique psychosocial and developmental issues of adolescents living with HIV in Canada. In a climate of increased accountability, well designed and articulated planning and evaluation research is paramount to securing funding and delivering successful health and psychosocial programs in communities. This dissertation represents a case example whereby research was undertaken to support community action. A qualitative community-based participatory research approach was undertaken to create a health promotion program model for adolescents living with perinatally-acquired HIV in British Columbia, Canada. This process involved a multi-step collaborative partnership process including HIV-infected young people, their family members, their healthcare and service providers, university researchers, and international experts. The major goals were to: collaboratively assess the needs of the adolescents living with HIV in BC; to examine existing evidence in the literature for potential application to program design; to consult with international experts in the field of adolescent HIV care; and to form successful partnerships with various community stakeholders. Methods included in-depth interviews, focus groups, planning committee meetings, and facilitator training sessions, involving over 50 stakeholders. The results from the various chapters included in this dissertation provide an example of the complexity inherent in working with such a ‘hidden’ population of adolescents. They identify priority program needs for the local population of HIV-positive children which include targeting areas of HIV stigma, sexual health, and mental health in adolescence and beyond. They show that partnerships such as this are challenged by factors such as technical, socio-political, and ethical quagmires. Findings from international ‘experts’ demonstrate that services targeting this population require multifaceted strategies for successful programs and that further examination of stigma opens upon a world of silences with intricate functions and meanings. This dissertation is one of the few existing published works that incorporates the use of community-based partnership research and program development with a population of adolescents living with perinatally-acquired HIV. Implementing interdisciplinary, creative and engaging health promoting research strategies is a step towards decreasing inequities through marrying knowledge generation and program development.Graduate and Postdoctoral StudiesGraduat

Taking another Look: developing a sustainable and expandable programme of qualitative research methods in psychology

This report reflects on the current provision of qualitative research methods within a UK psychology department's teaching programmes. It considers how this has contributed to the poor integration of qualitative research methods into undergraduate teaching and also considers how some key conceptual issues need to be addressed in order to facilitate student engagement with qualitative research methods. Furthermore it sets out the authors' plans to create a pragmatic approach to research methods teaching, by readdressing what they want their students to learn and how they deliver it. The authors suggest that students should be engaging with the criticisms and conceptual challenges faced by both paradigms. This is done with the overall aim of eventually creating a research methods teaching programme that focuses on creating pragmatic researchers able to use a variety of methods, regardless of whether they be quantitative or qualitative

Covalently linked polyoxometalate-polypyrrole hybrids: Electropolymer materials with dual-mode enhanced capacitive energy storage

Lindqvist-type polyoxometalates (POMs) derivatized with pyrrole (Py) via an aryl–imido linkage [Mo6O18NPhPy]2– (1) and [Mo6O18NPhCCPhPy]2– (2) undergo coelectropolymerization with pyrrole, producing the first electropolymer films with covalently attached POM “molecular metal oxides”. X-ray photoelectron spectroscopy (XPS) and energy-dispersive X-ray (EDX) elemental analyses indicate that the loadings of POM achieved are far higher than in conventional, noncovalent inclusion films, and covalent attachment prevents loss of POM on initial reduction cycles. Cyclic voltammetry, electrochemical impedance spectroscopy, and galvanostatic charge–discharge measurements together indicate that the POMs enhance the specific capacitance (up to 5×) and decrease the charge-transfer resistance of the films by both modifying the behavior of the polypyrrole (PPy) film and introducing a substantial additional faradaic contribution through the POM redox processes. Increasing the length of the POM–PPy linker improves both capacitance and stability, with PPy-2 retaining 95% of its initial capacitance over 1200 cycles

Covalently linked polyoxometalate-polypyrrole hybrids: Electropolymer materials with dual-mode enhanced capacitive energy storage

Lindqvist-type polyoxometalates (POMs) derivatized with pyrrole (Py) via an aryl–imido linkage [Mo6O18NPhPy]2– (1) and [Mo6O18NPhCCPhPy]2– (2) undergo coelectropolymerization with pyrrole, producing the first electropolymer films with covalently attached POM “molecular metal oxides”. X-ray photoelectron spectroscopy (XPS) and energy-dispersive X-ray (EDX) elemental analyses indicate that the loadings of POM achieved are far higher than in conventional, noncovalent inclusion films, and covalent attachment prevents loss of POM on initial reduction cycles. Cyclic voltammetry, electrochemical impedance spectroscopy, and galvanostatic charge–discharge measurements together indicate that the POMs enhance the specific capacitance (up to 5×) and decrease the charge-transfer resistance of the films by both modifying the behavior of the polypyrrole (PPy) film and introducing a substantial additional faradaic contribution through the POM redox processes. Increasing the length of the POM–PPy linker improves both capacitance and stability, with PPy-2 retaining 95% of its initial capacitance over 1200 cycles

Individual and structural vulnerability among female youth who exchange sex for survival

PURPOSE: Because of growing concerns regarding the heightened vulnerabilities and risk of human immunodeficiency virus infection among youth who exchange sex for survival, we investigated individual risk patterns and structural barriers among young (≤24 years) female sex workers (FSWs) in Vancouver, Canada. METHODS: Between 2005 and 2008, a total of 255 street-based FSWs (≥14 years) were enrolled into a community-based prospective cohort, and were asked to participate in baseline and biannual questionnaires administered through interviews and human immunodeficiency virus screening. We used contingency table analysis to compare individual and structural barrier results obtained at baseline for younger (≤24 years) FSWs with those of the older (>25 years) FSWs. For longitudinal data, we used generalized estimating equations throughout the follow-up period to determine factors associated with being a young FSW in the past 6 months. RESULTS: In comparison with older FSWs (n = 199), youth (n = 56) were more likely to spend fewer years engaging in sex exchange (median: 6.4 [interquartile range: 4.6-9.1] vs. 19.9 [interquartile range: 10.0-26.8]; p ≤ .001), belong to an aboriginal ancestry (59% vs. 44%; p = .052), and be homeless (68% vs. 36%; p ≤ .001). In the multivariate generalized estimating equations analysis, youth reported a significantly elevated proportional odds of being homeless (odds ratio [OR]: 1.26 [confidence interval {CI}: 1.08-1.48]), servicing clients in public places (OR: 1.28 [CI: 1.04-1.57]), injecting heroin on a daily basis (OR: 1.35 [CI: 1.06-1.74]), and a significantly reduced odds of accessing methadone maintenance therapy (OR: .76 [CI: .62-.93]). CONCLUSIONS: This study demonstrates significant displacement of youth who engage in sex exchange to marginalized working and living spaces. The findings of this study bring to attention the critical need for targeted structural interventions including access to youth and gender-specific social housing, safe working spaces, reduction in the amount of harm caused to them, and addiction treatment services for youth engaged in survival sex work.Medicine, Faculty ofNon UBCMedicine, Department ofReviewedFacultyResearcherGraduat

Association between Food Insecurity and Procurement Methods among People Living with HIV in a High Resource Setting.

ObjectivePeople living with HIV in high-resource settings suffer severe levels of food insecurity; however, limited evidence exists regarding dietary intake and sub-components that characterize food insecurity (i.e. food quantity, quality, safety or procurement) in this population. We examined the prevalence and characteristics of food insecurity among people living with HIV across British Columbia, Canada.DesignThis cross-sectional analysis was conducted within a national community-based research initiative.MethodsFood security was measured using the Health Canada Household Food Security Scale Module. Logistic regression was used to determine key independent predictors of food insecurity, controlling for potential confounders.ResultsOf 262 participants, 192 (73%) reported food insecurity. Sub-components associated with food insecurity in bivariate analysis included: &lt; RDI consumption of protein (p = 0.046); being sick from spoiled/unsafe food in the past six months (p = 0.010); and procurement of food using non-traditional methods (p &lt;0.05). In multivariable analyses, factors significantly associated with food insecurity included: procurement of food using non-traditional methods [AOR = 11.11, 95% CI: 4.79-25.68, p = &lt;0.001]; younger age [AOR = 0.92, 95% CI: 0.86-0.96, p = &lt;0.001]; unstable housing [AOR = 4.46, 95% CI: 1.15-17.36, p = 0.031]; household gross annual income [AOR = 4.49, 95% CI: 1.74-11.60, p = 0.002]; and symptoms of depression [AOR = 2.73, 95% CI: 1.25-5.96, p = 0.012].ConclusionsFood insecurity among people living with HIV in British Columbia is characterized by poor dietary quality and food procurement methods. Notably, participants who reported procuring in non-traditional manners were over 10 times more likely to be food insecure. These findings suggest a need for tailored food security and social support interventions in this setting