Enhancing the Safety of People Who Inject Drugs: A Program Evaluation of a Syringe Services Program in Atlanta

A syringe services program (SSP) is a public health initiative designed to combat the spread of HIV and other infections among populations of people who inject drugs (PWID). These syringe exchanges adhere to a model of care called harm reduction. A common goal of these initiatives is to reduce risky behaviors by providing health care resources that are necessary for PWID to avoid disease transmission, including sterile injection equipment and much more. These treatment systems contrast practices like forced abstinence, detoxification, and rehabilitation, which are standard ways to treat PWID within the dominant Western biomedical system. This thesis research utilizes ethnographic methods to provide a program evaluation of a SSP in Atlanta, Georgia. It relies on praxis principles to highlight and synthesize the ideas of participants in order to ultimately make recommendations for the development of SSPs in Atlanta and throughout the United States

Reimagining Drugs: An Anthropological Analysis of U.S. Drug Policy Frameworks and Student Activism

As the repercussions of the nearly 50-year U.S. War on Drugs are revealing themselves to be harmful and life-threatening, especially to lower-class and minority populations, social movements aimed at drug policy reform have been on the rise. While today\u27s generation of college students were raised on abstinence-based discourses, which constantly warned and threatened them about the dangers of drug use, these same students often change their perspective, some as early as high school, when they begin having their own experiences with drugs and engage in more drug-related conversations. As a result, many students become motivated to change drug policy and education and address the stigma associated with drug use in order to reduce drug-related harm to individuals. This thesis examines the ideas and efforts of students at a university in the southeastern United States who are actively engaged in making these changes. Based on interviews with students involved with two drug policy reform groups in 2018, this thesis highlights the role of student activism in the larger drug policy reform movement. Student activists raise awareness of the need for a critical examination of U.S. drug policy frameworks and their place in this endeavor. I argue that student activists\u27 involvement in the drug policy reform movement is motivated by the numerous disparities they experience and observe in the dominant abstinence-based drug approach. Based on these students\u27 perspectives, I argue for a shift towards a more holistic harm reduction education that aims to increase the quality of care and livelihood for drug users, an accomplishment they believe is inextricable from U.S. policy

The development of a fluidic counter

Dissertation submitted for obtain the degree of Ph. D., to the University of Birmingham, under supervision Dr. K. Fosto

Correlation equalities and upper bounds for the transverse Ising model

Starting from an exact formal identity for the two-state transverse Ising model and using correlation inequalities rigorous upper bounds for the critical temperature and the critical transverse field are obtained which improve effective results.Comment: 8 pages, 1 figur

Learning in higher education: strategies to overcome challenges faced by adult students – lessons drawn from two case studies in Portugal

This paper appears in International Journal of Information and Communication Technology Education edited by Lawrence A. Tomei (Ed.) Copyright 2007, IGI Global, www.igi-global.com. Posted by permission of the publisher. URL:http://www.idea-group.com/journals/details.asp?id=4287.The development of a knowledge-based society needs a technological infrastructure and a workforce with the necessary knowledge and competences, supported by a well-structured initial education and a continuous learning program, available to all citizens, including those who did not have the opportunity to attend Higher Education (HE) when they were younger. We recognize that these students may be rich in experience but they also have some difficulties in adapting to the pedagogical approaches of learning and teaching. Furthermore, their attitudes and problems are not necessarily the same as those of traditional students but they are still expected to fit into educational institutions designed for younger students. The project LIHE – Learning in Higher Education aimed to improve the learning experience and environment of adults, particularly non-traditional adults as well as to promote lifelong learning in HE, within a European dimension. In this paper we will present this project together with some of the results

Caracterização hidrogeológica e avaliação da vulnerabilidade à poluição agrícola do aquífero Mio-Pliocénico da região de Canhestros, Alentejo

O bloco de rega de Canhestros, ocupa uma extensão de 100 km2 e integra-se na 2ª Fase do Perímetro de Rega da Barragem de Odivelas, tendo sido a primeira estrutura do vasto sistema hidráulico baseado na Barragem do Alqueva, a entrar em funcionamento, em Fevereiro de 2002. No âmbito de um projecto de monitorização piezométrica e de qualidade da água subterrânea para a referida área, celebrado entre o IGM e a EDIA, tem sido realizadas periodicamente amostragens à composição físico-química da água subterrânea, incluindo compostos orgânicos de alguns pesticidas e nitratos, que constituem elementos indicadores de contaminação agrícola. A avaliação das condições hidrogeológicas e da vulnerabilidade à poluição dos sistemas aquíferos em áreas de agricultura intensiva reveste-se da maior importância para a definição da situação de referência dos aspectos hidrodinâmicos e de qualidade da água, numa fase anterior aos previsíveis impactes que as alterações do uso do solo e o incremento do regadio inevitavelmente irão provocar. O sistema hidrogeológico dominante na área de estudo corresponde à Formação de Esbarrondadoiro (Miocénico), de fácies detrítica, e aos depósitos Plio-Quaternários de cobertura. É possível identificar-se um aquífero superficial poroso livre e em profundidade vários níveis aquíferos confinados, constituindo no conjunto um sistema multicamada complexo, em que o aquífero superficial se apresenta mais vulnerável à contaminação pontual e difusa de origem agrícola. De acordo com diferentes metodologias empíricas e critérios hidrogeológicos a área do Perímetro de Rega de Canhestros, classifica-se, relativamente ao aquífero superficial, como área de vulnerabilidade média a extremamente elevada à poluição agrícola (ver tabela). Em face dos resultados preliminares do trabalho de campo não é aconselhável o uso agrícola das águas subterrâneas da área do Perímetro de Rega de Canhestros pelo elevado risco de salinização dos solos, potenciado pelo clima quente e seco da região. Não foram detectados valores significativos de fitofármacos no aquífero livre (ver tabela) e os teores em nitratos são normalmente inferiores a 25 mg/L, à excepção de alguns casos pontuais sem representatividade espacial (ver tabela). Os resultados obtidos com os trabalhos em curso, sob a forma de diagramas, índices hidrogeoquímicos e mapas de isovalores, serão posteriormente integradas em Bases de Dados/SIG constituindo instrumentos de gestão ambiental importantes na definição das futuras redes de monitorização, a implementar no final do projecto

The roles of vitamin d and cathelicidin in type 1 diabetes susceptibility

Type 1 diabetes has an increasingly greater incidence and prevalence with no cure available. Vitamin D supplementation is well documented to reduce the risk of developing type 1 diabetes. Being involved in the modulation of cathelicidin expression, the question whether cathelicidin may be one of the underlying cause arises. Cathelicidin has been implicated in both the development and the protection against type 1 diabetes by mediating the interplay between the gut microbiome, the immune system and ß cell function. While its potential on type 1 diabetes treatment seems high, the understanding of its effects is still limited. This review aims to contribute to a more comprehensive understanding of the potential of vitamin D and cathelicidin as adjuvants in type 1 diabetes therapy.This work was financed by FEDER – Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020 – Operacional Programme for Competitiveness and Internationalization (POCI), Portugal 2020, and by Portuguese funds through FCT – Fundação para a Ciência e a Tecnologia/ Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project PTDC/MED-OUT/30466/2017 and ‘Institute for Research and Innovation in Health Sciences’ (FCT – UID/BIM/04293/2019). Cecília Cristelo and Alexandra Machado would like to thank to Fundação para a Ciência e a Tecnologia (FCT), Portugal for financial support (SFRH/BD/139402/2018 and SFRH/BD132000/2017, respectively)

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review

INTRODUCTION: The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature. MATERIAL AND METHODS: Medline®, PubMed, Scopus, and the Cochrane Register of Controlled Trials were searched from January 1999 unto December 2015 for studies, regardless of language, including the words 'rotator cuff' and '65 years' or '70 years'. Inclusion criteria were studies (level I to IV) that reported clinical outcomes in patients older than 65 years, having undertaken surgical repair of a symptomatic rotator cuff tears. Arthroscopic, mini open and open techniques were included. Exclusion criteria were: studies with patients younger than 65 years, studies that did not use validated outcome evaluation scores as primary assessment tools and those with follow up under one year. This work followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. Data abstracted included patient demographics, tear pattern, surgical procedures, clinical and repair results. Outcome scores were converted to percentages, allowing comparison of data between studies. RESULTS: After deep analysis, 14 studies met the inclusion criteria: 11 level IV studies, 1 level III study and 2 level II studies. Seven studies found statistically significant outcome improvements between pre and postoperative evaluations. All studies reported good or excellent surgical outcomes. DISCUSSION: Better results would probably be achieved if all studies had rigorous and homogeneous patient selection criteria, but the fact is, that even though this was not the case, the clinical scores remained favorable, and with statistically significant outcome improvement in all studies with prospectively collected data. CONCLUSION: Based on current literature, rotator cuff repair in patients older than 65 years imparts favorable improvement in clinical outcome scores and overall patient satisfaction.info:eu-repo/semantics/publishedVersio

How to measure a Hill-Sachs lesion: a systematic review

Quantifying bone loss is important to decide the best treatment for patients with recurrent anterior glenohumeral instability. Currently, there is no standard method available to make a precise evaluation of the Hill-Sachs lesion and predict its engagement before the surgical procedure. This literature review was performed in order to identify existing published imaging methods quantifying humeral head bone loss in Hill-Sachs lesions.Searches were undertaken in Scopus and PubMed databases from January 2008 until February 2018. The search terms were "Hill-Sachs" and "measurement" for the initial search and "Hill-Sachs bone loss" for the second, to be present in the keywords, abstracts and title. All articles that presented a method for quantifying measurement of Hill-Sachs lesions were analysed.Several methods are currently available to evaluate Hill-Sachs lesions. The length, width and depth measurements on CT scans show strong inter and intra-observer correlation coefficients. Three-dimensional CT is helpful for evaluation of bony injuries; however, there were no significant differences between 3D CT and 3D MRI measurements. The on-track off-track method using MRI allows a simultaneous evaluation of the Hill-Sachs and glenoid bone loss and also predicts the engaging lesions with good accuracy. Cite this article: EFORT Open Rev 2019;4:151-157. DOI: 10.1302/2058-5241.4.180031.info:eu-repo/semantics/publishedVersio