Harm Reduction

As member states of the United Nations take stock of the drug control system, a number of debates have emerged among governments about how to balance international drug laws with human rights, public health, alternatives to incarceration, and experimentation with regulation. This series intends to provide a primer on why governments must not turn a blind eye to pressing human rights and public health impacts of current drug policies.Harm reduction is based on the idea that people have the right to be safe and supported even if they are not ready or willing to abstain from illicit drug use. A harm reduction approach involves giving people who use drugs choices that can help them protect their health. For many people who use drugs, harm reduction services are the most likely entry point into health care and the most likely means of protection from life-threatening conditions. As United Nations agencies have noted, the effectiveness of harm reduction services for HIV prevention and prevention of drug-related mortality is beyond dispute. The UN General Assembly Special Session on drugs in 2016 is an opportunity to re-energize the commitment to harm reduction pledged by UN member states at the 2001 UNGASS on HIV/AIDS. Funding for proven and cost-effective harm reduction services that protect not only people who use drugs but entire communities should be a top priority. This report details how harm reduction is a central pillar of effective drug response, critical to reaching people who use drugs with services that can help protect them, their families, and their communities

Harm Reduction: Spanish

As member states of the United Nations take stock of the drug control system, a number of debates have emerged among governments about how to balance international drug laws with human rights, public health, alternatives to incarceration, and experimentation with regulation. This series intends to provide a primer on why governments must not turn a blind eye to pressing human rights and public health impacts of current drug policies.Harm reduction is based on the idea that people have the right to be safe and supported even if they are not ready or willing to abstain from illicit drug use. A harm reduction approach involves giving people who use drugs choices that can help them protect their health. For many people who use drugs, harm reduction services are the most likely entry point into health care and the most likely means of protection from life-threatening conditions. As United Nations agencies have noted, the effectiveness of harm reduction services for HIV prevention and prevention of drug-related mortality is beyond dispute. The UN General Assembly Special Session on drugs in 2016 is an opportunity to re-energize the commitment to harm reduction pledged by UN member states at the 2001 UNGASS on HIV/AIDS. Funding for proven and cost-effective harm reduction services that protect not only people who use drugs but entire communities should be a top priority. This report details how harm reduction is a central pillar of effective drug response, critical to reaching people who use drugs with services that can help protect them, their families, and their communities

The Global Fund at a Crossroads: Informing Advocacy on Global Fund Efforts in Human Rights, Support to Middle-income Countries, and Access to Medicines

There is an urgent need to revive and re-energize civil society advocacy to hold the Global Fund to Fight AIDS, Tuberculosis, and Malaria accountable to its origins and founding principles. Recent changes in Global Fund policy and practice have taken it away from the country-driven character that set it apart from other aid agencies. It risks becoming less centered on rights-based strategies to support national responses to AIDS, TB, and malaria.In April 2015, the Open Society Public Health Program convened a consultation of experts and advocates concerned about the future of the Global Fund, particularly in these key areas:preserving support to important programs in middle-income countriesrealizing the Global Fund's human rights objectivessupporting access to essential medicinesWithout concerted and well-informed efforts by advocates the Global Fund risks repudiating its own history, undermining its investments, and damaging its stature as a leader in global health. Furthermore, the Global Fund's ambitious strategy to end the epidemics by 2030 will be a pipe dream without a reinvigoration of commitments in these three key areas. This briefing paper summarizes the deliberations of the consultation, and provides recommendations that the Global Fund should undertake in order to uphold its founding values

Palliative care for adolescents and young adults with cancer

Adolescents and young adults (AYAs) with cancer represent a unique and challenging group of patients with distinct developmental and psychosocial needs that may be unrecognized or unmet during their cancer experience. Palliative care refers to the total care of a patient, regardless of his or her disease status, and aims to improve quality of life by controlling symptoms and alleviating physical, social, psychological, and spiritual suffering. Integrating palliative care into standard oncology practice for AYAs is therefore valuable, if not imperative, in improving their overall cancer experience. In this review, we aimed to describe the scope, benefits, and challenges of palliative care for AYA oncology patients. We provide a broad impression of the existing literature describing or investigating palliative care in this population. Put together, the evidence suggests that palliative care is not only needed, but can also be critically beneficial to patients, families, and health care professionals alike. As we increase public and professional awareness of the needs and applications of palliative care for AYA patients with cancer, we will ultimately enable better psychosocial outcomes of the AYA patients and their larger communities

Tracking Climate Effects on Plant-Pollinator Interaction Phenology with Satellites and Honey Bee Hives

Background/Question/Methods: The complexity of plant-pollinator interactions, the large number of species involved, and the lack of species response functions present challenges to understanding how these critical interactions may be impacted by climate and land cover change on large scales. Given the importance of this interaction for terrestrial ecosystems, it is desirable to develop new approaches. We monitor the daily weight change of honey bee (Apis mellifera) colonies to record the phenology of the Honey Bee Nectar Flow (HBNF) in a volunteer network (honeybeenet.gsfc.nasa.gov). The records document the successful interaction of a generalist pollinator with a variety of plant resources. We extract useful HBNF phenology metrics for three seasons. Sites currently exist in 35 states/provinces in North America, with a concentration in the Mid-Atlantic region. HBNF metrics are compared to standard phenology metrics derived from remotely sensed vegetation indices from NASA's MODIS sensor and published results from NOAA's A VHRR. At any given time the percentage of plants producing nectar is usually a sma11 fraction of the total satellite sensor signal. We are interested in determining how well the 'bulk' satellite vegetation parameters relate to the phenology of the HBNF, and how it varies spatially on landscape to continental scales. Results/Conclusions: We found the median and peak seasonal HBNF dates to be robust, with variation between replicate scale hives of only a few days. We developed quality assessment protocols to identify abnormal colony artifacts. Temporally, the peak and median of the HBNF in the Mid-Atlantic show a significant advance of 0.58 d/y beginning about 1970, very similar to that observed by the A VHRR since 1982 (0.57 d/y). Spatially, the HBNF metrics are highly correlated with elevation and winter minimum temperature distribution, and exhibit significant but regionally coherent inter-annual variation. The relationship between median of the spring HBNF with the "Green-up" metric from the 500 meter MODIS NDVI phenology product, for sites throughout the Eastern US 2000-2009, is well described by a single linear fit (r(exp 2) = 0.72). We conclude.that for the tree-dominated areas of the Eastern US at least the spring HBNF can be tracked very well by MODIS phenology. Analysis of other regions and seasons is presently underway but with more limited data. Spatial patterns in the eastern US and management implications will be presented and discussed

Protocol: Evaluating the impact of a nation-wide train-the-trainer educational initiative to enhance the quality of palliative care for children with cancer

Background: There are identified gaps in the care provided to children with cancer based on the self-identified lack of education for health care professionals in pediatric palliative care and in the perceptions of bereaved parents who describe suboptimal care. In order to address these gaps, we will implement and evaluate a national roll-out of Education in Palliative and End-of-Life Care for Pediatrics (EPEC (R)-Pediatrics), using a 'Train-the-Trainer' model.Methods/design: In this study we are using a pre-post-test design and an integrated knowledge translation approach to assess the impact of the educational roll-out in four areas: 1) self-assessed knowledge of health professionals; 2) knowledge dissemination outcomes; 3) practice change outcomes; and 4) quality of palliative care. The quality of palliative care will be assessed using data from three sources: a) parent and child surveys about symptoms, quality of life and care provided; b) health record reviews of deceased patients; and c) bereaved parent surveys about end-of-life and bereavement care. After being trained in EPEC (R)-Pediatrics, 'Master Facilitators' will train 'Regional Teams' affiliated with 16 pediatric oncology programs in Canada. Each team will consist of three to five health professionals representing oncology, palliative care, and the community. Each team member will complete online modules and attend one of two face-to-face conferences, where they will receive training and materials to teach the EPEC (R)-Pediatrics curriculum to 'End-Users' in their region. Regional Teams will also choose a Tailored Implementation of Practice Standards (TIPS) Kit to guide implementation of a quality improvement project in their region; support will be provided via quarterly meetings with Co-Leads and via a listserv and webinars with other teams.Discussion: Through this study we aim to raise the level of pediatric palliative care education amongst health care professionals in Canada. Our study will be a significant step forward in evaluation of the impact of EPEC (R)-Pediatrics both on dissemination outcomes and on care quality at a national level. Based on the anticipated success of our project we hope to expand the EPEC (R)-Pediatrics roll-out to health professionals who care for children with non-oncological life-threatening conditions

Recommendations for myasthenia gravis clinical trials

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