In a few moments, I came to talk to them that hospitalization is a time of reflection, which can take advantage of, without the physical action of the drugs, to review some concepts, and go to the "plan B" of their lives, that each new day is shot and needs to be harnessed. Many go through several hospitalizations and cannot get rid of this ghost prowling. Get comfortable when in a safe place and assume no responsibility for their choices, so they become fully susceptible to face out there. That is why I advocate harmreduction. (Tulip, a psychologist with a background in educational psychology)
There are an estimated 60,000 PWID in Taiwan, among whom diagnosed HIV infections remained low until 2003, when an epidemic of HIV began to spread rapidly after an HIV recombinant virus, CRF 07_BC, was introduced into the PWID population [12,13]. In 2004, the Taiwanese government sought advice from experts abroad to develop harmreduction programs for PWID to control the epidemic. A pilot program, including NSP and health education, was started in four of Taiwan’s 23 administrative areas in July 2005, and MMT was introduced in February 2006. The programs were implemented nationwide in June 2006 [13,14]. In 2012, there were 102 MMT clinics, 929 NSP stations, and 415 needle/syringe vending machines in Taiwan. The Taiwanese government has offered free access to ART to HIV-positive individuals since 1997, including HIV-infected persons in prison . One recent report showed that these extensive harmreduction programs, especially health education, have been associated with a reduction in the number of new HIV cases reported among PWID in Taiwan; however, this ecological study had important limitations . An ecological study cannot detect individual-level biological effects, and the number of newly reported cases was not equal to the true HIV incidence because of incomplete detection and reporting. Data from the BED HIV-1 capture enzyme immunoassay (BED assay) can provide some insight into the true recent incidence of HIV infection [17,18]. In this study, we tested all newly detected HIV infections in prisoners who were PWID with BED assays, and we also initiated a systematic follow-up of a cohort of former
The state of the Portuguese prison system on matters pertaining to health care, infectious disease control and harmreduction programmes leaves much to be desired. The challenges facing any effort to positively alter the current practices in these areas can be measured by the Portuguese government’s other departments’ difficulties in influencing what goes on within prison walls. Laws are enacted to no avail. Programmes and protocols are instituted only to be ignored. Queries for information go unanswered. Of course none of this is possible without the existence of some profound systemic problems lying well beyond the prison walls. This might explain how the knowledge that Portuguese prisons suffer a death rate that is twice the European Union’s average can be accepted without anyone bothering so much as to try to justify the fact.
The majority of chewers were inactive, with 78% not meeting the recommended LTPA. Chewers thus have a large opportunity to engage in exercise to take advantage of its benefits.[28, 29]With regular exercise at 15 minute/day or more, life span of chewers could be extended due to the combined effect of improved physical and mental well-being. However, exercise benefits were limited when compared with the harm of chewing. Of course, quitting chewing or early screening and timely intervention for early BQ-related cancer could also extend their lives.
Brazil, the irst attempt at HRP was in 1989 in Santos, São Paulo; however, a court order prevented the distribution of syringes by health professionals. In 1993, a version of harm reducers appeared in the same city, in the role of health promoters. Only in 1995, in Bahia, did the realization of HRP actually occur in Brazil. From this experience, many programs and HarmReduction projects have been implemented in Brazilian states, consolidating it as a care strategy for drug users 1 .
Objective: to know the developed strategies by crack users to deal with arising risks of drug consumption. Method: qualitative, descriptive and exploratory study. Data collection occurred in 2011, in a downtown city of Rio Grande do Sul, with five users of crack who made use of the drug for at least one year. Data was recollected through semi structured interview with the aid of a recorder. Results: the main risks pointed to crack users are psychological and physical. To reduce the risks, they mentioned the individual use, keep the self-care, condom use, marijuana after crack use, the control of quantity of drug used and pipe care. Conclusion: the most part of users knows the risks that come with the drug consumption, but not everyone adopts strategies of harmreduction. Descriptors: Crack cocaine, Risk groups, Strategies.
Recommendations for a (re)formulation of harmreduction policies include: constant watchfulness of rates of infection by HIV and other infections transmitted sexually through blood among IDUs, implementation of actions aimed at improving SEP coverage, and provid- ing resources for the maintenance and empow- erment of SEP professionals. To improve their effectiveness, it is important to implement reg- ular monitoring/evaluation, using both the ca- pacities of the SEPs and those of independent auditors. It is fundamental to adopt two impor- tant practices to improve transparency and ren- dering of accounts of these programs: (a) re- quiring regular and systematic rendering of ac- counts as pertains to resources received and (b) developing contracting mechanisms as per goals and objectives to structure the relation- ship between public financiers and the pro- grams.
According to ordinance 122 of 2011, the SCt act as a com - ponent of basic care in the PSCN, constituting the gateway of this segment of the population in care services, and has as guidelines of care the actions of psychosocial attention, HarmReduction (HD), educational activities, and follow-up, being integrated with the Basic Health Units and the Psychosocial Care Centers (PSCN). 4 The SCt can be proposed in three different modalities and its financing is in accordance with the population census of the people in street situation of the municipality, being one team for every 80 to 1000 street dwellers 4 . The city of Macapá
Researchers have identiied the irst historical medical use of psychotropic drugs, but this initial use may not be applicable to the present proposal on harmreduction. The Rolleston Report in which the irst medical use of psychotropic drugs was recorded was written in 1926 by health professionals and discusses the use of opiates by medical inducement (Queiroz, 2001; Soares & Jacobi, 2000). However, it was not until the 1980s that the practice of harmreduction became globally recognized as publicity about the HIV/AIDS epidemic and the innovative health programs being implemented in Europe and Australia began to spread (Conte et al., 2004). Harmreduction also became more common in Brazil during the 1980s as local initiatives began to be developed in the cities of Santos/SP and Salvador/BA (Passos & Souza, 2011; Santos, Soares, & Campos, 2010). The majority of publications on practical harmreduction continue to address HIV/ AIDS health programs and injection drug use.
The Mexican legal framework proposes full rehabilitation without infrastructure or effective harmreduction strategies for heroin users, who need to control and reduce consumption in safe con- ditions. The lack of effective strategies for harmreduction is dangerous, reproducing harmful prac- tices that increase the risk of overdose and crimes, creating scenarios of violence for users and for the rest of the community. Besides, the users interviewed were living in poverty, their criminalization and stigmatization makes heroin consumption a spiral that limits access to all services until they become unreachable, and it is only worse in contexts of HIV 40,41 . Lack of access to services is a strong inequity
Two hypotheses can be generated based on our study results, and need to be verified by future studies. One is that, as poisoning was positively associated with severe DSH only in females when compared with stabbing/cutting, we hypothesize that gender- related difference in poisonous substance choosing when perform- ing self-harm behaviors may partly contribute to this discrepancy. The second is that, as we did not identify a significant association between gender and severe DSH, this finding may suggest that although it has been reported that the general mental health well- being of male internal migrants was much more worrying than their female counterparts , the proportion of gravely stressed individuals was not significantly different between two genders.
The idea of our memory reduction algorithm is to reduce the game graph G ′ before computing a winning strategy. To get this in a formal setting we transform infinite games into ω -automata, and vice versa. We view the simulating game Γ ′ as an ω-automaton A accepting exactly the plays winning for Player 0 in Γ. The automaton B is obtained from A by state space reduction in such a way that the structural properties of game simulation are preserved, i.e., Γ is simulated by Γ ′′ , where Γ ′′ is the automaton B viewed as infinite game. To reduce A we compute a language-preserving equivalence relation on the memory S.
The spatially explicit nature of the identified hotspots of self-harm report to a larger paradigm of the perception and geography of injustice as discussed by Vaz and others in the city of Toronto . Injustice, as argued by the authors, results from an intertwining and complex correlation of several environmental determinants, and the inequality of economic opportunities within urban cores. The demographics subdued to pressures of self-harm, share a profile of socially and economically depressed characteristics in an old setback, often within minority communities, and scaling into an ever increasing gap between the rich and the poor of larger urban cores . This not only effects the direct livability of neighborhoods, which should be carefully measured by city policymakers, but becomes an area-based concern rather than simply demographical , where the complexity can only be successfully understood by the efficient integration of spatially explicit indicators to measure injury and self-harm  in context with other exogenous determinants such as housing, homeless shelters, pollution, gender equality and ageism. It is within the transaction of humans and territory, that we might well find a more equitable solution for cities of tomorrow. The issues have become far from economic and social only. Within a positivistic approach to spatial analysis, we can assume that the increasing amount of geocoded data can help us towards smarter cities, which measure and monitor the interactions through data rich environments for a more sustainable future.
Following the premise (see discussion) that the presence of nitrate reduction genes in deeper sediments where porewater nitrate was absent was due to nitrate-accumulating bacteria in the sediment, pyrosequencing analysis was conducted to examine if these organisms were present. Pyrosequencing was performed on triplicate DNA samples using a Roche 454 FLX instrument with Titanium reagents for tag-encoded FLX amplicon pyrosequencing (TEFAP) (Research and Testing Laboratory, Lubbock, Texas, USA, http://www.researchandtesting.com) based upon standard methods . The 16S rRNA gene was PCR amplified using the primers Gray28F and Gray519R  (Table S1) and amplicon libraries analysed following a modification of the PANGEA pipeline . All sequences (total raw sequences = 157,000) were checked for the presence of correct pyrosequencing adaptors, 10- bp barcodes and taxon-specific primers and any sequences containing errors in these primer regions were removed. In addition, sequences .200 bp in read length, sequences with low quality scores ( ,20), and sequences containing homopolymer inserts (maximum homopolymer length = 6 bp) were also removed from further analysis. All sequences were aligned using the (mega)Blast algorithm  against a non-redundant database of 16S rRNA sequences from cultured isolates in the RDP and Greengenes databases. Once reads matching known cultured isolates (95% sequence similarity) had been identified the remaining unidentified reads were clustered into operational taxonomic units (OTUs – 95% sequence similarity) using the UClust algorithm  and representative sequences from each OTU were assigned taxonomy using RDP classifier, a naı¨ve Bayesian classifier . Finally, all singletons were removed before further analysis . The presence of Thioploca spp. (a known nitrate-accumulating bacteria) was further tested by aligning Thioploca spp 16S rRNA sequences (from GenBank) against all pyrosequencing reads using pairwise Needleman-Wunsch align- ments. All raw sequence reads from each of the 24 amplicon libraries have been submitted to MG-RAST (http:/metagenomics. anl.gov) and are stored under the project name ‘nitrate reduction in estuarine sediments’ (http://metagenomics.anl.gov/linkin. cgi?project = 7242), with accession numbers: 4547523.3– 4547546.3.