Migration and mobility processes are thought to be important (yet complex) modulators of health related risk and vulnerability as experienced by people who use drugs. Few studies in Canada have examined this relationship, and there is no research available addressing this specific aspect of health and well-being in people who use drugs in Ottawa-Gatineau. While migration can be defined as a permanent (or near permanent) relocation process, mobility refers to a person's temporary or short-term movement between geographic locations (Joint United Nations Programme on HIV/AIDS, 2001). Understanding how the reasons for mobility and migration, typically described as “push and pull” factors, and the processes itself impact on the local community is invaluable for informing intervention in terms of type, location and timing and identifying solutions to reduce the inequalities resulting in and from the migration process. This cross-sectional study aimed to assess the prevalence and geography of mobility and migration among study participants, characterize the circumstances surrounding the mobility and migration process, and explore their impact on health related outcomes, among people who use drugs in Ottawa-Gatineau, Canada. Understanding the prevalence, patterns and characteristics of mobility and migration events may offer greater insight into the associated health risks, which in turn will assist in the development of targeted health and social services for this group. We hypothesized that the act of moving itself, as well as type of mobility and migration (i.e. specific push and pull factors), may be associated with health risk behaviours and health outcomes. People 18 years or older currently living in Ottawa-Gatineau, and who used illicit drugs in the past six months were recruited using respondent-driven sampling. Geography of lifetime migration was mapped, and health related outcomes and access to social support services were evaluated against lifetime and recent migration and travel. Quantitative analysis of health and social support related outcomes was carried out by comparison of means and proportions between groups, and complemented by qualitative exploration of push and pull factors and effects of the last mobility and migration events. Our study identified a heterogeneous inner-city population of people who use drugs where widespread homelessness, incarceration, low income and a high degree of mobility and migration placed individuals at varying levels of health-related vulnerability. Participants moved to Ottawa-Gatineau from all over Canada and other countries, but most arrived from within Ontario. Multiple factors were involved in the decision to migrate and in choosing Ottawa-Gatineau in particular. Escaping a negative environment and seeking out family connections were the most commonly cited “push and pull” factors, respectively. Maintaining family connections was also identified as a major reason for mobility or lack thereof among travelers and non-travelers alike. There was evidence to suggest that the mobility and migration processes affected health, drug use and access to resources among some of the participants and for a wide variety of reasons. Comparing the two groups using t-test for means and Chi-square (or Fisher’s exact) test for proportions, we found crack cocaine and injection drug users who migrated recently to be poorly connected to harm reduction services and thus at particularly high risk for blood-borne infections and other drug-related harms. Similarly, participants using crack cocaine or injection drugs and who traveled were significantly less likely to access social support services. In this study we have shown that within a broad cohort of people who use drugs in Ottawa-Gatineau, subjects are a highly mobile group, and face a considerable number of environmental challenges that predispose individuals to increasing risk behaviour even when using drugs only occasionally. This vulnerability is greatest in the period following migration. While push and pull factors may vary by place, a common theme identified in this study is the perceived and actual positive influence of family. Further research employing a combination of quantitative and qualitative methods using a socioecological, intersectionality and lifecourse approach (Egan, et al., 2011) may provide added insights into the role of family in modulating vulnerability through social connectedness and support among drug users as they navigate the mobility and migration process.

Migration and mobility processes are thought to be important (yet complex) modulators of health related risk and vulnerability as experienced by people who use drugs. Few studies in Canada have examined this relationship, and there is no research available addressing this specific aspect of health and well-being in people who use drugs in Ottawa-Gatineau. While migration can be defined as a permanent (or near permanent) relocation process, mobility refers to a person's temporary or short-term movement between geographic locations (Joint United Nations Programme on HIV/AIDS, 2001). Understanding how the reasons for mobility and migration, typically described as “push and pull” factors, and the processes itself impact on the local community is invaluable for informing intervention in terms of type, location and timing and identifying solutions to reduce the inequalities resulting in and from the migration process. This cross-sectional study aimed to assess the prevalence and geography of mobility and migration among study participants, characterize the circumstances surrounding the mobility and migration process, and explore their impact on health related outcomes, among people who use drugs in Ottawa-Gatineau, Canada. Understanding the prevalence, patterns and characteristics of mobility and migration events may offer greater insight into the associated health risks, which in turn will assist in the development of targeted health and social services for this group. We hypothesized that the act of moving itself, as well as type of mobility and migration (i.e. specific push and pull factors), may be associated with health risk behaviours and health outcomes. People 18 years or older currently living in Ottawa-Gatineau, and who used illicit drugs in the past six months were recruited using respondent-driven sampling. Geography of lifetime migration was mapped, and health related outcomes and access to social support services were evaluated against lifetime and recent migration and travel. Quantitative analysis of health and social support related outcomes was carried out by comparison of means and proportions between groups, and complemented by qualitative exploration of push and pull factors and effects of the last mobility and migration events. Our study identified a heterogeneous inner-city population of people who use drugs where widespread homelessness, incarceration, low income and a high degree of mobility and migration placed individuals at varying levels of health-related vulnerability. Participants moved to Ottawa-Gatineau from all over Canada and other countries, but most arrived from within Ontario. Multiple factors were involved in the decision to migrate and in choosing Ottawa-Gatineau in particular. Escaping a negative environment and seeking out family connections were the most commonly cited “push and pull” factors, respectively. Maintaining family connections was also identified as a major reason for mobility or lack thereof among travelers and non-travelers alike. There was evidence to suggest that the mobility and migration processes affected health, drug use and access to resources among some of the participants and for a wide variety of reasons. Comparing the two groups using t-test for means and Chi-square (or Fisher’s exact) test for proportions, we found crack cocaine and injection drug users who migrated recently to be poorly connected to harm reduction services and thus at particularly high risk for blood-borne infections and other drug-related harms. Similarly, participants using crack cocaine or injection drugs and who traveled were significantly less likely to access social support services. In this study we have shown that within a broad cohort of people who use drugs in Ottawa-Gatineau, subjects are a highly mobile group, and face a considerable number of environmental challenges that predispose individuals to increasing risk behaviour even when using drugs only occasionally. This vulnerability is greatest in the period following migration. While push and pull factors may vary by place, a common theme identified in this study is the perceived and actual positive influence of family. Further research employing a combination of quantitative and qualitative methods using a socioecological, intersectionality and lifecourse approach (Egan, et al., 2011) may provide added insights into the role of family in modulating vulnerability through social connectedness and support among drug users as they navigate the mobility and migration process.

This work deals with the description of the communication using the VSAT satellite network. A used network topology, frequency bands, satellite orbits and also an access technology are defined. The next part is focused on the VSAT terminal, where the block diagram is shown. A model of the indoor unit IDU is designed in the system background of Ansoft Designer. Individual parts of the system model are analyzed in terms of input variables. The results of the simulation are shown. The curves of BER before Viterbi decoding and after Viterbi decoding are shown too.

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BACKGROUND: The needle exchange programme (NEP) started in Sweden in 1986 in Lund and shortly after in Malmo. The first NEP in Stockholm opened in spring 2013. The NEP is a service aimed at intravenous drug users (IDU) from 18 years old, with a goal of preventing the blood borne diseases, such as HIV, Hepatitis B (HBV), and Hepatitis C (HCV). With the on going HIV and Hepatitis epidemics, numerous countries around the world have adopted control strategies, such as the NEP to halt the spread of HIV, HBV, and HCV. The objective of this study was to examine if the needle exchange programme has decreased the incidence of HIV, HBV, and HCV in Sweden over a six-year period.  METHODS: Data for incidence and prevalence was extracted from the yearly reports of the Stockholm’s needle exchange programme from 2013 to 2018 and the yearly reports of the public health agency in Sweden from 2013 to 2018. The data was collected for Stockholm, and compared to Västra Götaland, and the whole of Sweden. RESULTS: The incidence of HIV was zero in 2013 and 2015 in the NEP. The incidence of HBV decreased to zero in 2013 in the NEP. There is an increased incidence of HCV in the NEP. CONCLUSION: The NEP has a protective effect through its combination of needle exchange, opiate substitute therapy, counselling, and vaccinations in reducing and stabilising incidences of the infections, in some instances to zero, as well as providing surveillance and treating infections.

The aim of this thesis is to present the situation of the intravenous drug-users (IDUs) living with HIV in Romania, with a focus on Bucharest. The study follows the IDUs experiences from the environment they live in, to the day-to-day examples of structural violence they face. The questions followed regard the lives of the IDUs in Romania, as well as how they are handled by various authorities and institutions’ representatives such as medical staff in hospitals, the national healthcare system, social workers, law enforcement representatives and other public servants. The fieldwork was conducted around Bucharest through the use of observation while volunteering on outreach with an NGO, and interviews in the form of life histories in a hospital, as research methods. The thesis offers a background look at the communist and transition periods that influenced everyday life in today’s Romania. I argue that because of the stigma attached to them for being part of risk groups, the IDUs face many different forms of structural violence. Whether it comes to governmental authorities, law enforcement or medical staff, the IDUs, as well as other vulnerable risk group members, are continuously pushed outside of society through various measures. This creates a continuous state of isolation from which they cannot remove themselves without outsider help.

This research project aimed to conduct a strategic analysis of the implementation of a supervised injecting facility (SIF) in Montérégie. Using a mixed design, we first completed a portrait of the injection drug user (IDU) population. We then explored the perceptions of IDU and stakeholders with regard to the relevance of implementing a SIF in the region. Although some similarities were found with the IDU populations of Montreal and the province of Quebec, this population in Montérégie is characterized by a lower frequency of injections in public, less homeless people and lower rates of HIV and HCV infections. Despite these differences, the IDU population in Montérégie was found to have important physical and psychosocial needs. Although the relevance of a SIF in Montérégie is undeniable, improvements regarding the accessibility, continuity and appreciation of the actual services dedicated to IDU remain a priority. / Ce projet de recherche visait à réaliser une analyse stratégique de l’implantation d’un service d’injection supervisée (SIS) en Montérégie. Utilisant un devis mixte, son premier volet consistait à tracer un portrait de la population usagère de drogues par injection (UDI) montérégienne, alors que le second explorait les perceptions des UDI et des acteurs stratégiques œuvrant auprès d’eux quant à l’implantation d’un SIS dans la région. Bien que similaire aux populations UDI montréalaise et du Québec, celle de la Montérégie s’en distingue par le fait qu’elle s’injecte moins souvent dans des lieux publics, qu’elle soit sans domicile fixe à moindre proportion et par ses taux inférieurs d’infection au VIH et au VHC. Elle présente toutefois des besoins physiques et psychosociaux importants. Bien qu’un SIS soit jugé pertinent en Montérégie, une amélioration de l’accessibilité, de la continuité et de l’appréciation de l’offre de services actuelle dédiés aux UDI est considérée comme prioritaire.