Opioid overdose deaths in the United States have been steadily increasing for decades. Initially, these deaths were driven by overdoses from prescription opioids. Strict limits were placed on opioid prescriptions to decrease the supply of available opioids. Instead, this prompted a shift toward the illicit opioid market, causing an increase in heroin-related overdoses. Fentanyl, a synthetic opioid that is more potent than heroin, has become commonplace in the illicit supply of opioids. The illicit opioid market is unregulated and unpredictable, and there is no way to know exactly what is in a bag sold as heroin or “dope”. Illicit drug use has been historically dealt with as a crime rather than a public health issue in the United States. Recently, harm reduction has been offered as an alternative to this punitive approach. Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Naloxone distribution and syringe service programs are examples of currently utilized harm reduction strategies in the United States. While these programs are necessary to improve the quality of life of people who use illicit drugs, the rates of death from overdose are continuing to increase. These strategies do not protect people from the toxic and unpredictable drug supply. Safe supply is a relatively new concept, but there have been some small-scale implementations of this practice in Canada. Safe supply refers to a legal and regulated supply of drugs with mind and body-altering properties that traditionally have been accessible only through the illicit drug market. This is a necessary strategy to combat the alarming rise in overdose mortality. In this paper, I will analyze the ethics of this strategy using a principalism approach. This analysis concludes that safe supply is ethically sound, and it should be a part of our approach to the overdose epidemic. Safe supply promotes autonomy, prevents harms, advances well-being, and upholds justice for people who use drugs. / Urban Bioethics

This study explores the United Kingdom’s Nationality and Borders Act’s inadmissibility criteria for asylum claims. An inadmissible asylum claim results in transferral to Rwanda to process the applicant’s claim, formalised under the Memorandum of Understanding. The study uses a normative legal method, applying international human rights law to national law to aim to determine whether the United Kingdom’s immigration law is in violation of articles 3 and 4 of the European Convention on Human Rights, as well as articles 31(1) and 33(1) of the Refugee Convention. Each article is applied respectively to sections 16 and 40 of the Nationality and Borders Act. The aim is subsequently achieved when the conclusion is reached that the Nationality and Borders Act is in breach of articles 3 and 4 of the European Convention on Human Rights, as well as articles 31(1) and 33(1) of the Refugee Convention. The results of this study highlight a discussion surrounding impermissible externalisation of asylum law, the limitations of international human rights law, and the interrelation between law and politics.

No description available.

No description available.

At Epiroc’s drill rigs a safe system is installed to make sure the vehicle is driven in a safe manner. In the development both machine tests and hardware-in-the-loop (HIL) tests have been performed but when changes are made the firmware in the safe modules has to be updated. To speed up the process a digital twin would be beneficial. This enables testing of parameters and formulation of criteria detecting faults. The purpose of the work is to develop a digital twin for steering and braking safe functions and evaluate the performance using data from machines as well as data from a HIL-rig. Also, the impact of the hydraulic model used in the HIL-rig is investigated. When the model is built two test cases are used to investigate how well the model replicates the behaviour of the real system and how sensitive it is to what input data is used. The biggest difference in the data is the sampling time, machine logs have 80 ms interval while logs from the rig are logged every 5 ms. It is discovered that some of the fault detection functions work very well no matter what data is used while others must have the better resolution to be trusted. The complexity of the hydraulic model used impacts the pressures but seem to have little effect on which fault codes are activated. With this the main purpose is partly achieved and further investigation is needed before the model can be used for all fault codes.

Introduction: The entire United States has felt the effects of the overdose epidemic, but rural Appalachia has experienced disproportionate overdose deaths. This variation in overdose mortality can be attributed to the risk environment for overdose in rural Appalachia. Overdose prevention behaviors are individual level behaviors that people who inject drugs can implement that may have the potential to reduce their risk of overdose, however limited research exists regarding the utilization of those behaviors. It is important to consider how the risk environment can influence the utilization of overdose prevention behaviors among people who inject drugs. Therefore, the purpose of this research was to identify overdose prevention behaviors among people who inject drugs in rural Appalachia and better understand the relationship between those behaviors and the rural risk environment for overdose. Methods: This research was conducted using a mixed methods approach, including a scoping review, qualitative, and quantitative study. A scoping review was used to identify overdose prevention strategies and behaviors in rural America. Semi-structured interviews were used to identify overdose prevention behaviors among people who inject drugs in rural Appalachia. A quantitative survey was used to examine the relationship between risk environment determinants and overdose prevention behaviors utilization among people who inject drugs in rural Appalachia. Results: Results of primary data collection showed that people who inject drugs in rural Appalachia do utilize overdose prevention behaviors, including several drug checking methods and safe use behaviors. However, environmental barriers and disparities among people who inject drugs in rural Appalachia were highlighted in this research. Potential relationships exist between environmental determinants and the utilization of some overdose prevention behaviors. Conclusion: This research found the need for several policy and community program implications which all stem from the War on Drugs. Results highlighted the need for systems level change regarding the care for people who inject drugs, which includes the necessity for policy makers to consider harm reduction methods to reduce overdose mortality among people who live in rural Appalachia.

Humour can be a valuable tool for psychotherapists, if executed in a respectful manner. Laughter has myriad health benefits, and is associated with reduced depression, increased self-esteem, and lower perceived levels of stress (Eckstein et al., 2003). It can strengthen the therapeutic alliance and simplify the process of confronting clients on dysfunctional behaviours (Thomas et al., 2015). However, rigorous empirical study of humour in psychotherapy is scarce, as is clinical training in its use (Franzini, 2001). Ergo, this study queries: (1) How do counsellors and psychotherapists use humour in their therapy sessions? (2) In what contexts do counsellors and psychotherapists perceive humour use as being appropriate and beneficial in therapy? And (3) In what contexts do counsellors and psychotherapists perceive humour use as being potentially harmful? A semi-structured interview protocol was used to interview seven psychotherapists in Canada with a minimum of five years of work experience. Interviews were audio recorded, and data obtained was analyzed using Thematic Analysis (Braun & Clarke, 2012). This study examined the experiences of psychotherapists to determine how they use humour safely and effectively in therapy sessions, with the aim of gaining knowledge to inform clinical training on how best to minimize the potential for harm, and maximize the therapeutic benefits of humour in therapy. Eleven main themes, each with several subthemes, emerged in the data analysis. Implications for therapy, counsellor education and further research are discussed.

Bakgrund: Patientsäkerheten är en stor global utmaning och individer som vårdas på sjukhus hamnar i risk för att drabbas av vårdskada. Framsteg har gjorts kring säkerhetsåtgärder, samtidigt tyder forskning på att mänskliga misstag kvarstår. Sjuksköterskor har en viktig bidragande roll i arbetet mot säker vård för att motverka skada och lidande. Syfte: Att beskriva sjuksköterskors upplevelse av vad som påverkar det patientsäkra arbetet inom slutenvården.  Metod: Litteraturöversikten utgick från en kvalitativ metod baserat på en induktiv ansats. Totalt formade tretton vetenskapliga artiklar resultatet som kvalitetsgranskades och analyserades med Fribergs femstegsanalys.   Resultat: Resultatet presenteras i två teman följt av sex subteman. Arbetsmiljö; verksamhetens ansvar och patientens rättigheter, en stressad atmosfär, hög arbetsbelastning och brist på personal.  Teamsamverkan och ledarskap; Samarbete med andra professioner, samarbete med patient och närstående, sjuksköterskans ledarskap och kompetens.  Slutsatser: Sjuksköterskans roll är av vikt för att skapa säker vård. Faktorer som påverkar patientsäkerheten presenteras i följande huvudfynd; Stress, samarbete med andra professioner och sjuksköterskans kompetens. För att slutenvården ska kunna bistå med patientsäkerhet krävs en gynnsam arbetsmiljö, god kommunikation mellan kollegor och rätt kompetens hos sjuksköterskan. / Background: Patient safety is a major global challenge and individuals who are cared for in hospital run the risk of suffering a healthcare injury. Progress has been made on security measures, while research indicates that human error remains. Nurses have an important contributing role in the work towards safe care to counteract injury and suffering.  Purpose: To describe nurses' experience of what affects patient-safe work in inpatient care.  Method: The literature review was based on a qualitative method based on an inductive approach. A total of thirteen scientific articles shaped the results, which were quality reviewed and analyzed with Friberg's five-step analysis.  Results:  The result is presented in two themes followed by six subthemes. Working environment; the responsibility of the business and the patient's rights, a stressed atmosphere, high workload and lack of staff. Team collaboration and leadership; Collaboration with other professions, collaboration with patients and relatives, the nurse's leadership and competence.  Conclusions: The role of the nurse is important in creating safe care. Factors that affect patient safety are presented in the following main findings; Stress, collaboration with other professions and the nurse's skills. In order for inpatient care to be able to assist with patient safety, a favorable work environment, good communication between colleagues and the right competence of the nurse are required.

No description available.

The concentrations of heavy metals (Cd, Cu, Fe, Ni, Pb, Zn) were measured in water, and fish samples caught from the pond at Fishery Park in Unicoi County, TN. The water samples were collected once a week for 8 weeks. The amounts of metals in the muscle tissues, gill, and liver of the two fish species were measured. This was to determine if any correlation exists between the metal contents in water and those in the fish samples. The concentration ranges for the heavy metals found in the water samples are as follows: Zn 0.04-0.13; Cu, 0.00-0.00; Pb, 0.00-0.59; Cd, 0.0067-0.0071; Fe, 0.208-0.512; and Ni, 0.044-0.270 ppm. The concentration range for the heavy metals found in the fish tissues are as follows: Zn 0.0-0.48; Cu, 0.00-0.00; Pb, 0.00-0.43; Cd, 0.00-99.7; Fe, 25.7-1245.5; and Ni, 0.00-268.5 ppm. There was a strong correlation found between the water and fish tissue samples.