Community pharmacies in England offer convenient and safe disposal of unwanted medicines, including antimicrobials, and better uptake of this service could limit environmental antimicrobial resistance. However, there is limited information on the extent and nature of antibiotic returns to community pharmacies. The impact of an antibiotic amnesty campaign promoting antibiotic disposal through community pharmacies was evaluated with the intention of collecting detailed information on the antibiotics returned. An antibiotic amnesty campaign was delivered by community pharmacies in the Midlands (England) with an audit of returned antibiotics conducted in 19 community pharmacies in Leicestershire. Detailed information on antibiotics returned for disposal was gathered during the month-long amnesty campaign and again 3 months later in the same pharmacies. Antibiotics accounted for 3.12%-3.35% of all returned medicines. The amnesty campaign led to a significant increase in defined daily doses of returned antibiotics compared to the post-amnesty period (P = 0.0165), but there was no difference in the overall number of returned medicines. Penicillins were the most commonly returned antibiotics in both periods (29.3% and 42.5% of packs, respectively), while solid oral dose formulations predominated. A total of 36.6% of antibiotics returned during the amnesty period were expired, increasing to 53.4% in the post-amnesty period. Amnesty conversations had a significant impact on the number of antibiotic returns but campaign posters did not. Antibiotic conversations can increase the amount of antibiotics returned to community pharmacies for safe disposal, and passive campaign materials had limited impact. More research is needed to identify the most effective interventions to increase returns.
To make recommendations for improving medical amnesty policy implementation in collegiate athletics based on exploration of relevant policy implementation, implementation frameworks, and athletic department input. 54 published peer-reviewed articles, 78 collegiate athletics professionals, 5 content experts with direct responsibilities related to policies that impact college student and athlete well-being, and 113 higher education institutions' Athletics Healthcare Administrators (AHA). Mixed methods using narrative literature review, surveys, and interview data. Data coding was guided by the Consolidated Framework for Implementation Research (CFIR) and quantitative data were analyzed with descriptive statistics. Using coded data from the literature review and needs assessment, we identified modifiable implementation determinants and mapped these onto implementation strategies. With feedback from key organizational representatives, ten recommendations were developed and mostly viewed as feasible. We present recommendations for amnesty policy implementation within athletics departments, but additional research and evidence-based resources are needed to support implementation.
Objective: To describe common components of medical amnesty (MA) policies and examine how MA policies differ across institutions. Participants: 50 U.S. colleges and universities with current MA policies. Methods: A checklist was developed to compare and assess the campus MA policies of 50 institutions. Descriptive statistics, chi-square, and regression analyses were used to examine common policy components and differences across types of institutions. Results: 40% of policies did not include a purpose statement. 42% of policies had no mention about how to use the policy. 48% did not mention restrictions on amnesty. 32% did not mention follow-up actions. 24% of policies mentioned extending amnesty for additional person(s) present. There were no significant differences in policy components across school characteristics. Conclusions: Many policies lacked detail, highlighting the need for guidelines and best practices to develop MA policies. Future research could examine the effects of these policy components on help seeking intentions.
Cocaine is the second most popular traditional illicit drug in the European Union, after cannabis, and its high potential for addiction makes it a significant public health concern. Therefore, monitoring trends in the content and purity of street samples can provide valuable information to support harm reduction strategies. This study analysed a selection of 160 street cocaine samples collected at a large British summer festival between 2014 and 2024. A comparison between a low-cost, transportable 60 MHz benchtop nuclear magnetic resonance (NMR) instrument and a more expensive, larger laboratory-based 400 MHz NMR device was used to assess variations in composition and purity levels. Despite a lower signal-to-noise ratio and signal overlap causing some differences in values, the benchtop NMR produced almost identical results to those of the 400 MHz system. Until 2014, cocaine samples were highly adulterated; their purity increased sharply from 2015 onwards, with levels ranging from 80% to 98%, before showing a downward trend in 2024. The most commonly detected cutting agents were benzocaine, levamisole, caffeine, phenacetin, and lactose. Overall, this work demonstrates that low-field NMR can be effectively used to quantify cocaine in street samples. This could be especially beneficial on-site for guiding and enhancing harm reduction services and law enforcement.
Sexual violence (SV) is common among college students, but the vast majority of these experiences are not formally reported to institutions of higher education (IHEs). While it is well known that alcohol and drug use is highly associated with SV, little is known about whether policies and procedures regarding substance use (SU) at IHEs may contribute to low rates of reporting. This study describes the association between SU violations and SV reporting at IHE campuses in the US and examines whether SU amnesty policies are associated with more SV reporting. Linear regression was used to estimate the association between SU violations and SV reporting and assess differences between IHE campuses by amnesty policy status. Around 50% of campuses between 2001 and 2018 document neither SV reports nor SU violations. IHE campuses with amnesty policies have more SV reports. On average, IHEs with amnesty policies have 2.7 SV reports per 1000 students and an additional 0.02 SV reports for each SU violation per 1000 students. Amnesty policies that reduce the potential costs of reporting like facing disciplinary action for alcohol or drug use are positively associated with both the level and rate of SV reporting. Institutions of higher education administrators interested in making reporting an option for more SV survivors should examine how their policies, especially those related to alcohol, may play in creating barriers to SV reporting.
This editorial highlights the different barriers and enablers of antibiotic amnesty campaigns in community pharmacies. The main enablers of antibiotic amnesties included effective counselling and successful use of promotional resources, whilst the main barriers included lack of education in patients and staff. Enabling factors such as effective counselling and use of promotional resources should be continued with patients, whilst the main barriers can be tackled with provision of sufficient education, training, and knowledge for patients. Educating staff, by providing appropriate training to all staff members present in the pharmacy, can positively contribute to the success of antibiotic amnesty campaigns. The findings of this work can inform the development of interventions needed to improve antibiotic amnesties, resulting in more antibiotics being returned and contributing towards tackling the issue of antimicrobial resistance (AMR).
Antimicrobial resistance is a recognised threat to human health and may be driven by the unsafe disposal of antibiotics via domestic waste streams, contaminating the environment. A community pharmacy based antibiotic amnesty could address this. We evaluated the impact of an antibiotic amnesty promoting the return of unused antibiotics to community pharmacies in the Midlands region of England during World Antibiotic Awareness Week in November 2021. Two hundred and thirty nine pharmacies participated voluntarily and held amnesty conversations with 7399 people, 369 part used and 126 full packs of antibiotics were returned. This is an important public health initiative that could be replicated more widely.
The surging number of people who abuse drugs has a great impact on healthcare and law enforcement systems. Amnesty bin drug analysis helps monitor the "street drug market" and tailor the harm reduction advice. Therefore, rapid and accurate drug analysis methods are crucial for on-site work. An analytical method for the rapid identification of five commonly detected drugs ((3,4-methylenedioxymethamphetamine (MDMA), cocaine, ketamine, 4-bromo-2,5-dimethoxyphenethylamine, and chloromethcathinone)) at various summer festivals in the U.K. was developed and validated employing a single quadrupole mass spectrometer combined with an atmospheric pressure solids analysis probe (ASAP-MS). The results were confirmed on a benchtop gas chromatography-mass spectrometry instrument and included all samples that challenged the conventional spectroscopic techniques routinely employed on-site. Although the selectivity/specificity step of the validation assessment of the MS system proved a challenge, it still produced 93% (N = 279) and 92.5% (N = 87) correct results when tested on- and off-site, respectively. A few "partly correct" results showed some discrepancies between the results, with the MS-only unit missing some low intensity active ingredients (N-ethylpentylone, MDMA) and cutting agents (caffeine, paracetamol, and benzocaine) or detecting some when not present. The incorrect results were mainly based on library coverage. The study proved that the ASAP-MS instrument can successfully complement the spectroscopic techniques used for qualitative drug analysis on- and off-site. Although the validation testing highlighted some areas for improvement concerning selectivity/specificity for structurally similar compounds, this method has the potential to be used in trend monitoring and harm reduction.
Globally, the number of drug users and the proportion of the drug using population has increased from 210 million in 2009 to 269 million in 2019. Several studies suggest that music festival attendees are more likely to abuse illicit substances and have a high-risk profile. Consequently, it is crucial to develop robust field drug analysis methods that facilitate harm reduction and drug monitoring. The work presented in this report aimed at developing and validating qualitative analytical methods for 3,4-methylenedioxymethamphetamine, 4-bromo-2,5-dimethoxyphenethylamine (2C-B), ketamine and N-ethylpentylone on two portable gas chromatography-mass spectrometry (GC-MS) systems: Griffin G510 (Teledyne FLIR, West Lafayette, IN) and Torion T-9 (PerkinElmer, Shelton, CT). The diagnostic ability of the mobile GC-MS units was assessed on 200 samples in total, seized at two large summer music festivals in the United Kingdom. The method validation process included selectivity/specificity, limit of identification, carry-over, ruggedness/robustness, and inter- and intra-day precision (repeatability and reproducibility). The Griffin G510 demonstrated a limit of identification from 1 mg/mL for 2C-B to 0.063 mg/mL for ketamine and good ruggedness and precision results. The precision for 2C-B using the Torion T-9 was poorer than for the Griffin G510, but equivalent for the other compounds tested. Correct identifications (versus benchtop GC-MS) for the two festivals were 85%-86% and 74%-83% for the Griffin G510 and the Torion T-9, respectively. The two portable instruments were able to adequately cover current on-site drug-testing analytical gaps and proved to be a powerful addition to the on-site drug analysis techniques.
暂无摘要（点击查看详情）
The use of drug detection dogs and other punitive policing methods remain common at music festivals in Australia and elsewhere, despite concern about iatrogenic effects and recommendations for their overhaul. While drug amnesty bins are a commonly implemented strategy purported to mitigate risk associated with policing, the efficacy of this intervention is debated. This paper investigates two of the most concerning iatrogenic effects of drug policing practices at Australian festivals - internal concealment and panic consumption - and explores the potential efficacy of drug amnesty bins. A stepped, mixed methods study (qual→QUANT→qual) comprised qualitative interviews with key informants and festivalgoers, and a quantitative online survey completed by almost 2000 Australian festivalgoers (52% male; median age 20 years old). Descriptive statistics were performed alongside bivariable and multivariable logistic regressions predicting internal concealment and panic consumption. Inductive thematic analysis was used to examine the qualitative data. Among respondents who had ever used illicit drugs at festivals (n=1065), 23% reported hiding drugs internally to evade police detection and 17% reported panic consumption. Female respondents and respondents expecting dogs were at greater odds of reporting internal concealment. The qualitative data provided greater insight into the risky nature of internal concealment practices and panic incited by police at the gates. When asked if they would have considered discarding their drugs into a drug amnesty bin had they been concerned about detection, less than a quarter (24%) said they definitely or probably would have. This paper adds to the evidence regarding iatrogenic effects of punitive drug policing practices at festivals. The findings have implications for shifting away from punitive policies to ones focused on public health. Additionally, the findings suggest drug amnesty bins should not be viewed as an adequate response for averting harms from drug policing.
Studies indicate that a leading reason young people do not seek medical assistance for alcohol-related emergencies is worry of "getting in trouble". To assuage these fears, over 30 states and numerous universities have passed medical amnesty laws. However, there are variations in protections between states. Objectives: This study aimed to (1) assess students' knowledge of Nevada's medical amnesty law; (2) knowledge of alcohol poisoning indicators; (3) whether variations in the law's coverage relates to differences in intention to seek medical attention; (4) whether knowledge of the law is associated with intent to seek medical attention; and (5) whether attitudes, perceived norms, and personal agency are associated with intent to seek medical attention for an alcohol-related emergency, specifically alcohol poisoning. Method: This study surveyed 564 graduate and undergraduate students aged 18 and older from the University of Nevada, Reno. Results: The results suggest that that students were severely undereducated about the state's medical amnesty law. Having a medical amnesty law at all is related to increased intent to call for medical attention in an alcohol poisoning situation. Further, components of the integrated behavior model (i.e. attitudes, perceived norms, and perceived personal agency) are associated with increased intent to call for medical attention. Conclusions: The presence of medical amnesty laws versus a law providing no protections for underage drinkers is positively related to an individual's intention to seek medical attention in an alcohol-related emergency. Educational implications and recommendations for policy implementation are discussed.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
This article establishes a new fact about immigration policies: granting legal status to undocumented immigrants has long-term effects on their formal employment and assimilation. We exploit the broad amnesty enacted in Italy in 2002, together with rich survey data collected in 2011 on a representative sample of immigrant households, to estimate the long-run effects of receiving legal amnesty. Immigrants who were not eligible for the amnesty have a 14% lower probability of working in the formal sector a decade later, are subject to more severe ethnic segregation on the job, and display less linguistic assimilation than those who obtained legal status through the amnesty.
Human rights research increasingly employs computational text analysis, but existing datasets provide either document-level aggregations or event-level extractions from news sources, limiting fine-grained analysis of primary organizational reports. We present the Human Rights Violation Reporting Dataset, a comprehensive paragraph-level corpus comprising reports from Amnesty International, Human Rights Watch, the US State Department, and the Working Group on Enforced or Involuntary Disappearances, spanning 1999-2023. The dataset contains 832,220 paragraphs processed using a custom pipeline combining PDF extraction, custom crawlers, language model-based text correction (reducing character-level errors from 8.3% to 1.7%), and comprehensive natural language processing (NLP) enrichment, including named entity recognition, sentiment analysis, text classification, and content moderation. Each paragraph is enriched with 23 metadata fields enabling entity network analysis, topic modelling, cross-organizational comparison, and machine learning applications. Data are provided in comma-separated values (CSV) format, with standardized country-year identifiers compatible with existing political science datasets. This dataset enables previously impossible fine-grained computational analysis of how major human rights organizations document violations across time, space, and organizational contexts.
Harm reduction can decrease negative consequences of substance use, but the extent to which harm reduction practices are implemented in emergency shelter settings is unknown. We conducted 55 semi-structured interviews at four shelters across Massachusetts to understand guest (40) and staff (15) experiences with harm reduction practices. We conducted thematic analysis rooted in the Social Ecological Model (SEM). Well-established harm reduction practices include naloxone distribution, bathroom checks, and safe-sex supplies. Less established practices include wound care supplies, bad-date lists for people engaging in survival sex work, "no questions asked" lockers, amnesty beds, and abolishing curfews. Recommended future practices include safer consumption spaces, drug checking, and a full suite of harm reduction supplies. Key findings at each SEM level were: At the individual level: guest and staff attitudes toward harm reduction were mixed and influenced by personal experience, or gender identity. At the interpersonal level: tensions between people who use drugs (PWUD) and others who are abstinent; stigma prevents guests from being candid with staff about substance use, and fuels tension between staff and guests. At the community level: Guests and staff have access to naloxone at shelters, carry it, and use it regularly; communication around the presence and availability of naloxone is essential; women innovate distinct interventions for themselves. Last, at the societal level: prohibitory policies do not stop people from using drugs but make people less safe; shelters can collaborate with community organizations to provide necessary harm reduction services. Shelters are implementing increasingly creative programs of harm reduction practices.
ObjectiveThis study conducted a comprehensive analysis of psychological and institutional factors that lead to the transformation of criminal behaviour in conditions of armed conflict, using the Russian-Ukrainian war as a case study.MethodThis research was based on qualitative analysis of secondary data. The study examined reports and analytical materials from international monitoring missions, including the United Nations, the Organization for Security and Co-operation in Europe, the Parliamentary Assembly of the Council of Europe, and Amnesty International. These sources were compared with theoretical approaches from criminal psychology and criminology in order to identify patterns in behavioural transformation under wartime conditions.ResultsThe findings demonstrate that the transformation of criminal behaviour occurs at 3 interconnected levels. First, the destruction or weakening of legitimate legal institutions in occupied territories creates an institutional vacuum and a state of anomie, which facilitates opportunistic crimes such as looting and organised criminal activity, including enforced disappearances. Second, among combatants there is a normalisation of violence supported by psychological mechanisms such as dehumanisation and moral disengagement, which contributes to systematic war crimes, including torture, sexual violence, and indiscriminate attacks. Third, changes occur in the behaviour of the civilian population, manifested in survival-related crimes, aggression caused by trauma, and forced criminalisation through collaboration with occupying authorities.ConclusionsThis report describes how armed conflict significantly alters patterns of criminal behaviour through the interaction of institutional collapse and psychological adaptation to violence. The results emphasise the need to incorporate psychological factors into post-war justice mechanisms and conflict-zone law enforcement strategies. They may also contribute to the development of post-war rehabilitation programs, improvements in transitional justice systems, and the training of peacekeeping personnel and law enforcement agencies operating in conflict environments.