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Search Results: 1 - 10 of 5149 matches for " Calvin Lai "
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Multistream influenza surveillance for situational awareness
Eric Lau,Benjamin Cowling,Lai-ming Ho,Calvin Cheng
Emerging Health Threats Journal , 2011, DOI: 10.3402/ehtj.v4i0.11029
Addiction Treatment and Stable Housing among a Cohort of Injection Drug Users
Anita Palepu,Brandon D. L. Marshall,Calvin Lai,Evan Wood,Thomas Kerr
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0011697
Abstract: Unstable housing and homelessness is prevalent among injection drug users (IDU). We sought to examine whether accessing addiction treatment was associated with attaining stable housing in a prospective cohort of IDU in Vancouver, Canada.
HIV seroprevalence among participants at a Supervised Injection Facility in Vancouver, Canada: implications for prevention, care and treatment
Mark W Tyndall, Evan Wood, Ruth Zhang, Calvin Lai, Julio SG Montaner, Thomas Kerr
Harm Reduction Journal , 2006, DOI: 10.1186/1477-7517-3-36
Abstract: In response to a large open public drug scene, high rates of HIV and hepatitis C transmission, fatal drug overdoses, and poor health outcomes among injection drug users, Vancouver established North America's first government sanctioned medically supervised safer injection facility (SIF) in September 2003 [1-3]. The SIF has been approved as a three year scientific evaluation by Health Canada with a predetermined set of outcomes to be evaluated through a comprehensive prospective strategy [4,5]. Initial findings from the evaluation have been published, including evidence that the SIF has attracted a wide range of marginalized injection drug users (IDUs) [6,7], has reduced drug related public disorder [8], and has been associated with reduced syringe sharing [9,10].With respect to HIV, the focus of the SIF to date, as with other harm reduction initiatives, has been on reducing HIV transmission through the provision of sterile syringes and providing a space where self-administered injections can be conducted in a clean and controlled environment [4,11]. It has been previously shown in this community that HIV infection has a disproportional impact on injection cocaine users [12], women [13], and those of Aboriginal ethnicity [14], and efforts to specifically engage and accommodate these groups at the SIF are ongoing. Given the high representation of these groups at the SIF, it is anticipated that attending the SIF will result in reduced transmission of HIV.The purpose of this analysis is to measure the prevalence and correlates of baseline HIV among those who are using the SIF. This information is important to determine if the SIF could be used as a site for HIV related care and treatment. This is also important in order to measure the longitudinal incidence of HIV transmission among those using the SIF.As part of a comprehensive evaluation strategy, a representative cohort of SIF users (SEOSI) was recruited and followed prospectively. The methods have been described pre
Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand
Nadia Fairbairn, Karyn Kaplan, Kanna Hayashi, Paisan Suwannawong, Calvin Lai, Evan Wood, Thomas Kerr
BMC International Health and Human Rights , 2009, DOI: 10.1186/1472-698x-9-24
Abstract: Multivariate logistic regression was used to identify factors associated with evidence planting of drugs by police among a community-based sample of IDU in Bangkok. We also examined the prevalence and average amount of money paid by IDU to police in order to avoid arrest.252 IDU were recruited between July and August, 2008, among whom 66 (26.2%) were female and the median age was 36.5 years. In total, 122 (48.4%) participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11), recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66), syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66), and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36). Among those who reported having drugs planted on them, 59 (48.3%) paid police a bribe in order to avoid arrest.A high proportion of community-recruited IDU participating in this study reported having drugs planted on them by police. Drug planting was found to be associated with numerous risk factors including syringe sharing and participation in government-run drug treatment programs. Immediate action should be taken to address this form of abuse of power reportedly used by police.Illicit injection drug use is associated with significant morbidity and mortality, including infectious disease transmission and overdose [1,2]. Numerous strategies have been implemented to address these harms and deter drug use, including a variety of supply and demand reduction measures [3,4]. Many governments internationally allocate the majority of resources to law enforcement strategies [5-7]. These tactics include arresting individuals who allegedly use drugs or deal drugs in an effort to reduce drug availability and consumption [8,9]. Despite continued investment in these efforts, there is evidence indicating that this type of enforcement often has little impact on the
Drug use patterns among Thai illicit drug injectors amidst increased police presence
Dan Werb, Kanna Hayashi, Nadia Fairbairn, Karyn Kaplan, Paisan Suwannawong, Calvin Lai, Thomas Kerr
Substance Abuse Treatment, Prevention, and Policy , 2009, DOI: 10.1186/1747-597x-4-16
Abstract: Drug users in Thailand continue to face a variety of harms. In addition to the health risks associated with the consumption of illicit drugs through injection and other means, Thai drug users face stigmatization and an elevated risk of violence as a result of their government's 'hard line' response to illicit drug use [1]. In February 2003, the Thai government implemented a widely-publicized "War on Drugs" aimed at disrupting a burgeoning demand for methamphetamines [2]. The stated goal of this campaign was to make Thailand "drug free" by targeting drug dealers [1,3]. It has been reported that over 2,200 people, not necessarily drug dealers, were killed during its implementation [3]. Despite a massive outcry from human rights groups and a government pledge to treat drug users "as patients, not criminals" [4,5], the reinstitution of the Thai "War on Drugs" was announced in February 2008. At that time, Thailand's interior minister Chalerm Yubamrong publicly stated that the crackdown would continue even if "thousands of people have to die" [6].Little is known regarding the effect of the Thai War on Drugs on demand for illicit drugs, though recent studies suggest that this campaign may have altered drug use patterns among illicit drug users and reduced consumption of methamphetamine among youth in the short term [7,8]. However, the campaign may have also contributed to a systematic underreporting of illicit drug use and related risk behaviors and may have increased the misuse of diverted licit drugs [7]. This campaign was implemented in response to a massive increase in methamphetamine use among Thais since the mid-1990s, as well as a steady increase in heroin injection that has been linked to the effective eradication of the country's indigenous opium cultivation industry beginning in the 1970s [7]. Research further suggests that the Thai government is continuing to rely on drug crackdowns as a primary response to illicit drug use in the country [9]. We therefore sough
Impact of a medically supervised safer injecting facility on drug dealing and other drug-related crime
Evan Wood, Mark W Tyndall, Calvin Lai, Julio SG Montaner, Thomas Kerr
Substance Abuse Treatment, Prevention, and Policy , 2006, DOI: 10.1186/1747-597x-1-13
Abstract: Despite existing interventions [1,2], illicit injection drug use continues to fuel infectious disease and fatal overdose epidemics in many settings, and has prompted substantial community concern [3-5]. Public health programming aimed at reducing the harms of illicit drug use commonly face community and legal opposition due to concerns that these services may lead to increases in criminal activity in their vicinity [6].In an effort to address longstanding epidemics of HIV and drug-related overdose, Vancouver opened North America's first medically supervised safer injection facility (SIF) on September 22, 2003. Consistent with most SIF [7], within the facility, injection drug users (IDU) can inject pre-obtained illicit drugs under the supervision of medical staff, and an addictions counsellor and nursing care are available on site [8]. A major concern prior to the opening of the SIF was that the facility would result in increased migration of IDU and drug dealers to the city's Downtown Eastside where the facility is located, and subsequently prompt increases in criminal activity [8-11]. To examine these concerns, the present study was therefore conducted to examine patterns of criminal activity (drug trafficking and other drug-related crime) in the city's Downtown Eastside since the facility opened.For the present analyses, we accessed Vancouver Police Department statistics regarding charges for drug trafficking (which is defined to include selling, administering, giving, transferring, transporting, sending, or delivering illicit drugs), assaults and robberies, and vehicle break-ins and vehicle theft in the neighborhoods broadly defined as the Downtown Eastside area (Downtown Eastside proper, Chinatown, Gastown, Victory Square, and Strathcona). These indicators were selected for several reasons. First, although a reduction in public drug use and publicly discarded syringes has been attributed to the opening of the SIF [12], the potential influx of drug dealers to sel
Incarceration experiences among a community-recruited sample of injection drug users in Bangkok, Thailand
Kanna Hayashi, M-J Milloy, Nadia Fairbairn, Karyn Kaplan, Paisan Suwannawong, Calvin Lai, Evan Wood, Thomas Kerr
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-492
Abstract: We examined the prevalence of incarceration among community-recruited IDU participating in the Mitsampan Community Research Project. Multivariate logistic regression was used to identify factors associated with a self-reported history of incarceration. We also examined the prevalence of injection drug use and syringe sharing within prisons.252 IDU were recruited in August 2008; 66 (26.2%) were female and the median age was 36.5 years. In total, 197 (78.2%) participants reported a history of incarceration. In multivariate analyses, reporting a history of incarceration was associated with a history of compulsory drug treatment (adjusted odds ratio [AOR] = 4.93; 95% confidence interval [CI]: 1.95 - 12.48), non-fatal overdose (AOR = 3.69; 95%CI: 1.45 - 9.39), syringe sharing (AOR = 2.20; 95%CI: 1.12 - 4.32), and female gender (AOR = 0.41; 95%CI: 0.20 - 0.82). Among those who reported a history of incarceration, 59 (29.9%) reported injection drug use in prison, and 48 (81.4%) of these individuals reported sharing syringes in prison. Incarceration was not associated with the number of injections performed in the previous week (p = 0.202).Over three-quarters of the IDU participating in this study reported a history of incarceration, and 30% of these individuals reported injection drug use within prison. Further, an alarmingly high level of syringe sharing within prison was reported, and incarceration was not associated with reductions in drug use. These findings provide further evidence of the need for community diversion strategies, as well as harm reduction programs, in Thai prisons.In many countries, drug law enforcement continues to be a dominant societal response to illicit drug use [1,2]. Consequently, injection drug users (IDU) are frequently arrested and incarcerated [3-5]. A large body of evidence indicates that incarceration is associated with elevated risks of drug-related harm among IDU, including the spread of blood-borne pathogens such as human immunodeficien
High rates of midazolam injection among drug users in Bangkok, Thailand
Thomas Kerr, Niyada Kiatying-Angsulee, Nadia Fairbairn, Kanna Hayashi, Paisan Suwannawong, Karyn Kaplan, Calvin Lai, Evan Wood
Harm Reduction Journal , 2010, DOI: 10.1186/1477-7517-7-7
Abstract: We examined the prevalence and correlates of midazolam injection among 252 IDU participating in the Mitsampan Community Research Project, Bangkok, using multivariate logistic regression. We also examined the use of midazolam in combination with other drugs.252 IDU participated in this study, including 66 (26.2%) women. In total, 170 (67.5%) participants reported ever having injected midazolam, and 144 (57.1%) reported daily midazolam injection in the past six months. In multivariate analyses, a history of midazolam injection was independently associated with using drugs in combination (adjusted odds ratio [AOR] = 5.86; 95% confidence interval [CI]: 2.96-11.60), younger age (AOR = 0.43; 95%CI: 0.22-0.83), having a history of methadone treatment (AOR = 3.12, 95%CI: 1.55-6.90), and binge drug use (AOR = 2.25, 95%CI: 1.09-4.63). The drugs most commonly used in combination with midazolam were heroin (72.3%) and yaba (methamphetamine) (30.5%).We observed a high rate of midazolam injection among Thai IDU. Midazolam injection was strongly associated with polysubstance use and binge drug use, and was most commonly used in combination with both opiates and methamphetamines. Our findings suggest that midazolam injection has become increasingly common within Thailand. Evidence-based approaches for reducing harms associated with midazolam injection are needed.Thailand, like many other countries globally has been experiencing shifting patterns of drug supply and use [1-7]. Studies undertaken during the past decade suggest a number of Thai people who inject drugs (IDU) are now injecting midazolam (Thai trade name: Dormicum?), a legal, rapid onset, short duration benzodiazepine with potent sedative, amnestic and ventilatory depressant effects [8-10]. Midazolam is prescribed in tablet form, although it is often administered intravenously for sedation in hospital settings [9]. However, it has been reported anecdotally that some Thai physicians also prescribe midazolam for the treatme
A profile of the online dissemination of national influenza surveillance data
Calvin KY Cheng, Eric HY Lau, Dennis KM Ip, Alfred SY Yeung, Lai Ho, Benjamin J Cowling
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-339
Abstract: We searched for national influenza surveillance websites for every country and reviewed the resulting sites where available during the period from November 2008 through February 2009. Literature about influenza surveillance was searched at MEDLINE for relevant hyperlinks to related websites. Non-English websites were translated into English using human translators or Google language tools.A total of 70 national influenza surveillance websites were identified. The percentage of developing countries with surveillance websites was lower than that of developed countries (22% versus 57% respectively). Most of the websites (74%) were in English or provided an English version. The most common surveillance methods included influenza-like illness consultation rates in primary care settings (89%) and laboratory surveillance (44%). Most websites (70%) provided data within a static report format and 66% of the websites provided data with at least weekly resolution.Appropriate dissemination of surveillance data is important to maximize the utility of collected data. There may be room for improvement in the style and content of the dissemination of influenza data to health care professionals and the general public.Upper respiratory viruses cause significant global mortality and morbidity each year [1]. Influenza virus is of particular public health concern due to its association with severe infections and deaths, and its propensity of causing large scale seasonal epidemics and pandemics. Local and national prospective influenza and influenza-like illness surveillance systems provide important and timely information to policy makers and public health practitioners for monitoring trends and disease burden, planning, implementing, and evaluating appropriate prevention and control interventions, and allocating resources [2]. Recent decades have seen dramatic improvements in influenza surveillance systems [3]. Surveillance websites serve as an excellent tool for communicating timely i
Reasons for Hope: Canadian Breast Cancer Research Conference, Le Concorde Hotel, Quebec City, Quebec, Canada, 3–5 May 2001
Calvin Roskelley
Breast Cancer Research , 2001, DOI: 10.1186/bcr331
Abstract: The Canadian Breast Cancer Research Initiative (CBCRI) sponsored its second 'Reasons For Hope' Conference, 3–5 May 2001, in Quebec City. This gathering brought together researchers, clinicians, healthcare providers and advocates to present and discuss some of the latest findings in breast cancer research, diagnosis and treatment. The multidisciplinary objective of the meeting's organizers was clearly illustrated by the initial reports from the CBCRI's recently instituted 'Streams of Excellence' program, which has brought together teams of researchers from across Canada to tackle large scale projects in a thorough and comprehensive manner. For example, Tim Whelan (McMaster University, Hamilton, Ontario, Canada) and Irene Andrulis (Lunenfeld Institute, Toronto, Ontario, Canada) outlined their group's conceptual framework for accelerating the discovery of clinically relevant molecular changes in breast cancer and rapidly translating these findings into novel treatment paradigms. Michael Pollak (Jewish General Hospital, Montreal, Quebec, Canada) and his group are taking a similar approach as it specifically relates to insulin-like growth factors in breast cancer development and progression. Both of these programs, and other CBCRI-funded ventures, have strong basic research components. The following is a sampling of the basic research highlights from this meeting.In a plenary session entitled 'Genetic Approaches to Understanding the Conversion of Normal to Malignant Cells', Phil Leder (Harvard Medical School, Boston, MA, USA) and Mina Bissell (Berkeley National Laboratory, Berkeley, CA, USA) presented data and persuasive arguments for the importance of genetic and epigenetic change, respectively, in breast tumorigenesis. Leder's laboratory pioneered the use of transgenic mice to identify the functional consequences of combinatorial oncogene overexpression in the mammary gland. This group has more recently used single oncogenes as genetic 'initiators' followed by mouse ma
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