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Larnder A, Burek P, Wallace B, Hore DK. Third party drug checking: accessing harm reduction services on the behalf of others. Harm Reduct J 2021; 18:99. [PMID: 34535157 PMCID: PMC8447798 DOI: 10.1186/s12954-021-00545-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/02/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Drug checking uses chemical analytical technologies to analyze drugs from the unregulated market to reduce substance use-related risks. We aim to examine the frequency of third party use of a community drug checking service to explore the potential for harm reduction to extend beyond the individual into the community, increase service accessibility, and to contribute to upstream interventions in the supply. METHODS Over 31 months, data were collected from a point-of-care drug checking service operated in Victoria, Canada. Through the implementation of survey questions at the intake of the service, data were collected about whether the drug check was for the individual, to sell, and/or for others. RESULTS Just over half (52%) of service users were checking for reasons that extended beyond individual use. When checking for others, friends were the most common response, representing 52% of responses, and outreach/support workers checking for others was the second most at 32%. Twelve percent of service users reported checking to sell or for a supplier. CONCLUSIONS Third party checking is a frequent, and important aspect of drug checking services, which through facilitating community engagement and increasing accessibility, has expanded the reach of interventions beyond individuals to reduce risks within the unregulated market. Therefore, drug checking as an overdose response should be responsive and accessible for those using the service on the behalf of others.
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Affiliation(s)
- Ashley Larnder
- Department of Chemistry, University of Victoria, Victoria, V8W 3V6, Canada
| | - Piotr Burek
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, V8W 2Y2, Canada
| | - Bruce Wallace
- School of Social Work, University of Victoria, Victoria, V8W 2Y2, Canada. .,Canadian Institute for Substance Use Research, University of Victoria, Victoria, V8W 2Y2, Canada.
| | - Dennis K Hore
- Department of Chemistry, University of Victoria, Victoria, V8W 3V6, Canada.,Department of Computer Science, University of Victoria, Victoria, V8W 3P6, Canada
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Withers B, Clancy L, Burgess J, Simms R, Brown R, Micklethwaite K, Blyth E, Gottlieb D. Establishment and Operation of a Third-Party Virus-Specific T Cell Bank within an Allogeneic Stem Cell Transplant Program. Biol Blood Marrow Transplant 2018; 24:2433-2442. [PMID: 30172015 DOI: 10.1016/j.bbmt.2018.08.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/21/2018] [Indexed: 11/28/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT) donor-generated virus-specific T cells (VSTs) can provide effective treatment for viral infection post-HSCT but are not readily accessible to all patients. Off-the-shelf cryopreserved VSTs suitable for treatment of multiple patients are an attractive alternative. We generated a bank of 17 cytomegalovirus (CMV)-, 14 Epstein-Barr virus (EBV)-, and 15 adenovirus (AdV)-specific T cell products from 30 third-party donors. Donors were selected for expression of 6 core HLA antigens expressed at high frequency in the local transplant population. T cells were generated by co-culturing venous blood or mobilized hematopoietic stem cell (HSC)-derived mononuclear cells with monocyte-derived dendritic cells pulsed with overlapping peptides covering CMV pp65, AdV5 hexon, or EBV BZLF1/LMP2A/EBNA1 proteins. Addition of a CD14+ selection step instead of plate adherence to isolate monocytes before culture initiation significantly improved expansion in cultures from HSC material. Phenotyping showed the CD8+ subset to have significantly higher numbers of terminal effector T cells (CD45RA+62L-) and lower numbers of effector memory T cells (CD45RA-62L-) when compared with the CD4+ subset. Increased expression of the immunoinhibitory markers PD-1 and TIM-3 was noted on CD4+ but not CD8+ cells when compared with the control group. VST showed antiviral activity restricted through a variety of common HLAs, and modelling suggested a suitably HLA-matched product would be available for >90% of HSCT patients. Only a small number of carefully selected third-party donors are required to generate a VST bank of broad coverage, indicating the feasibility of local banking integrated into existing allogeneic HSCT programs.
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Affiliation(s)
- Barbara Withers
- Westmead Institute for Medical Research, University of Sydney, Australia; Blood and Bone Marrow Transplant Unit, Westmead Hospital, Sydney, Australia; Department of Haematology, Westmead Hospital, Sydney, Australia
| | - Leighton Clancy
- Westmead Institute for Medical Research, University of Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - Jane Burgess
- Westmead Institute for Medical Research, University of Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - Renee Simms
- Westmead Institute for Medical Research, University of Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - Rebecca Brown
- Westmead Institute for Medical Research, University of Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - Kenneth Micklethwaite
- Westmead Institute for Medical Research, University of Sydney, Australia; Blood and Bone Marrow Transplant Unit, Westmead Hospital, Sydney, Australia; Department of Haematology, Westmead Hospital, Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - Emily Blyth
- Westmead Institute for Medical Research, University of Sydney, Australia; Blood and Bone Marrow Transplant Unit, Westmead Hospital, Sydney, Australia; Department of Haematology, Westmead Hospital, Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - David Gottlieb
- Westmead Institute for Medical Research, University of Sydney, Australia; Blood and Bone Marrow Transplant Unit, Westmead Hospital, Sydney, Australia; Department of Haematology, Westmead Hospital, Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.
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van Doorn J, Zeelenberg M, Breugelmans SM. An exploration of third parties' preference for compensation over punishment: six experimental demonstrations. Theory Decis 2018; 85:333-351. [PMID: 30956365 PMCID: PMC6413721 DOI: 10.1007/s11238-018-9665-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Research suggests that to restore equity, third parties prefer compensation of a victim over the punishment of a perpetrator. It remains unclear, however, whether this preference for compensation is stable or specific to certain situations. In six experimental studies, we find that adjustments in the characteristics of the situation or in the available behavioral options hardly modify the preference of compensation over punishment. This preference for compensation was found even in cases where punishment might refrain a perpetrator from acting unfairly again in the future, and even when punishment has a greater impact in restoring equity than compensation does. Thus, the preference of compensation over punishment appears to be quite robust. Implications and ideas for future research are discussed.
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Affiliation(s)
- Janne van Doorn
- Department of Criminology, Leiden University, PO Box 9520, 2300 RA Leiden, The Netherlands
| | - Marcel Zeelenberg
- Department of Social Psychology, Tilburg Institute for Behavior Economics Research, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- VU Amsterdam, Amsterdam, The Netherlands
| | - Seger M. Breugelmans
- Department of Social Psychology, Tilburg Institute for Behavior Economics Research, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
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Li J, Tomasello M. The development of intention-based sociomoral judgment and distribution behavior from a third-party stance. J Exp Child Psychol 2017; 167:78-92. [PMID: 29154032 DOI: 10.1016/j.jecp.2017.09.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 12/27/2022]
Abstract
The current study investigated children's intention-based sociomoral judgments and distribution behavior from a third-party stance. An actor puppet showed either positive or negative intention toward a target puppet, which had previously performed a prosocial or antisocial action toward others (i.e., children witnessed various types of indirect reciprocity). Children (3- and 5-year-olds) were asked to make sociomoral judgments and to distribute resources to the actor puppet. Results showed that 5-year-olds were more likely than 3-year-olds to be influenced by intention when they made their judgment and distributed resources. The target's previous actions affected only 5-year-olds' intent-based social preference. These results suggest that children's judgments about intent-based indirect reciprocity develop from ages 3 to 5 years.
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Affiliation(s)
- Jing Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China; Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany.
| | - Michael Tomasello
- Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany
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Abstract
The principle of subsidiarity is a bastion of Catholic social teaching. It is also a principle in the philosophy of the American Founding Fathers. In the USA, subsidiarity is ignored without a sense of the proper harmony between authority and responsibility. Human dignity and wise stewardship are compromised. Conscience protection becomes a concerning issue as highlighted by the conflicts arising after passing of the Patient Protection and Affordable Care Act. A reconnection of the patient to be steward of his health care is critical in addressing these issues. Third parties, including the government, business, and insurance companies, are firmly entrenched in health care oftentimes with the result being increased cost and detachment of the patient from the stewardship of his or her care. Vitally needed is a return to the principle of subsidiarity in health care. Hopeful solutions include the Zarephath Health Center, the Surgery Center of Oklahoma, and the clinic of Dr. Juliette Madrigal-Dersch. Summary : The principle of subsidiarity is a bastion of Catholic social teaching. It is a principle in the philosophy of the American Founding Fathers. In the US, subsidiarity is ignored without a sense of the proper harmony between authority and responsibility. Human dignity, wise stewardship, and solidarity are compromised. A reconnection of the patient to personal stewardship of his health care is critical in addressing these issues. Third parties are firmly entrenched in health care oftentimes with the result being increased cost and detachment of the patient from his or her care. Vitally needed is a return to the principle of subsidiarity in health care.
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Mothes H, Enge S, Strobel A. The interplay between feedback-related negativity and individual differences in altruistic punishment: An EEG study. Cogn Affect Behav Neurosci 2016; 16:276-88. [PMID: 26530245 DOI: 10.3758/s13415-015-0388-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To date, the interplay betwexen neurophysiological and individual difference factors in altruistic punishment has been little understood. To examine this issue, 45 individuals participated in a Dictator Game with punishment option while the feedback-related negativity (FRN) was derived from the electroencephalogram (EEG). Unlike previous EEG studies on the Dictator Game, we introduced a third party condition to study the effect of fairness norm violations in addition to employing a first person perspective. For the first time, we also examined the role of individual differences, specifically fairness concerns, positive/negative affectivity, and altruism/empathy as well as recipients' financial situation during altruistic punishment. The main results show that FRN amplitudes were more pronounced for unfair than for fair assignments in both the first person and third party perspectives. These findings suggest that FRN amplitudes are sensitive to fairness norm violations and play a crucial role in the recipients' evaluation of dictator assignments. With respect to individual difference factors, recipients' current financial situation affected the FRN fairness effect in the first person perspective, indicating that when being directly affected by the assignments, more affluent participants experienced stronger violations of expectations in altruistic punishment decisions. Regarding individual differences in trait empathy, in the third party condition FRN amplitudes were more pronounced for those who scored lower in empathy. This may suggest empathy as another motive in third party punishment. Independent of the perspective taken, higher positive affect was associated with more punishment behavior, suggesting that positive emotions may play an important role in restoring violated fairness norms.
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Mondoloni A, Buard M, Nargeot J, Vacheron MN. [The imminent peril in the law of July the fifth 2011, two years later: the impact on health?]. Encephale 2014; 40:468-73. [PMID: 24703930 DOI: 10.1016/j.encep.2014.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 01/09/2014] [Indexed: 11/18/2022]
Abstract
In 1938, the French government decided to enact a first legislation to enforce admission of the mentally ill to hospitals. Later in 1990, the law took into consideration the evolution of practices with an increase of free admissions and the right to maintain the mentally ill in cities. Three types of psychiatric hospitalization were defined: free, on third party request and for involuntary confinement. A review had theoretically to be conducted every 5 years. In practice this was not the case, probably due to the balance between individual freedom, patient care and public safety always hard to find. However, considering the imperative European harmonization and the fact the Constitutional Council declared a double unconstitutionality of the law, the Act of July 5th was enacted in a hurry during the summer 2011. The Act defines the "rights and the protection of people subject to psychiatric care and methods of coverage". In this document, we will briefly review the context of this law. We will also explore the clinical implications of the very innovative measure: the "péril imminent". We will use the admissions at the Sainte-Anne hospital in Paris in 2010 to 2012. Three major key points were introduced in the law: a judge controls an agreeable release after 15 days and 6 months of continuous hospitalization. The law let the new possibility to provide ambulatory cares under constraints, and these to make an involuntary confinement without a third party request, using the "imminent peril". This law implies the involvement of the judge and the lawyer. This one has to defend a client who needs care, he controls the formal validity of decisions concerning the patient. To provide treatment without consent in "imminent peril" to someone, conditions are requested: these mental disorders make his consent impossible and his mental state requires immediate care with immediate care of constant medical monitoring justifying a full hospitalization or regular medical monitoring for support under another form of full hospitalization (Article L.3212. 1 of the Code of Public Health). Moreover, a demand for care by a third party has also to be impossible to obtain and an imminent peril to the person's health has to exist, supported by a medical certificate from a doctor who does not belong to the patient's psychiatric hospital. The imminent peril would be an immediate danger to the health or life of the patient. What has been the impact of this law adopted in emergency at Sainte-Anne hospital? This psychiatric hospital is in charge of the population in southern Paris, where reside about 655,000 people. This work observes the evolution of the type of hospitalization and care before and after the adoption of the law. We can observe an overall increase in entries under constraints. There is a decrease in admissions for involuntary confinement for the benefit of imminent peril. This imminent peril corresponds to only a small proportion of hospitalizations without consent but are rising between 2011 and 2012, perhaps in part due to a better understanding of the law. But this progression is to monitor to ensure compliance with the restrictive conditions laid down by this law. Also note that the imminent peril may be used at the refusal of the family or entourage to make the demand for care. The number of hospitalizations at the request of a third party with two certificates is down, which is probably due to a change in status of the CPOA, emergency structure within Sainte-Anne, which is no longer seen as extraterritorial. The imminent peril has advantages: it allows access to the care of people isolated and desocialized, of people whose identity is unknown, of pathological travellers. It avoids hospitalization at the request of the representative of the State for social reasons and not for risks to the safety of persons, even when this type of hospitalization is more stigmatizing and often more difficult to remove. It protects the entourage sometimes, when the family is ambivalent or hostile to care, or has been designated as a persecutor. The imminent peril also has disadvantages. One of them is the risk of its misuse to allow rapid hospitalization without taking the time to seek a third party. The imminent danger made when there is an entourage but which refuses to request care can undermine the development work on information about the disease, the need for care and treatment and the importance of the involvement of the entourage in the care plan. The alliance with the patient may be compromised. In some cases, a decision of care by the request of the representative of the State is more appropriate than the "imminent peril". The "imminent peril" may be preferred because of the administrative burden of prefectural measures when patient presents clinical improvement and we would go up to the ambulatory care in a care program. Yet, the use of a symbolic third, carrying authority, can avoid the too direct confrontation with the patient. Do not use it can complicate the management of the patient. Finally, with desocialized patients, imminent peril can facilitate access to care, but not continuity of care. Indeed, for the care program it is necessary to have an address for the patient. Once the crisis is not to develop a plan of care. Finally in some situations of desocialized patients, the imminent peril can promote access to care but not the continuity of care as to the care program it is necessary to have an address for the patient. Once the crisis is past, it is impossible to implement a program of care. The Law of 5 July 2011 marks a change in the practice of psychiatrists. Take into account the fundamental rights of the patient and to harmonize legislation at EU level was necessary. Some measures are designed to promote access to care as the "imminent peril", we now need to be vigilant to ensure that it is not diverted to promote an increase in care under constraints and that psychiatrists remain in an obligation of means and not of result.
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Affiliation(s)
- A Mondoloni
- Centre hospitalier Sainte-Anne, secteur 75G13, pavillon Piera-Aulagnier, 1, rue Cabanis, 75014 Paris, France.
| | - M Buard
- Centre hospitalier Sainte-Anne, secteur 75G13, pavillon Piera-Aulagnier, 1, rue Cabanis, 75014 Paris, France
| | - J Nargeot
- Centre hospitalier Sainte-Anne, secteur 75G13, pavillon Piera-Aulagnier, 1, rue Cabanis, 75014 Paris, France
| | - M-N Vacheron
- Centre hospitalier Sainte-Anne, secteur 75G13, pavillon Piera-Aulagnier, 1, rue Cabanis, 75014 Paris, France
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