Supply Program Research Articles

Perspectives on Diversion of Medications From Safer Opioid Supply Programs.

Safer supply programs were implemented in Canada to provide pharmaceutical-grade alternatives to the toxic unregulated drug supply. While research shows clinical benefits and reduced overdose mortality among safer supply patients, medication diversion remains a concern. To examine provider (prescribing clinicians and allied health professionals) and patient perspectives on diversion of opioids prescribed in safer supply programs. In 2021, qualitative interviews and sociodemographic questionnaires were conducted with patients and providers across 4 safer supply programs in Ontario, Canada. Interviews with 21 providers (physicians, nurse practitioners, and allied health professionals) and 52 patients examined experiences implementing safer supply or receiving care. Initial data analysis was conducted from December 2021 to March 2022, and the subanalysis focused on diversion was conducted from December 2023 to March 2024. Participation in safer supply program as a patient or provider. Data about diversion were coded, extracted, and thematically analyzed. Of 52 patient participants, 29 (55.8%) were men and 23 (44.2%) were women; 1 was Black (1.9%), 9 (17.3%) were Indigenous, 1 was Latino (1.9%), and 41 (78.8%) were White; and the mean (SD) age was 46.5 (9.6) years. Of 21 provider participants, 6 (28.6%) were men, 13 (61.9%) were women, and 2 (9.5%) were nonbinary; and the mean (SD) age was 37.6 (7.6) years. Participants characterized diversion as a spectrum ranging from no diversion, to occasional medication sharing and loss, to selling all prescribed doses of safer supply (considered rare and easy to detect). Most patients reported they consumed all or most of their prescribed medications and rarely shared or sold their doses. However, providers and patient participants shared that people might share, trade, and/or sell some of their medications with other opioid-using people for multiple reasons. Most prominent reasons for diversion were (1) compassionate sharing with intimate partners and friends to manage withdrawal and overdose risk; (2) selling or trading medications to address their own unmet substance use needs (eg, high opioid tolerance); and (3) medication loss due to poverty, homelessness, and associated vulnerabilities to theft and coercion. Programs used nonpunitive urine drug screening practices and patient self-report to monitor medication use. When diversion was identified, providers described using nonjudgmental conversations to understand patients' needs and develop mitigation strategies that addressed underlying reasons for diversion, including changing doses and medications prescribed to better match patients' needs, enrolling eligible intimate partners, and developing safety plans to mitigate vulnerabilities to theft and coercion. Diversion encompasses a wide spectrum of practices (selling, sharing, and loss of medications), and occurs for complex reasons that surveillance and punitive measures are unlikely to mitigate. Diversion may be best addressed by expanding medication options to better match patients' diverse substance use needs and high tolerance, alongside wraparound social supports.

Harm Reduction: The Neglected Pillar of US Drug Policy.

Harm reduction programs provide tools that enable people who use drugs to do so more safely in a nonstigmatizing environment without the goal of them necessarily seeking treatment or abstinence. Most harm reduction programs in the United States distribute sterile syringes and naloxone and safely dispose of used syringes and other drug use supplies. Many also provide drug checking services, and other safer use supplies. These programs exist on a limited scale and often face restrictions on their funding and scope of operations. While research demonstrates the effectiveness of existing programs in preventing infectious disease transmission and fatal overdose, there is less evidence about conditions that support the effective expansion and sustainment of existing models. Other harm reduction interventions such as overdose prevention centers and safer supply programs have promising international evidence but are prohibited or severely restricted under US law. In this review, we summarize the evidence for harm reduction interventions, describe the policy environment in which they exist, and provide recommendations to better align drug policy with existing and emerging evidence in the US context.

Gendered Experiences of Ontological Insecurity Among Women Who Use Drugs and Experience Housing Insecurity: A Critical Narrative Analysis

Introduction: Research has established that experiences of substance use and housing insecurity leads to violence, alienation, and health deterioration for women. However, no literature has assessed how the gendered nature of substance use and housing insecurity influence the ontological insecurity of women. This paper examines the relationship between ontological insecurity, substance use, and housing insecurity for women. We provide considerations for the theorization of ontological (in)security to account for gender. Methods: Feminist-informed interviews were conducted with 20 women who were clients of a safer supply program located in Kitchener-Waterloo, Ontario. Interviews took place in person, were audio-recorded, and transcribed. Interviews focused on women’s experiences of substance use and housing insecurity across their lives. Data analysis was guided by a feminist re-reading of the theory of ontological security. All women completed a socio-demographic questionnaire. Results: Most women were aged between 22 and 43 ( n = 11), with nine being over the age of 44. Fifteen women identified as white, with five identifying as First Nation, Indigenous, or Metis. Ten women resided in supportive housing units, five resided in transitional housing units, social service agency run motels, or in the private rental market, and five resided in tents or encampments. Women shared how gendered experiences of substance use and housing insecurity, which were associated with trauma and violence, contributed to perceptions of ontological insecurity. Dimensions of ontological insecurity which were discussed by women included a disrupted sense of self, instability, and a loss of autonomy. Conclusion: Our results demonstrate how mechanisms of ontological insecurity for women who use drugs and experience housing insecurity are engrained in the gendered structuring of society. These findings suggest that the current theorization of ontological (in)security is insufficient in examining complete mechanisms which promote ontological security or insecurity for women. Future work which explores ontological (in)security must consider the gendered ordering of society.

Analysis of different populations accessing online overdose response training and harm reduction supplies (ADORES)

BackgroundAn online mail order naloxone and harm reduction supply program was created by an interdisciplinary team at the University of Rhode Island College of Pharmacy and hosted on the university website (UNIV). The program was subsequently funded by the Rhode Island Department of Health (DOH) and added to the DOH website. This study compares demographic characteristics of the two populations submitting requests through the program’s distinct access points, UNIV and DOH, to those of populations at-risk for overdose.MethodsThis is a retrospective comparative analysis using voluntarily provided information from mail order request forms submitted through two websites from June 2020 through October 2023. The primary objective was to compare demographic characteristics of requesters through the two access points to those of individuals at-risk for experiencing or responding to an overdose. Descriptive statistics were used to characterize the two distinct populations. Chi-square tests were performed to determine if statistically significant differences in population demographics existed between access points. Odds ratios were estimated using a simple logistic regression model to assess the relationship between access point and demographic characteristic to determine if either access point had a greater likelihood of reaching individuals with at-risk demographics.ResultsA total of 5,783 (UNIV = 1662; DOH = 4121) mail order request forms were included in the analysis. Participants who completed requests through UNIV were more likely to be 44 years old or younger and/or reside in rural areas. Participants who submitted requests through DOH were more likely to reside in non-rural and/or low-income areas, and/or identify as gender minorities. Additionally, UNIV respondents were more likely to be first-time naloxone requesters while DOH respondents were more likely to have obtained and used naloxone before.ConclusionsResults establish that different access points can reach different at-risk population subsets and support the use of multiple access points and advertising strategies to expand the reach of online mail order harm reduction programs.Study registrationThe study was retrospectively approved by the University of Rhode Island Institutional Review Board (IRB reference #2124391-2).

Predicting well productivity in cratonic regions using remote sensing lineaments and weathered cover thickness: A case study from Bobo Dioulasso, Burkina Faso

In western African cratonic regions, fractured crystalline bedrock, Neoproterozoic sedimentary covers, and regolith deposits constitute the most productive aquifer systems. Structural lineaments derived from remote sensing data and weathered cover thickness from borehole interpretations provide cost-effective methods for evaluating well productivity in regions with limited economic resources and hydrogeological knowledge, such as Houet province in Western Burkina Faso. Structural lineaments were interpreted using 1:200,000 Landsat TM images and 1:50,000 aerial photographs, revealing NE and NW as the most significant directions. An analysis of 101 borehole stratigraphic profiles from rural water supply program reports revealed the weathering depth and cover thickness. Borehole productivity exhibited a strong correlation with increased weathered cover thickness. Negative well results were concentrated in areas with less than 5 m of cover. In contrast, significant differences in specific yield rates were observed with greater thicknesses, ranging from 2.5 m³/d for 20 m of saturated thickness to 7.6 m³/d when the regolith reached a depth of 40 m. These preliminary groundwater exploration tools effectively target successful well sites by accounting for differing lithologies, regional tectonics, and regolith development. This approach is particularly relevant for cratonic regions with limited resources and hydrogeological knowledge, aiding in sustainable groundwater development and land-use planning.

Understanding the impact of deep structures on the hydrological setting of the Eastern Bahira Basin in Morocco using combined geophysical analysis of gravity, seismic, and electrical resistivity data

In arid regions like the Eastern Bahira Basin, communities mainly rely on groundwater for drinking and irrigation. However, efficiently managing these vital resources requires a deep understanding of the underlying aquifers’ structure and identifying the most suitable areas for exploitation. This presents a significant challenge for the success of water supply and irrigation programs in the Eastern Bahira Basin. This study is based on an integrative approach, combining Electrical Resistivity Tomography data, with the compilation and reinterpretation of pre-existing seismic, gravimetric and vertical electrical sounding data. This approach is based on compiling old gravimetric data and applying advanced processing techniques to determine the horizontal gradient maxima, which helps highlight the major structural alignments in the basin. Furthermore, the approach utilizes seismic data in order to enhance understanding of the deep structure of the basin, reinterpreting it in light of recent drilling data. The interpretation of the gravimetric and seismic data has also been validated by the results of vertical electrical soundings and electrical tomography that we recently acquired in the Eastern Bahira basin. The outcomes of this research provide new insights into the deep structure of the Eastern Bahira Basin and suggest the most promising hydrogeological prospects, thereby contributing to the success of the ongoing drinking water supply and irrigation program in the Eastern Bahira Basin.

Project Time Management and Performance of Kenya Towns Water Supply and Sanitation Programme at Central Rift Water Works Development Agency.

The general objective of the study was to examine the influence of Project time management on the performance of Kenya Towns Water Supply and Sanitation Projects at Central Rift Water Works Development Agency specifically the study. The study was anchored by pickle jar theory, theory of constraints, theory of effective project implementation and communication theory. A descriptive survey design was used in this research. The study targeted project managers, consultants, coordinators, engineers, contractors, community representatives, and representatives from the Ministry of Water and Irrigation in three projects under the Kenya Towns Water Supply and Sanitation Programme, carried out by the Central Rift Valley Water Works Development Agency. The counties involved are Narok and Nyandarua. A sample size of 83 respondents was used. The participants in the study were chosen using a simple random selection method. Data was collected using a questionnaire and interview schedule. The analysis was both qualitative and quantitative. Quantitative data collected was analysed using Statistical Package for Social Sciences version 25. The study analysed both descriptive and inferential statistics. Thematic analysis was used to analyse qualitative data collected from the interview schedule. The analysis revealed a Pearson correlation of (r=0.512, p<0.05). This indicated a moderate positive and significant relationship between project time planning and the performance of Kenya Towns Water Supply and Sanitation Projects. The also showed a Pearson correlation of (r= 0.553 p<0.005) which indicates a positive and significant relationship, suggesting that effective prioritization of time-related tasks plays a crucial role in enhancing project performance. Additionally, the correlation analysis for time tracking yielded a Pearson correlation of (r=0.390 p<0.005). This suggests a moderate positive and statistically significant relationship between time tracking and project performance. Lastly, the study revealed the impact of project team communication on performance, finding a Pearson correlation of (r= 0.672 p<0.005). This indicated a strong positive and significant relationship, suggesting that effective communication among project teams significantly enhances performance outcomes. The findings indicated that 45.1% of the variation in the performance of the project could be explained by the independent variables studied, while 54.9% of the variation is attributed to other factors not covered in this study. The study concluded that project time planning, time prioritization, time tracking, and project team communication had an effect performance of Kenya Towns Water Supply and Sanitation Projects at Central Rift Water Works. The study recommends implementing structured time planning methods, enhancing time tracking, and fostering effective communication within teams to improve project performance. Future research should explore stakeholder engagement and the role of emerging technologies in water project management

Repurposing prescribed hydromorphone: Alternative uses of safer supply and tablet-injectable opioid agonist treatment to meet unaddressed health needs

BackgroundIn response to the ongoing overdose crisis in Canada, a number of opioid agonist treatment and safer supply programs provide people at high overdose risk with daily-dispensed tablet hydromorphone, with some requiring witnessed ingestion and others providing take-away doses. While these programs are intended to reduce overdose events by limiting people's use of the contaminated drug supply, the experiences of people receiving hydromorphone vary. In this article we explore the ways people repurpose hydromorphone to address unmet needs. MethodsThis article draws on in-depth qualitative interviews from two studies evaluating hydromorphone tablet distribution programs in British Columbia, Canada. We used thematic analysis to identify themes related to repurposing hydromorphone. We compared themes across the two studies to identify any similarities or differences in relation to the ways study participants discussed repurposing hydromorphone tablets. We utilize vignettes – snapshots of participant experiences – to analyse and represent the data. ResultsFour vignettes demonstrate how hydromorphone tablets are often being used to address and resolve unmet needs of people who use drugs. While most participants reported reducing their use of illicit drugs, a variety of instrumental uses of tablet hydromorphone were also discussed, including reducing anxiety, addressing sleep issues, withdrawal management, and managing chronic pain. ConclusionOur findings demonstrate how people who use drugs are maximizing the benefits of tablet hydromorphone distribution to address unmet needs. Hydromorphone distribution programs represent a public health and harm reduction intervention that is usefully addressing experiences related to structural vulnerabilities (such as inadequate pain management), which are often overlooked amongst stigmatized groups.

Safer supply and political interference in medical practice: Alberta's Narcotics Transition Services

Across much of Canada, opioid poisoning deaths have been increasing due to a toxic, contaminated, and unpredictable drug supply. Multiple prescribed safer supply pilot projects are being implemented and evaluated in an attempt to save lives. In the province of Alberta, however, new regulations introduced in 2022 significantly constrain safer supply prescribing by banning the prescription, dispensing, and administration of safer supply outside of a very limited number of clinics. In this commentary, we review prescribed safer supply programs in Canada and outline how the Alberta Government's change in regulations conflict with emerging evidence and efforts by other jurisdictions to address the rising opioid poisoning deaths. We examine the development of these regulations and analyze how the Alberta government shaped and justified this restrictive policy. We conclude by identifying important lessons learned from the experience in Alberta for researchers, healthcare providers, and decisionmakers in other jurisdictions.

Application of K-Means Clustering and OR-Tools to Optimize Rice Distribution: A Case Study of Perum Bulog Indonesia

Food security is one of the Indonesian government's priority policies aimed at maintaining economic and political stability. To ensure the nutritional needs of its population are met, the government requires sufficient food availability distributed nationwide at stable and affordable prices. Rice is the main staple food in Indonesia. According to data from the National Food Agency, rice consumption in Indonesia is very high, averaging 139 kilograms per capita per year, with a dependency rate of 97%. In response to food security challenges, the Indonesian government has entrusted the Food Supply and Price Stabilization Program (SPHP) for rice to Perum BULOG, a State-Owned Enterprise (SOE) specializing in food logistics. To optimize distribution to Perum BULOG’s retailers, called Rumah Pangan Kita (RPK), efficient routes and transport capacity are prioritized. Therefore, this paper proposes an approach using the Heterogeneous Capacitated Vehicle Routing Problem (HCVRP) to enhance distribution efficiency and reduce delivery costs. By employing the K-Means algorithm to cluster RPK addresses and Guided Local Search via OR-Tools to determine suitable transportation types, this study successfully identified optimal delivery routes for each cluster and corresponding vehicle types. The results demonstrated a reduction in delivery costs of up to 21%, significantly improving the efficiency of the SPHP rice distribution process. This outcome ultimately supports rice availability and price stability, crucial for maintaining food security in Indonesia.

Pengaruh Pendidikan Kesehatan Menggunakan Leaflet terhadap Sikap Ibu dalam Pemberian MP-ASI pada Bayi Usia < 6 Bulan

The Complementary Food Supply Program (MPASI) was designed to replace breast milk supply for infants older than 6 months so that the two do not overlap. The aim of this study is to analyze the effect of health education through leaflets on mothers' attitudes towards providing MPASI to infants under 6 months of age. The research method used was a quasi-experimental one-group post-test design. Population and sample consisted of all mothers who had children younger than 6 months, i.e. a total of 30 people. The Wilcoxon test was used for data analysis. The results showed a p value of 0.000, indicating that health education through pamphlets influences mothers' attitudes towards providing MPASI to infants under 6 months of age. This study has important implications for health care providers. Design more effective health education programs tailored to the needs of mothers in the region.

Optimal Scheduling of Island Microgrids with Seawater Pumped Storage Plants for Multi‐Energy Complementarity

The rapid development of new energy sources, such as offshore wind power and photovoltaic power, has provided a new solution to the problem of power supply for islands far from the mainland. Wave energy is a kind of renewable energy originated from the ocean, but the existing island power supply programs seldom consider this favorable natural condition. In addition, seawater variable‐speed pumped storage is a new idea to consume offshore wind power and improve the reliability of coastal and island power systems. In view of the stochastic and intermittent nature of new energy sources, this paper adopts seawater variable‐speed pumped storage power plants as energy storage equipment, and put forward an island power supply scheme with wind power, photovoltaic power generation, wave power generation, pumped storage power plants and diesel generator sets as a multifunctional complementary isolated grid. Firstly, wave energy generators, wind farms, photovoltaic farms, pumped storage power stations and diesel generator sets are modeled separately. Then, considering their respective operating conditions, constraints and load requirements, the optimal scheduling of island microgrids with multi‐energy complementarity is constructed. Finally, based on the improved particle swarm optimization algorithm, the model is solved. According to the wind power photovoltaic and wave power output curves of several typical scenarios in an island far away from the mainland, the cost and benefit of different schemes are compared to verify the effectiveness of the optimal scheduling in this paper. © 2024 Institute of Electrical Engineers of Japan and Wiley Periodicals LLC.

A qualitative evaluation of a fentanyl patch safer supply program in Vancouver, Canada

BackgroundThe ongoing overdose crisis in Canada has prompted efforts to increase access to a “safer supply” of prescribed alternatives to the unregulated drug supply. While safer supply programs predominantly distribute hydromorphone tablets, the Safer Alternatives for Emergency Response (SAFER) program in Vancouver, Canada offers a range of prescribed alternatives, including fentanyl patches. However, little is known about the effectiveness of fentanyl patches as safer supply. Drawing on the perspectives and experiences of program participants, we sought to qualitatively evaluate the effectiveness of the SAFER fentanyl patch program in meeting its intended aims, including reducing risk of overdose by decreasing reliance on the unregulated drug supply. MethodsAs part of a larger mixed-methods evaluation of SAFER, semi-structured qualitative interviews were conducted with 17 fentanyl patch program participants between February 2022 and April 2023. Thematic analysis of interview data focused on program engagement, experiences, impacts, and challenges. ResultsThe flexible program structure, including lack of need for daily dispensation, the extended missed dose protocol, and community pharmacy patch distribution fostered engagement and enhanced autonomy. Improved management of withdrawal symptoms and cravings due to steady transdermal dosing led to reduced unregulated drug use and overdose risk. Participants also experienced economic benefits and improvements in overall health and quality of life. However, skin irritation and patch adhesion issues were key barriers to program retention. ConclusionOur findings demonstrate the value of including fentanyl patch safer supply in the substance use continuum of care and offer insights for innovations in delivery of this intervention.

Employment generation potentials in the implementation of a rural drinking water supply program: evidence from India's Jal Jeevan Mission

ABSTRACT Policymakers in India are finding it challenging to generate adequate employment to meet the requirements of growing population. An avenue consistently used is to invest in large-scale public infrastructure projects. In 2019, the Jal Jeevan Mission (JJM) was launched with the aim of providing potable drinking water to every rural household in India. Underscoring the large investments in infrastructure development, the mission holds significant potential to create employment. The evidence base of studies assessing the effect of rural development programs on employment was weak. Against this backdrop, we assessed the employment generation potential of JJM at various phases of its implementation. We utilized secondary and scheme-level primary data across states of India and used the input-output model and ratio method to assess employment prospects. Our results suggest that JJM has the potential to generate an average of 5.99 million person-year of direct and 22.25 million person-year of indirect employment during the construction phase, and 1.11 million person-year of additional direct employment annually during the maintenance phase. Our study highlights the spillover effects of public investments in the form of employment generation and indicates that the impact of JJM is likely to be substantial once the program is complete and operational.

Impacts of Community Participation on Sustainability of Rural Water Supply Sytems: A Study from District Lahore, Pakistan

The availability and functionality of an improved water supply system among the population are basic human rights and imperative to prevent numerous viral/infectious diseases. The provision of safe drinking water, improved sanitation, and hygiene plays a central role in individual and communal health, but unfortunately, the situation is strikingly poor among nations, especially in developing countries like Pakistan. To understand the existing situation and the impacts of community participation on the sustainability of the water supply system, this study was conducted in the district of Lahore, Pakistan. The prime objective was to find out the participation of the community in planning, execution, operation and maintenance, evaluation process, and the management approaches and techniques with a view of seeing how best community participation level contributed to the sustainability of the water supply program. For this purpose, a simple random sampling procedure was applied to draw the sample from the population. A semi-structured questionnaire was used as a tool for data collection and validated through pilot testing. Results showed that participatory approaches in water supply program planning, execution, operation, maintenance, and evaluation led to community satisfaction and program sustainability.

Reasons for Enrolling in Safer Supply Programs: A Longitudinal Qualitative Study on Participant Goals and Related Outcomes in the MySafe Program.

Safer supply programs are a novel response to the ongoing overdose crisis in Canada--providing people at high overdose risk with a safer alternative to the highly toxic unregulated drug supply. The MySafe program provides pharmaceutical-grade opioids to participants via biometric dispensing machines. This study examines program-related goals and related outcomes across time. Longitudinal, semi-structured interviews were conducted with 29 study participants at baseline and 1-year follow-up. Interviews covered program functionality, experiences, outcomes, and reasons for enrollment and engagement. Baseline and follow-up interviews were compared to explore changes over time, including the effectiveness of the MySafe program in supporting individuals' achievement of their stated goals. Most participants reported similar goals at their baseline and follow-up interviews. The most common goal for initiating and staying in the program was to stop or reduce using street-purchased drugs, followed by abstinence and wanting to stop injecting drugs. Several participants described goals addressing issues related to structural vulnerability (e.g., improving living situations). At follow-up, some participants reported reducing street-purchased drug use, no participants reported abstinence, and all those wanting to stop injecting drugs reported achieving their goals. Our findings highlight a strong desire among study participants to be separated from the unpredictable street drug supply. Participants reported variable success in attaining their stated goals. However, our results demonstrate the need for such programs to better attend to participant goals, especially those affected by structural vulnerability, that can be supported with wrap-around social and health care supports.

“If it wasn’t for them, I don’t think I would be here”: experiences of the first year of a safer supply program during the dual public health emergencies of COVID-19 and the drug toxicity crisis

BackgroundIn response to the devastating drug toxicity crisis in Canada driven by an unregulated opioid supply predominantly composed of fentanyl and analogues, safer supply programs have been introduced. These programs provide people using street-acquired opioids with prescribed, pharmaceutical opioids. We use six core components of safer supply programs identified by people who use drugs to explore participant perspectives on the first year of operations of a safer supply program in Victoria, BC, during the dual public health emergencies of COVID-19 and the drug toxicity crisis to examine whether the program met drug-user defined elements of an effective safer supply model.MethodsThis study used a community-based participatory research approach to ensure that the research was reflective of community concerns and priorities, rather than being extractive. We interviewed 16 safer supply program participants between December 2020 and June 2021. Analysis was structured using the six core components of effective safer supply from the perspective of people who use drugs, generated through a prior study.ResultsEnsuring access to the ‘right dose and right drugs’ of medications was crucial, with many participants reporting success with the available pharmaceutical options. However, others highlighted issues with the strength of the available medications and the lack of options for smokeable medications. Accessing the safer supply program allowed participants to reduce their use of drugs from unregulated markets and manage withdrawal, pain and cravings. On components related to program operations, participants reported receiving compassionate care, and that accessing the safer supply program was a non-stigmatizing experience. They also reported receiving support to find housing, access food, obtain ID, and other needs. However, participants worried about long term program sustainability.ConclusionsParticipants in the safer supply program overwhelmingly appreciated it and felt it was lifesaving, and unlike other healthcare or treatment services they had previously accessed. Participants raised concerns that unless a wider variety of medications and ability to consume them by multiple routes of administration became available, safer supply programs would remain unable to completely replace substances from unregulated markets.

Implementation of Youth for Environment in School Organization (YES-O) in the Secondary Schools and Its Impact on Science Learning Progress

The deliberate attempt to prevent the environment from being completely destroyed has gained attention. Schools are recognized as a vital platform for implementing environmental education. Accordingly, the Youth for Environmental in School Organization (YES-O) stands out as the only recognized implemented environmental co-curricular organization in basic education. Hence, this study evaluated the implementation of the Youth for Environmental in School Organization (YES-O) programs and its impact to the students’ science learning progress in the secondary schools in Oquendo 3 District, Schools Division of Calbayog City, Philippines. The study revealed that YES-O successfully implemented its mandated programs. These programs included seed banks and nurseries, the collection of seeds and seedlings from native and endemic species, emphasis on tree planting and care, implementation of water conservation initiatives, promotion of power supply programs, organization of clean-up drives, and implementation of ecological solid waste management programs. Similarly, YES-O programs had a high impact on students' science learning progress, particularly in terms of their pro-environmental behavior and science performance. There was a strong positive relationship between the implementation of YES-O programs and its impact on students' science learning progress. The study promoted creativity in environmental education and positioned YES-O as an effective organization that inspired students to become genuine stewards of the environment thereby contributing to a sustainable future.

Achieving a high share of non-hydro renewable integration in Brazil through wind power: Regional growth and employment effects

Brazil is a case of the achievement of a high share of wind energy integration to an interconnected power system in an emerging market. A series of successful energy supply programmes and a strong renewable-oriented finance framework implemented since 2002, have promoted alternative renewables – wind installed capacity increased over 22-fold from 927 MW in 2011 to 21 GW in 2022, reaching 11.77% of total procured power. From this, about 90% are concentrated in Brazil's least developed region, the Northeast, where wind investment should create jobs and propel socioeconomic development. Despite that, there is no studies specific assessing the regional and economy-wide effects of those programmes, gap that this paper aims to fill by applying the regional Computable General Equilibrium (CGE) model TERM-BR10. We assess that by modelling an alternative scenario for the period 2010-19 based on an official electricity matrix built in 2010, that projected 3.4 additional GW of wind power while not considering all the success of renewable policies, against the observed installed capacity expansion, where wind power was 3.7 times higher than what had been planned. Our results show that in the absence of renewable policies, Brazil would have faced economic losses such as GDP (−0.27%) and investment (−4.76%). The Northeast region would have been the most impacted in terms of GDP (−1.3%), real wage (−2.99%) and employment creation (−0.1%). We propose that such socioeconomic co-benefits are incorporated in energy planning, which could promote regional equality through renewable energy expansion.

"And this is the life jacket, the lifeline they've been wanting": Participant perspectives on navigating challenges and successes of prescribed safer supply.

In 2021, 43% of drug toxicity deaths in Ontario were reported by public health units serving medium-sized urban and rural communities. Safer supply programs (SSPs) have been primarily established in large urban centres. Given this, the current study is based on an evaluation of a SSP based in a medium-sized urban centre with a large catchment area that includes rural and Indigenous communities. The aim of this research paper is to understand the challenges and successes of the nurse practitioner-led SSP from the perspective of program participants. Interpretive description was used to understand the experiences of 14 participants accessing a SSP. Each participant was interviewed using a semi-structured approach, and 13 of the interviewees also completed surveys accessed through Qualtrics. An iterative process using NVivo software was used to code interviews, and a constant comparative data analysis approach was used to refine and categorize codes to themes. Three overarching themes were the result of this analysis: feeling better, renewed hope, and safety. These three themes capture the experiences of participants in the SSP, including both the challenges and successes they faced. The findings and subsequent discussion focus on both the key best practices of the program, and areas for future development and improvement. Despite barriers to services, prescribed SSPs are improving the lives of people who use drugs, and the current outcomes align with reports and evaluations from other SSPs across Canada.