'This is PEEP' participatory qualitative study: learning from a provincial consultation and advisory group of people with lived and living experience of substance use in British Columbia, Canada.

Objectives: To summarise PEEP's (Professionals for Ethical Engagement of Peers-a group of consultants with lived and living experience of substance use) outputs and gain insights into PEEP's impact and suggestions for the future.

Design: Included an environmental scan to collate PEEP activities and outputs and a participatory qualitative design using thematic analysis.

Setting: British Columbia, Canada.

Social Media Response to the Introduction of the Swallowable Gastric Balloon Treatment for Severe Obesity in the NHS: A Snapshot of Public Opinion.

Background: Swallowable gastric balloons are available in the UK to treat severe obesity. Our hospital introduced this treatment in 2023, the first to do so in the National Health Service (NHS). The event was featured by the British Broadcasting Corporation (BBC) on regional television, in multiple radio interviews, and online by numerous news outlets in February 2024.

Access and barriers to safer supply prescribing during a toxic drug emergency: a mixed methods study of implementation in British Columbia, Canada.

Background: In March 2020, British Columbia, Canada, introduced prescribed safer supply involving the distribution of pharmaceutical grade alternatives to the unregulated toxic drug supply. Prior research has demonstrated positive impacts on overdose mortality, but with limited reach to people who use substances. Objectives of this study were to (1) identify barriers to accessing safer supply prescribing among people who use substances; and (2) determine whether and how barriers differed between people with and without prescriptions, and between urban and rural settings.

Introduction of Native Submerged Macrophytes to Restore Biodiversity in Streams.

Streams are biodiversity hotspots that provide numerous ecosystem services. Safeguarding this biodiversity is crucial to uphold sustainable ecosystem functioning and to ensure the continuation of these ecosystem services in the future. However, in recent decades, streams have witnessed a disproportionate decline in biodiversity compared to other ecosystems, and are currently considered among the most threatened ecosystems worldwide.

Development of the Addenbrooke's MSK screening tool (AMST) for children and adolescents with cystic fibrosis.

Background: Musculoskeletal (MSK) issues are common in the paediatric population and in people with CF. There is currently no MSK screening tool for children and adolescents with CF.

Methods: The protocol to develop the pGALS (paediatric Gait, Arms, Legs, Spine) was followed to create this screening tool.

Associations with experience of non-fatal opioid overdose in British Columbia, Canada: a repeated cross sectional survey study.

Introduction: Lives lost in North America due to the unregulated drug poisoning emergency are preventable and those who survive an opioid overdose may suffer long-term disability. Rates of opioid overdose more than doubled following the onset of the COVID-19 pandemic in British Columbia, Canada.

Materials And Methods: Our analytical sample was comprised of 1447 participants from the 2018, 2019, and 2021 Harm Reduction Client Survey who responded yes or no to having experienced an opioid overdose in the past 6 months.

The Impact of Injectable Opioid Agonist Treatment (iOAT) on Involvement in Criminalized Activities: A Secondary Analysis from a Clinical Trial in Vancouver, BC.

Purpose: A significant portion of the economic consequences of untreated Opioid Use Disorder (OUD) relate to individuals' involvement in the criminal justice system. The present study uncovers if treatment with iOAT is related to the number of criminal charges amongst participants, what type of crime participants were involved in, and the frequency with which participants were victims of crime. This study contributes to the body of research on the effectiveness of iOAT reducing criminal involvement.

Taxonomic and Feeding Trait-Based Analysis of Macroinvertebrates in the Antisana River Basin (Ecuadorian Andean Region).

High-elevation tropical streams are under increasing threat from human activities and climate change. Specifically, Ecuadorian Andean streams require priority actions such as bioassessment (e.g.

Facing uncertainty - Pilot testing of a palliative prognostic index training with hospital aged care assessment teams.

Background: Prognostic avoidance can delay discussions about older hospital patients' life expectancy. This pilot study examined the effects of a prognostic training program on hospital clinicians' knowledge and confidence in identifying older patients at risk of dying.

Methods: Fifty-seven clinicians from aged care assessment teams at two Australian hospitals were introduced to the Palliative Prognostic Index, a 5-item checklist indicating prognoses between 3 and 6 weeks.

Doing community-based research during dual public health emergencies (COVID and overdose).

Meaningful engagement and partnerships with people who use drugs are essential to conducting research that is relevant and impactful in supporting desired outcomes of drug consumption as well as reducing drug-related harms of overdose and COVID-19. Community-based participatory research is a key strategy for engaging communities in research that directly affects their lives. While there are growing descriptions of community-based participatory research with people who use drugs and identification of key principles for conducting research, there is a gap in relation to models and frameworks to guide research partnerships with people who use drugs.

Smoking identified as preferred mode of opioid safe supply use; investigating correlates of smoking preference through a 2021 cross-sectional study in British Columbia.

Background: The increasing number of illicit drug toxicity deaths in British Columbia (BC) has led to calls for a regulated (pharmaceutical grade) supply of substances ("safe supply"). In order to inform safe supply recommendations, we aimed to identify why people currently smoke opioids and assess the preferred mode of consumption if people who use opioids were provided with opioid safe supply.

Methods: The BC Harm Reduction Client Survey (HRCS) is an annual survey that gathers information about people who use drugs' (PWUD) substance use characteristic with the goal of contributing to evidence-based policy.

Awareness, predictors and outcomes of drug alerts among people who access harm reduction services in British Columbia, Canada: findings from a 2021 cross-sectional survey.

Objectives: To assess the awareness and predictors of seeing/hearing a drug alert in British Columbia (BC) and subsequent drug use behaviour after seeing/hearing an alert.

Methods: This study analysed the 2021 BC harm reduction client survey (HRCS)-a cross-sectional self-reported survey administered at harm reduction sites throughout the province and completed by participants using the services.

Results: In total, n=537 respondents participated and n=482 (89.

Determining Tipping Points and Responses of Macroinvertebrate Traits to Abiotic Factors in Support of River Management.

Although the trait concept is increasingly used in research, quantitative relations that can support in determining ecological tipping points and serve as a basis for environmental standards are lacking. This study determines changes in trait abundance along a gradient of flow velocity, turbidity and elevation, and develops trait-response curves, which facilitate the identification of ecological tipping points. Aquatic macroinvertebrates and abiotic conditions were determined at 88 different locations in the streams of the Guayas basin.

"As long as that place stays open, I'll stay alive": Accessing injectable opioid agonist treatment during dual public health crises.

Background: Since the onset of the COVID-19 pandemic, overdose rates in North America have continued to rise, with more than 100,000 drug poisoning deaths in the past year. Amidst an increasingly toxic drug supply, the pandemic disrupted essential substance use treatment and harm reduction services that reduce overdose risk for people who use drugs. In British Columbia, one such treatment is injectable opioid agonist treatment (iOAT), the supervised dispensation of injectable hydromorphone or diacetylmorphine for people with opioid use disorder.

"It's just a perfect storm": Exploring the consequences of the COVID-19 pandemic on overdose risk in British Columbia from the perspectives of people who use substances.

Background: Despite the implementation and expansion of public health and harm reduction strategies aimed at preventing and reversing overdoses, rates of overdose-related events and fatalities continue to rise in British Columbia. The COVID-19 pandemic created a second, concurrent public health emergency that further exacerbated the illicit drug toxicity crisis, reinforced existing social inequities and vulnerabilities, and highlighted the precariousness of systems in place that are meant to protect the health of communities. By exploring the perspectives of people with recent experience of illicit substance use, this study sought to characterize how the COVID-19 pandemic and associated public health measures influenced risk and protective factors related to unintentional overdose by altering the environment in which people live and use substances, influencing the ability of people who use substances to be safe and well.

Guideline development in harm reduction: Considerations around the meaningful involvement of people who access services.

Background: Harm reduction seeks to minimizes the negative effects of drug use while respecting the rights of people with lived and living experience of substance use (PWLLE). Guideline standards ("guidelines for guidelines") provide direction on developing healthcare guidelines. To identify essential considerations for guideline development within harm reduction, we examined whether guideline standards are consistent with a harm reduction approach in their recommendations on involving people who access services.

Feasibility of Testing Client Preferences for Accessing Injectable Opioid Agonist Treatment (iOAT): A Pilot Study.

Purpose: Injectable opioid agonist treatment (iOAT) is an effective treatment for opioid use disorder (OUD). To our knowledge, no research has systematically studied client preferences for accessing iOAT. Incorporating preferences could help meet the heterogenous needs of clients and make addiction care more person-centred.

Concurrent use of opioids and stimulants and risk of fatal overdose: A cohort study.

Background: Stimulant use has been rising among people with opioid use disorder in recent years in North America, alongside a parallel rise in illicit drug toxicity (overdose) deaths. This study aimed to examine the association between stimulant use and overdose mortality.

Methods: Data from a universal health insurance client roster were used to identify a 20% random general population sample (aged ≥12) in British Columbia, Canada between January 1 2015 and December 31 2018 (N = 1,089,682).

The ostrich approach - Prognostic avoidance, strategies and barriers to assessing older hospital patients' risk of dying.

Background: Predicting older patients' life expectancy is an important yet challenging task. Hospital aged care assessment teams advise treating teams on older patients' type and place of care, directly affecting quality of care. Yet, little is known about their experiences with prognostication.

Identifying behaviours for survival and wellness among people who use methamphetamine with opioids in British Columbia: a qualitative study.

Background: British Columbia (BC) has been in a state of public health emergency since 2016, due to the unprecedented numbers of fatal and non-fatal drug toxicity (i.e. overdose) events.

Motivations for concurrent use of uppers and downers among people who access harm reduction services in British Columbia, Canada: findings from the 2019 Harm Reduction Client Survey.

Introduction: An increase in crystal methamphetamine (methamphetamine) use during the overdose epidemic is being observed in British Columbia (BC), Canada, and across North America. Concurrent use (ie, using uppers and downers one after the other or together) can increase the risk of fatal and non-fatal opioid overdose.

Objectives: We investigated motivations for concurrent use of uppers and downers, specifically how (eg, in what order) and why people use concurrently, to identify potential interventions to prevent overdose and other harms.

'It All Kind of Links Really': Young People's Perspectives on the Relationship between Socioeconomic Circumstances and Health.

Meaningful inclusion of young people's perceptions and experiences of inequalities is argued to be critical in the development of pro-equity policies. Our study explored young people's perceptions of what influences their opportunities to be healthy within their local area and their understandings of health inequalities. Three interlinked qualitative focus group discussions, each lasting 90 to 100 min, with the same six groups of young people ( = 42) aged 13-21, were conducted between February and June 2021.

'Unprepared for the depth of my feelings' - Capturing grief in older people through research poetry.

Background: Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people's bereavement stories and the effects of grief on their physical and mental health.

Changes in household food and drink purchases following restrictions on the advertisement of high fat, salt, and sugar products across the Transport for London network: A controlled interrupted time series analysis.

Background: Restricting the advertisement of products with high fat, salt, and sugar (HFSS) content has been recommended as a policy tool to improve diet and tackle obesity, but the impact on HFSS purchasing is unknown. This study aimed to evaluate the impact of HFSS advertising restrictions, implemented across the London (UK) transport network in February 2019, on HFSS purchases.

Methods And Findings: Over 5 million take-home food and drink purchases were recorded by 1,970 households (London [intervention], n = 977; North of England [control], n = 993) randomly selected from the Kantar Fast Moving Consumer Goods panel.