ABSTRACT
Introduction: Chemsex refers to the intentional consumption of specific substances, Gamma Hydroxybutyrate/Gamma Butyrolactone (GHB/GBL), Crystal Methamphetamine and/or Cocaine to facilitate or enhance the sexual experience. However, there was a plethora of associated problems ranging in severity to complex, life-threatening situations. Since its inception in 2014, The Club Drugs Clinic Ireland, the first outpatient-based clinic for GHB/GBL Detoxification in Ireland, had evolved to include managing problematic chemsex. Objective(s): The Chemsex Working Group Ireland is a collaborative response from governmental and non-governmental agencies. Details of current medical and psychiatric management along with preliminary outcome findings on detoxification, relapse risk and associated factors will be presented. Method(s): Data collected include socio-demographic variables, gender and sexuality, detoxification setting, relapse history and attendance for counselling or aftercare. Descriptive analyses were conducted on referral counts, drug trends, success of first treatment episode, subsequent relapse rate, and uptake of counselling and aftercare. Result(s): There have been over 200 referrals to the Club Drugs Clinic Ireland. A number of predisposing and precipitating factors, contributed to the relapse rate (up to 70%) both in Ireland and internationally. The salutogenic, biopsychosocial-based model of addiction recovery produced the best outcomes. This integrated Dual Diagnosis Psychiatry, Sexual Health Medicine, Emergency Medicine and external services for a more comprehensive care. Conclusion(s): The pattern of referrals reflects population trends in chemsex, despite the COVID-19 restrictions. While detoxification is largely successful, the high relapse rate highlights the challenge of maintaining abstinence. In order to competently address problematic chemsex, service coordination across various medical professions and ongoing monitoring of the substances consumed is quintessential.
ABSTRACT
The COVID-19 pandemic has recently emerged as a worldwide health emergency that necessitates coordinated international measures. To contain the virus's spread, governments and health organisations raced to develop vaccines that would lower Covid-19 morbidity, relieve pressure on healthcare systems, and allow economies to open. Following the COVID-19 vaccine, the vaccination certificate has been adopted to help the authorities formulate policies by controlling cross-border travelling. To address serious privacy concerns and eliminate the need for third parties to retain the trust and govern user data, in this paper, we leverage blockchain technologies in developing a secure and verifiable vaccination certificate. Our approach has the advantage of utilising a hybrid approach that implements different advanced technologies, such as the self-sovereignty concept, smart contracts and interPlanetary File System (IPFS). We rely on verifiable credentials paired with smart contracts to make decisions about who can access the system and provide on-chain verification and validation of the user and issuer DIDs. The approach was further analysed, with a focus on performance and security. Our analysis shows that our solution satisfies the security requirements for immunisation certificates. © 2021 IEEE.
ABSTRACT
To get a more accurate picture of the significance of Covid-19 mortality in Dublin, a study was conducted to analyse notices posted in 2020 to RIP.ie relative to the previous five years. Examining monthly notices posted to RIP.ie relative to previous years also helped identify those parts of the city most affected by the disease in terms of excess mortality during the pandemic. From examination of factors that may affect levels of Covid-related mortality in Dublin, the authors have quantitatively established that social inequalities that persist throughout districts in Dublin have a statistically significant influence on mortality levels related to Covid-19. The significant relationship that exists between Covid-related mortality and area deprivation confirms that Covid-19 has differential impacts on Dublin's population depending on residential location. This suggests that approaches to combat the impacts of Covid-19 in Dublin should take into consideration the socio-economic dynamics that exist throughout the county's four authorities. One fundamental problem is that restrictions set up to effectively avoid contracting the virus automatically shield the portion of population that are socially and economically more privileged. Yet the remainder of the population that reside in more deprived districts, who are less able to adapt to restrictions, are disregarded and more likely to be seriously impacted by the effects of the virus. An additional caveat is that usage of rip.ie amongst migrant communities is not widespread and they may not be fully represented. For one worker with a stable, well-paying job, restrictions may mean working from home and being protected from the virus. For another worker, restrictions may not provide such security and they may face the choice of going to work, and increasing their risk of contracting the virus, or staying at home and sacrificing their income.