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Abstract Background People who use drugs (PWUD) are known to fear calling emergency medical services (EMS) for drug overdoses. In response, drug-related Good Samaritan Laws (GSLs) have been widely adopted in the USA and Canada to encourage bystanders to call emergency medical services (EMS) in the event of a drug overdose. However, the effect of GSLs on EMS-calling behaviours has been understudied. We sought to identify factors associated with EMS-calling, including the enactment of the Canadian GSL in May 2017, among PWUD in Vancouver, Canada, a setting with an ongoing overdose crisis. Methods Data were derived from three prospective cohort studies of PWUD in Vancouver in 2014–2018. Multivariable logistic regression was used to determine factors associated with EMS-calling among PWUD who witnessed an overdose event. An interrupted time series (ITS) analysis was employed to assess the impact of GSL on monthly prevalence of EMS-calling. Results Among 540 eligible participants, 321 (59%) were males and 284 (53%) reported calling EMS. In multivariable analysis, ever having administered naloxone three or more times (adjusted odds ratio [AOR] 2.00; 95% confidence interval [CI] 1.08–3.74) and residence in the Downtown Eastside (DTES) neighbourhood of Vancouver (AOR 1.96; 95% CI 1.23–3.13) were positively associated with EMS-calling, while living in a single occupancy hotel (SRO) was negatively associated with EMS-calling (AOR 0.51; 95% CI 0.30–0.86). The post-GSL enactment period was not associated with EMS-calling (AOR 0.81; 95% CI 0.52–1.25). The ITS found no significant difference in the monthly prevalence of EMS-calling between pre- and post-GSL enactment periods. Conclusion We observed EMS being called about half the time and the GSL did not appear to encourage EMS-calling. We also found that individuals living in SROs were less likely to call EMS, which raises concern given that fatal overdose cases are concentrated in SROs in our setting. The link between many naloxone administrations and EMS-calling could indicate that those with prior experience in responding to overdose events were more willing to call EMS. Increased efforts are warranted to ensure effective emergency responses for drug overdoses among PWUD.
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Women were also more likely to have talked to somebody about their experience following an incident of unwanted behaviour or assault. * Women were more likely than men to have experienced multiple incidents in the past 12 months and to have experienced unwanted behaviour or violence while on the street versus while in another public place, such as a bar or restaurant. * Beside gender, being younger, having experienced harsh parenting, having been physically or sexually abused by an adult during childhood, and being single, never married, all play a role in experiencing gender-based violence. * One in three (32%) women and one in eight (13%) men experienced unwanted sexual behaviour in public. The victims-and even the perpetrators-may not themselves perceive the motivations for the incident as being rooted in social structures and systems, which can serve to produce and reproduce gender inequality and gendered violence across many dimensions. Because of this, asking about gender-based violence directly in a survey may not lead to accurate findings or conclusions. Previous research indicates that disabled women, Indigenous women, girls and young women, lesbian and bisexual women, and gay and bisexual men are more at risk of experiencing violence (Boyce 2016; Burczycka 2018a; Conroy 2018; Conroy and Cotter 2017; Cotter 2018; Cotter and Beaupré 2014; Ibrahim 2018; Perreault 2015; Rotenberg 2019; Rotenberg 2017; Simpson 2018). By also including questions which measure violence that meets the criminal threshold, such as physical and sexual assault, the SSPPS allows for a comparative analysis of the risk factors across the continuum of gender-based violence, while also providing more recent self-reported statistics on violent victimization.
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Experiences of First Nations, Métis and Inuit women in Canada: Highlights * Violence against Indigenous peoples reflects the traumatic and destructive history of colonialization that impacted and continues to impact Indigenous families, communities and Canadian society overall. * Violent victimization is defined in the 2018 Survey of Safety in Public and Private Spaces (SSPPS), as a physical assault (an attack, a threat of physical harm, or an incident with a weapon present) or a sexual assault (forced sexual activity or attempted forced sexual activity). * Results from the SSPPS indicate that more than six in ten (63%) Indigenous women have experienced physical or sexual assault in their lifetime. * Almost six in ten (56%) Indigenous women have experienced physical assault while almost half (46%) of Indigenous women have experienced sexual assault. First Nations, Métis and Inuit (Indigenous) peoples are diverse and have unique histories, languages, cultural practices and spiritual beliefs. [...]Indigenous women may face unique barriers to reporting experiences of violent victimization or seeking help following victimization, including a lack of access to culturally appropriate resources, inaccessibility of support services, a general distrust of law enforcement, and perceived lack of confidentiality in the justice system (Truth and Reconciliation Commission of Canada 2015). [...]homicide data highlights the prevalence and characteristics among homicide of Indigenous women in Canada.
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Negocier de Bonne Foi: Les Accords Commerciaux, les Societes d'Etat et le Principe de l'Honneur de la Couronne-article
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