A qualitative analysis of rural syringe service program fidelity in Appalachian Kentucky: Staff and participant perspectives.

PURPOSE: As drug-related epidemics have expanded from cities to rural areas, syringe service programs (SSPs) and other harm reduction programs have been slow to follow. The recent implementation of SSPs in rural areas demands attention to program fidelity based on core components of SSP success. METHODS: Semistructured interviews conducted with clients and staff at 5 SSPs in 5 counties within 2 Central Appalachian health districts. Interviews covered fidelity of SSP implementation to 6 core components: (1) meet needs for harm reduction supplies; (2) education and counseling for sexual, injection, and overdose risks; (3) cooperation between SSPs and local law enforcement; (4) provide other health and social services; (5) ensure low threshold access to services; and (6) promote dignity, the impact of poor fidelity on vulnerability to drug-related harms, and the risk environment's influence on program fidelity. We applied thematic methods to analyze the data. FINDINGS: Rural SSPs were mostly faithful to the 6 core components. Deviations from core components can be attributed to certain characteristics of the local rural risk environment outlined in the risk environment model, including geographic remoteness, lack of resources and underdeveloped infrastructure, and stigma against people who inject drugs (PWID) CONCLUSIONS: As drug-related epidemics continue to expand outside cities, scaling up SSPs to serve rural PWID is essential. Future research should explore whether the risk environment features identified also influence SSP fidelity in other rural areas and develop and test strategies to strengthen core components in these vulnerable areas.

[Intensity of free radical oxidation and the blood lipid fatty acid composition in ischemic heart disease]. / Intensivnost' svobodnoradikal'nogo okisleniia i zhirnokislotnyi sostav lipidov krovi u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A comprehensive study of the intensity of free radical oxydation of lipids, of changes in the total polyunsaturated free acids and antiradical activity of the blood lipids undertaken in 73 patients with different forms of ischaemic heart disease showed that in all forms of illness there exists intensification of peroxyde oxydation of lipids, more marked in acute myocardial infarction. Rise of antiradical activity of lipids is a sequel to activation of the compensatory mechanisms, directed at neutralization of the negative action of toxic lipid peroxydes. Correlation between the changes in the total polyunsaturated fatty acids and antiradical activity of the lipids permits one to consider that accumulation of polyene acids may be one of the factors helping the intensification of free radical processes.

[Effects of copper melting production on the composition and characteristics of oral fluid]. / Vliianie neblagopriiatnykh faktorov medeplavil'nogo proizvodstva na sostav i svoistva rotovoi zhidkosti.

Industrial air of copper-melting factory in Almalyk contains a considerable quantity of copper and antioxidant elements (selen and zinc) in combination with poor quantity of prooxidants (ferrum, cobolt, chrome). The workers saliva contains increased concentrations of selen and zinc resultant in lowering intensity of free radical oxidation of lipids in the saliva and subnormal activity of antioxidant system's enzymes. Increased hydroperoxides quantity was discovered in saliva of patients with partial secondary adentia accompanied by hyper activity of antioxidant system's enzymes.