法学最新文献

Background: Alcohol Use Disorder (AUD) is a leading contributor to global morbidity and mortality, disproportionately affecting people experiencing homelessness. Managed Alcohol Programs (MAPs) represent a harm reduction-based strategy for individuals with severe AUD and homelessness, providing controlled amounts of alcohol alongside comprehensive health and social supports. While evidence of MAP benefits continues to grow, important questions remain about how best to integrate social and medical care, and how to tailor services to align with participants' goals, values, and broader social and structural contexts.

Main body: This commentary explores the operational strategies and clinical practices of the Ottawa Inner City Health (OICH) MAP, which has been running since 2001. We describe how the program is embedded within supportive housing and leverages an interdisciplinary team-including peer workers and an Indigenous healer-to deliver person-centered care. Key components include structured alcohol delivery tailored to individual needs, meal provision, social supports including life skills training, medication administration and comprehensive physical and mental health services. Clinical care is tailored to participants' day-to-day circumstances, challenges, and goals in managing their AUD, with particular attention to hygiene and nutrition, proactive screening for health decline, and timely management of common health complications. The program operates through strong partnerships with community organizations, pharmacies and subspecialists, to enable integrated, coordinated care. Collaborative and trauma-informed approaches reduce reliance on emergency care and foster a sense of dignity, stability, and community.

Conclusion: MAPs have evolved from experimental interventions into internationally recognized harm reduction models. The OICH MAP demonstrates how the integration of housing, healthcare, and social supports can address the complex needs of individuals experiencing homelessness and severe AUD. However, challenges remain in scaling these models, refining screening protocols, and developing evidence-based policy frameworks. This commentary offers practical insights to inform the effective operation of MAPs and calls for continued research and dialogue to ensure they remain adaptable, sustainable, and aligned with the realities of the populations they serve.

Empirical discourses surrounding bisexuality often focus on challenges and disparities. This analysis identifies counternarratives of coping and survival among 21 midlife and older bisexual individuals. Findings are presented in three found poems followed by interpretations within participants' life experiences. Each poem depicts an "act" of life, separating narratives into three stages of meaning-making. Act I: The Struggle captures early-to midlife experiences fraught with confusion, isolation, mental health challenges, and interpersonal conflict. In Act II: Coping and Survival Looks Like…participants reflect on strengths, skills, and relationships they used to confront significant challenges. Act III: Healing Bisexual Futures presents reflections on what bisexuality means to participants in later life and how they envision their futures. This streamlined version of complex and messy life histories represents an agentive story-telling process in which participants seek meaning and cohesion in narrating their lives. Creative methodologies are well-suited to capturing this narrative nuance and poignance.

This research note discusses one underexplored aspect of the study of polygyny, namely, the extent to which the practice remains viable from a purely demographic standpoint. Using data from the United Nations World Population Prospects 2022 covering 48 countries in sub-Saharan Africa (SSA), I evaluate a simple indicator-gamma-for capturing the "demographic potential" of polygyny, that is, the fraction of men who can have two wives with no other man pushed out of the marriage market. I estimate how this indicator has evolved between 1950 and 2021 across regions of SSA and show how the measure correlates with polygyny estimates from available men's and women's Demographic and Health Surveys. Gamma shows inverted U-curve patterns aligned with stages of the demographic transition, from modestly low levels to high levels during periods of rapid population growth and then declining again. Recent declines are starkest in South SSA, while potential remains moderate elsewhere. Gamma correlates positively with polygyny estimates from Demographic and Health Surveys-particularly in Central and South SSA-and can explain up to 50‒70% variation in polygyny, albeit not everywhere. Findings primarily hold within regions, suggesting this is one of manifold factors at play. I conclude by outlining fruitful directions for the study of polygyny.

Background: Harms associated with gamma-hydroxybutyrate (GHB) use have increased recently in Australia. However, research predominantly focuses on the experience of GHB use among LGBTQ + populations. Non-prescribed GHB use has not been well described in heterosexual populations. Research to examine the experience of heterosexual people, including motivations for use, experiences of harms, and utilisation of harm reduction practices, can inform public health messaging.

Methods: We recruited 26 participants at least 18 years of age, reporting three or more occasions of GHB use in the past 12 months, via a national social media campaign and snowball methods. Semi-structured interviews were conducted via video conference, and analysed using a thematic framework analysis.

Results: Nineteen women (73%) and seven men (27%), mean age 29 years (standard deviation 7 years) completed interviews. Participants described three distinct patterns of occasional, regular, or daily GHB use. Across these patterns, four key themes emerged: (1) Escapism: participants used GHB to manage mental health symptoms, counteract stimulant effects of methamphetamine, enhance self-confidence, and facilitate sex. Women described using GHB to alleviate body consciousness/dysmorphia. (2) Diverse understandings and experiences of overdose: participants described a spectrum from mild to life-threatening toxicity. Notably, dosing GHB to achieve unconsciousness (intentional overdose) was a theme that dovetailed with boundary play in our sample. Misconceptions included using stimulants to counter GHB toxicity. Fear of police involvement delayed or prevented help seeking. (3) Stigma: Participants reported stigma from peers who use and do not use drugs. (4) Gendered harm reduction practices: A set of practices centred on women protecting women from harms associated with GHB use emerged, with narrations of heightened vigilance and protective behaviours to reduce risks of sexual violence.

Conclusion: In our heterosexual sample of people who use GHB in Australia, we identified novel aspects of GHB use characterised by escapism, intentional risk-taking, and gendered harm reduction strategies, while stigma featured alongside GHB use. Findings highlight gaps in public health education, particularly regarding intentional dosing towards unconsciousness, misconceptions about overdose management, and barriers to help seeking. Targeted, context-specific harm reduction and mental health interventions responsive to these experiences are required.

In the 21st Century, geopolitical confrontation between the Eurasian continental powers and the sea powers works to divide Asia. The US-Japan alliance has transformed itself from Japanʼs asymmetrical security dependence of the Cold War period into a mutual and more integrated partnership today. Japan is doing more in collective security to ensure US commitment to the alliance through its own enhanced utilities to the United States. Japan leads emmeshing of the US-Japan bilateral alliance into the growing network of security partnerships, transforming the “hub-and-spoke” security architecture of East Asia at least partly into a NATO-like multilateral security arrangement. Yet Asian economic dependence on China and the uncertain prospects of the US commitment to Asian security and geopolitical realignment at the level of international system allow Japan to pursue hedging on its own and Asian behalf.

Despite growing public knowledge of false confession cases, research with students and community members continues to find that people assume confessions indicate guilt. The present research explored the implications of belief perseverance: the tendency to maintain a belief even when confronted with compelling contradictory evidence. Across two studies (vignettes in Study 1; video interrogation footage in Study 2), students' pre-existing beliefs regarding confessions led them to assume suspects who confessed were more guilty, and were interrogated more justly, than suspects who did not confess. Further, although being presented with post-conviction DNA evidence tempered participants' views, pre-existing beliefs about confessions continued to impact both suspect and interrogation perceptions in Study 1, and interrogation perceptions in Study 2. The implications of students exhibiting these biases and current legal safeguards focusing on confession voluntariness, rather than veracity, are discussed.