And our final speaker this morning is Dr. Adam Bourne, who is an associate professor at the Australian Research Center in Sex, Health, and Society at La Trobe University. Dr. Bourne's work examines patterns of drug use among LGBT populations and their specific harm reduction policy and service delivery needs. So among other things today he will discuss HIV exceptionalism and the fact that research on gay men only looks at drug use in relation to sex sexual risk rather than examining it as an important issue by itself. Dr. Bourne. Thank you very much, Monique. And I can assure you that when I stepped off the plane after 35 hours of travel through a foggy haze of jet lag, the first thing I did was reach for some poutine. I love Canadian cuisine, so. Okay, it was a great honour to be asked to give this talk, specifically on LGBT drug use. Also something of a challenge, I was just saying to Trevor, it's difficult for someone in my position to think of how to condense such a complexity of evidence and literature relating to a whole population of people into only 12 minutes. I've tried to keep it concise and I've tried to think of the four key things I'd really like you to go away knowing a little bit more about the four things I'd like you to remember. So first of all, diversity. One of the most crucial things to remember when you're thinking about LGBT populations that this is not a homogenous group of people. We share in common a marginalised identity, a member of a minority group. We might share in common the fact that we're attracted to someone of the same gender, but beyond that, we exhibit all the same kind of complexity and variation as you would see in any other population. There are lots of differences between lesbian, gay, bisexual and transgender people as well as among them. If you look at the ranking of different substances that are most popular for lesbian and bisexual women, then of course cannabis comes pretty close towards the top. Alcohol is most definitely the most popular substance as it would be with heterosexual women as well. But what's important is that studies from Canada, the US, from Australia, from the UK, the Netherlands, Germany, lots of places tell us that problematic alcohol use is significantly higher among lesbian women compared to their heterosexual counterparts. And it's a difference you actually don't observe in relation to gay men versus straight men. If we are talking about gay men though, cannabis of course comes near the top, but you also observe a much higher prevalence of so-called club drugs or party drugs. Cannabis, I'm sorry, ecstasy, cocaine, methamphetamine, GHB or GBL, and these are present for lesbian and bisexual women in lots of surveys, but they certainly nowhere near as high. When it comes to transgender populations, to be honest, it's astonishingly hard to say. There is extremely little data collected and published about transgender people.  And what you see in all of those is that transgender people probably have the highest drug use of all within the LGBT populations. When we have samples that are large enough to look at the constituent parts of populations, if we're looking just at gay men, you see associations with ethnicity, with income, with education, all of the kind of usual axes of health inequalities. We know that problematic use is much more likely among gay men who are from poorer backgrounds, who are of minority ethnic status, sorry, minority ethnic origin, and who have lower levels of educational attainment. All LGBT people have more than one identity is the point I'm trying to make. Now the prevalence of drug use among LGBT populations isn't always very easy to establish because quite simply, in many countries, we don't ever ask the question. And at least a quarter of countries around the world, including most of Africa, most of the Middle East, most of Central Asia, and a lot of far Eastern Europe, we simply don't have any data whatsoever. And in a lot of other countries, we're reliant on one or two very small-scale community surveys that were often conducted quite a few years ago, and the data's very out of date. There are very few countries where in their national health or household surveys, they collect and disaggregate data by sexual orientation. And this is the ideal means, really, of establishing whether there are differences between different parts of the population, when you're using that same kind of methodology in the same sampling frame. But very often, questions about sexual orientation aren't asked, or inappropriate, or inadequate questions about gender identity are asked. And we know that a lack of evidence is very often used as an excuse for inaction. Trying to secure government or donor support for LGBT-specific interventions is challenging if we don't have the data to illustrate the prevalence of use and the extent of harm among these populations. But in nearly every survey that has been conducted that does disaggregate data by sexual orientation, we see significantly higher rates of use among lesbian, gay, and bisexual people than we do their heterosexual counterparts, significantly higher. So as two examples, from the data from the crime survey of England and Wales, established that the use of any illicit drug within the previous 12 months was five times higher among gay and bisexual men compared to heterosexually identifying men. The use of stimulant drugs was seven times higher, and the use of chrysanthomethamphetamine was 15 times higher among gay men compared to heterosexual men. In relation to lesbian and bisexual women, the use of any illicit drug was four times higher than among heterosexually identified women. If you look at data from Australia, from the National Drug Strategy Household Survey, it also shows significantly elevated rates of use among sexual minorities, and the use of any illicit drug within the previous 12 months was at least three times higher for both gay and bisexual men and lesbian and bisexual women. And there were a handful, a small number, of surveys from other countries that reinforce this same kind of pattern. But what about the harm that they're exposed to? Prevalence is one thing, but what harm are they exposed to or experiencing? Now, LGBT people are people. Many of the harms that they are exposed to when using drugs are exactly the same as would be the case for any other population, but they're much more concentrated given those significantly higher rates of use. And the harms may be amplified due to the additional marginalization that they often experience. At a population level where we have the data, opiates haven't often been the drug of choice for many LGBT people. So perhaps unsurprisingly, injection drug use had historically been relatively low. But as we heard in Katie Stone's opening yesterday, and as we heard again in the stimulant session in the afternoon, we are seeing significant rises in the injection of stimulants. And LGBT people are definitely a part of that picture. We're seeing increasing rates of injection of crystal meth and of methadone in several parts of the world now. And remember, this is a relatively naive population in terms of injection drug use. And I think we have to be very attentive to whether or not we're meeting their safe needle and syringe exchange harm reduction needs. But there are also harms that are a little more unique to LGBT populations, given their much high likelihood of using certain drugs. So GHB, for example, is really the one that I think in many countries we're most concerned about. It's a drug you take in very small, carefully timed doses. It makes it very easy to overdose. And earlier, just a few months ago, toxicologists at Imperial College in London found that the number of deaths from GHB in London had more than doubled between 2014 and 2015, with one person dying every 12 days of a G-related overdose. And as far as we're able to tell, the vast majority, if not all of those, were gay men. And crystal meth, obviously a drug used by multiple populations, but as I said, this significantly higher prevalence among gay men makes it a particular concern. And there's lots of data documenting ambulance submissions for people requiring medical assistance in dealing with panic attacks, with paranoia, hallucinations, and these mirror findings documented in London and North America and several other parts of the world. And there's also a fairly robust literature indicating that the adherence to antiretroviral therapy is significantly reduced, impeded, when using crystal meth among HIV positive men. Now I mentioned the association between drug use and HIV antiretroviral therapy with some degree of hesitation, actually, because I'm always very reluctant to reinforce the idea that the only drug-related harm for LGBT people, or for gay men specifically, is HIV. The vast majority of studies conducted worldwide among gay men and drug use are focused on understanding the relationship between drug use and sexual risk-taking behavior. The likelihood is this taking this drug, causing you to do something risky where you'll transmit HIV or another STI. We've been completely obsessed by it. This is the only time we paid attention to drug use among this population. And the answer, after those hundreds of different studies looking at that relationship, is that it's complex, it's quite complicated. Yes, there's definitely a correlation between the two, between using drugs and sexual risk-taking, but it isn't necessarily causal. Chemsex, the use of drugs or party and play, the use of drugs in sexual settings, has dominated media discourse and media coverage of gay men in lots of countries around the world over the last few years. But Chemsex is always treated as a sex problem. It's seeing, oh, if many using drugs in a sexual setting, the anxiety is about whether or not they're transmitting HIV or STIs. And far less attention is ever paid to overdose, to drug-related deaths, to injection site injuries, to the psychological harms and traumas that we know people are experiencing.  There's a massively disproportionate burden of HIV among this population. I've spent the last 10 years of my working life on this topic, of course, I think it's important, but I think sometimes the obsession with HIV is to the detriment of other health concerns among gay and bisexual men. LGBT drug use is more than just gay men, and gay men are more than just HIV. And my fourth point then, service in terms of service provision, what is the current state of harm reduction for LGBT populations and what should it look like? Well, I think we can probably agree that the world over, the majority of drug services specialize in opiate addiction, and in opiate addiction, harm reduction, more so than it does in relation to stimulants and other drugs that are commonly more popular among LGBT people. And it's simply the case that many drug services don't necessarily have the skills or the capacity or the experience to work with the particular harm reduction needs of this population. Studies indicate that gay men often have higher rates of substance dependence and of psychological distress at the point of treatment entry into traditional drug services, but they also have worse treatment outcomes when compared to heterosexual men in traditional drug service settings. It's often a perception or indeed an unfortunate experience of discrimination by LGBT people from healthcare staff, and it's a very sad fact that LGBT people experience a great deal of discrimination at the hands of those people who they look to for help or support. And this causes reluctance in approaching harm reduction services who are often seen as part of that same healthcare system. And often this is especially because of fears that staff won't understand the world that they live in and the settings in which they use drugs, the gay bars and clubs that they frequent, the LGBT social scenes within which their drug use is very intertwined. The sexual contexts of use, if you are an LGBT person who engages in chem sex, trying to explain that highly sexual and adventurous environment to someone who has no conception of your world can be really challenging. And of course, the personal reality of being gay or being lesbian or being transgender. And I'm really reluctant to pathologize drug use, but it is a reality that for many people who have a problematic relationship with drugs, coming to terms with their sexual identity or their gender identity is often central to how and why they're using them. And this can be really hard to discuss with someone who doesn't understand or has no training on how to address these kinds of issues. There is a small but growing body of evidence to inform what good harm reduction for LGBT populations should look like. And it's not rocket science. It's the things that we should already all know that services need to be technically competent in the drugs that this population are using and the appropriate harm reduction techniques, that they recognize the role of drugs in LGBT communities and aren't judgmental of the settings or contexts of their use. And that their LGBT affirming, okay, some people may be struggling with their sexual agenda identity, but they should not be made to feel that they are abnormal or that there is anything wrong. They should be supported to make sense of their reality and to use drugs in a way that is safe for them. And then let's not kid ourselves. The biggest barrier to implementing such services for LGBT people is the ongoing criminalization of same-sex populations and the social exclusion of people who are transgender. More than 70 countries in the world still criminalize homosexuality. And it's these laws that stand in a way of making a difference. My four key points in 12 minutes. LGBT people are diverse. They use drugs significantly more than their heterosexual counterparts. They experience a range of harms. Some of them are very similar. Some of them are very unique and often overlooked in drug services. And they often struggle to access services that meet their needs. We should all think about what we're doing to address this. Thank you.


Hello and welcome to this presentation of the STM32L4 safety support. It covers the requirements for compliance with safety standards and how STM microelectronics helps customers targeting safety for their projects. Safety requirements for electronic devices increase permanently as the use of electronic control systems expands into the huge range of human activities. The massive expansion of these devices requires their compliance with specific safety standards. The primary goal is to prevent human death or injury as well as environmental damage. But there are many other important factors at a lower level, such as the devaluation of an industrial process, including the loss of important data, connections, power or control, and many others. The process for developing harmonized standards at both national and international levels is rather complex, sometimes involving completely opposite efforts, such as local market protection versus its globalization. In any case, the main influencing factors come from field experience, market requirements, insurance issues and the globalization of trade and business. The standards are produced by specific legislative and executive bodies while specific worldwide recognized testing houses inspect and verify all the required appliances to ensure their compliance. Applications targeting safety can benefit from the acceleration of software development. Efficient and early diagnostics using specific hardware features, together with the application of proper hardware and software methods, decrease the probability of hazardous events due to possible component malfunctions. Applying certain hardware design and manufacturing methods can even increase component reliability. ST supports two basic general safety standards, a specific one targeting household appliances known as a Class B or Class C standard, and a more common industrial standard targeting safety integrity levels called SIL. The second one is a generic standard which produces a large number of derivative standards dedicated to different fields of application. ST, in compliance with these standards, cares about both systematic and random failures. Systematic failures are predictable and their avoidance and monitoring are based on practical experience gained in the industry. Systematic failures can be avoided mainly by applying correct internal processes throughout a project's life cycle. These requirements are defined in specific internal quality documentation. Regular inspections and audits ensure that these internal rules are applied and comply with the recognized standards. To ensure integrity against random failures, specific software methods and hardware design techniques must be applied as described in the following slides. Not all random failures result in a hazardous event, and they may even be considered as safe from a safety point of view. Basically, safety standards require monitoring to detect dangerous failures that may be directly or indirectly related to safety and have the potential to cause a dangerous situation. Both safe and dangerous errors can either be detected or stay hidden and undetected by the system. The more often dangerous errors are discovered and prevented in time, the more the probability of a failure propagating into a hazardous event decreases. The time needed to detect dangerous errors and prevent hazardous events must fit into overall process safety time or PST available, which includes all the possible delays and reaction times for the system, such as on sensors or actuators. For quantification purposes, safety standards recognize a safe failure fraction and diagnostic coverage. The safe failure fraction, or SSF, is the ratio of the rate of safe failures, including the rate of detected dangerous failures to the total failure rate of safe failures, as well as detected and undetected dangerous failures. The diagnostic coverage, or DC, is the ratio of the probability of detected dangerous failures to the probability of all the dangerous failures. Random failures can cause permanent or recoverable errors. Hard failures cause permanent physical damage to the component and the system is no longer able to operate normally. If no compensation is possible, the system has to be put into a safe state until it is repaired. Random soft latch-up and transient failures are returnable and some kind of recovery process is usually applicable. In addition to being detected, these failures can also be compensated for in certain cases. Latch-up failures can be matched by both hardware and software, while transient failures need fast hardware methods exclusively. Software tests can never compensate for these temporary and short-lived errors efficiently, as they are considerably slower and limited by their execution time. From a cross-product point of view, we can recognize single-point, latent, or common types of failure causes. Common causes of failure require a special focus, especially as they can potentially destroy even quite complex safety structure. When random failures are detected and cannot be compensated for, especially after a dangerous error is detected, the system has to be stopped and placed into a safe state or go through a recovery process like reset, rollback, or a specific check function. Compensation methods usually allow the system to continue operating normally while using error correction, passivation, or masking functions. Generally, a sure voting process is used to identify the damaged part or incorrect data which is then replaced by the correct one. Standards recognize hard-fault tolerance or the maximum number of errors which the system can absorb while it still can continue at normal operation. In addition to specific functional testing, redundancy is the essential diagnostic principle here. Both detection and compensation techniques always require a sure level of redundancy to be efficient. Compensation is considerably more demanding than detection, as not only discrepancies but the correct state has to be identified as well. To do so, specific comparison and voting mechanisms have to be additionally applied. The required level of redundancy can be achieved using a wide range of different software or hardware methods and techniques. Some of them are listed here and others will be highlighted later in this presentation. The techniques can usually be achieved either by hardware or software or a combination of both. From a safety point of view, a microcontroller is a relatively complex programmable electronic component which has to comply with specific requirements determined by the applicable standards. In regards to support safety for a microcontroller, a vendor considers the product as a component out of context as its final application purpose and safety tasks are not known in advance. This is why we can speak about components ready or suitable for a determined common level of safety tasks. The effort is always to cover the component's overall reliability and fulfill the overall budget of diagnostic coverage defined by the standard for the given safety integrity level required by the final application. A complex component like a microcontroller can be considered as a set of partial components involved in various safety tasks each with a different diagnostic coverage and weight in the overall component's safety budget. An effective way to ensure the required overall safety budget has to be focused on crucial and generic parts of the microcontroller especially those used by most applications. Any small improvement in the safety of these fundamental and significant parts of the design always brings the biggest gain in the overall safety budget of the component which is beneficial for each application. Once a microcontroller is included in an application design and the safety task is specified then the safety support can be deployed much more efficiently and cover just the very specific parts of the microcontroller involved in the required safety case. Many efficient methods can then be applied based on detailed knowledge of the application requirements, its design, the process and the equipment under control. Redundancy and knowledge of the system behavior are crucial principles applied either separately or together. Inputs and outputs can be multiplied or checked by feedback tested for logical state, value or expected response in trends or time intervals. The processes can be monitored for correct timing and flow order. Correct decisions can be made on the comparison of results coming from redundant and independent flows, analysis, calculations or data. STM32L4 microcontrollers feature specific data for efficient diagnostic testing and to quickly react to failures with the potential to cover a wide range of lower level safety applications. The hardware tests are autonomous with minimal or no software control. This is especially helpful in detecting transient errors and consumes the least amount of time of the overall process safety time. Nevertheless, all the tests listed here with the exception of ECC are exclusively dedicated to the detection of failures. This is why additional software tests must be added when compensation or an additional check is required, for example, to achieve a higher level of SIL. In this case, the user must ensure that the software testing period takes into account the process safety time. This slide lists application-specific safety features. A sure level of safety integrity can be achieved with an STM32L4XX microcontroller if the specific conditions and limitations described in dedicated documentation are respected. This slide lists the software checks included in the ST self-test firmware solution with a brief summary of why they are available. Generally, the firmware focuses on generic parts of the microcontroller based on in-depth knowledge of the design while packages dedicated to achieve SIL standards use more extensive testing methods proved by specific methodology for their efficiency. The packages are not available for free download. Users should ask their local ST representative for the firmware. The flash memory is protected using an error correcting code or ECC, but an additional CRC test can be helpful to detect latent and multiple bit failures, especially early. The ECC status should be checked in parallel. This regular scrubbing can detect problems in the parts of memory which are used exceptionally. A comparison with a pre-calculated CRC pattern can then verify the overall firmware image. Part of the embedded RAM is covered by a hardware parity check. This method reliably detects single bit errors. Due to applied design, the probability of multiple errors raised contemporarily at single byte is very low. To prevent multiple single bit errors, the user can apply scrubbing when the overall memory area content is read out at regular intervals. This prevents latent faults as well. If memory where no parity bit is applied needs to store safety critical information, the user should apply a Marchex algorithm functional test. This test additionally checks the data and address buses, but it is destructive towards the memory content. It is suitable as an initial functional test of all the RAM space. At runtime, it has to be done per parts and in a transparent way to prevent corruption of the actual memory content. Clock cross-reference measurements can use dedicated timer interconnections. The proportional ratio between two independent clock sources has to stay within an expected range. One frequency is used as timer input, while the other gates the timer input and raises timer capture events. A specific set of instructions can verify the CPU unit and its registers. For peripherals, it is suggested to verify the correct configuration at regular intervals. In principle, self-test procedures are included as an additional task when initializing the application main loop during system startup. This runtime self-test task provides periodic testing of the CPU, clock system, stack boundary, program flow, and both volatile and non-volatile memories. The watchdog timeout is refreshed upon completion if everything goes correctly. The memory areas are tested step-by-step per parts within the task. The test is synchronized by time-based ticks derived from timer interrupts. The interval required to complete the test depends mainly on the size of the memory areas under test, frequency of the task calls, and sizes of the blocks tested in a single step. Optionally, a one-time initial startup overall self-test can be additionally implemented at power-on or after application reset. Whenever a malfunction or discrepancy is found during these tests, the fail-safe routine is called. It should put the application into safe state and determine the next recovery possibilities. ST provides support for customers developing applications with safety requirements. Specific self-test libraries certified by Worldwide Recognized Safety Inspection Institutes are available upon request for different products. Detailed documentation describes specific conditions and limitations when the software is implemented. ST cooperates with external expertise companies with the goal to provide complex consultancy and support services from the start of design to the final certified product. For more details, please refer to dedicated documentation and contact your local ST representatives for the availability, status, and possible delivery of the firmware and associated documentation.


What is a random team group break? Each collector is assigned a random team. We use dice to determine how many times we will random the list of collectors' names and teams. Using random.org, we random the two lists separately, then match up the list in order. The results are read, matching each collector to their team, and posted in the results tab on our website. Now just sit back and enjoy the break. Be sure to join us live with hundreds of other collectors and root for your team to get big hits. All of our breaks are streamed on YouTube and Twitch. We also break on Fanatics Live. You can re-watch your breaks by finding the live video and clicking on your break name. You will be directed to your break to enjoy. Stay informed. Sign up to receive our newsletter on the homepage of latinsportscards.com and check out our all-new rewards program where you can earn points towards purchases, discounts, and member exclusive experiences. Follow us on socials and Fanatics Live.


In this module, we are going to look at the worst case scenario, when firefighters find themselves in an area where the fire behavior is exceeding their expectations, their escape route is cut off, or their safety zone is not proving to be adequate. Despite our hopes of never being in this position, we still need to plan for it. And for this reason, you are still required to get with your local facilitator and review the proper procedures for deploying your fire shelter. We want to remind you that there are still two types of fire shelters in the system, and although the deployment procedures are very similar, there are a few differences between the new generation fire shelter and the older model. It's your responsibility to know which model you are carrying on the fire line and how to properly deploy it if necessary. Your local facilitator will now review these procedures with you and help you practice the deployment sequence. We at the BLM Training Unit would like to thank you for your attention and participation during this program, and we want to wish you a very, very safe fire season.