Unknown and Under-Researched: The Anatomy of Drinking Under Control Programs

2017 ◽  
Vol 63 (5) ◽  
pp. 277-288
Author(s):  
Harald Klingemann ◽  
Justyna Klingemann
Keyword(s):  
Quality Of Life ◽  
Harm Reduction ◽  
Evaluation Studies ◽  
Mission Statements ◽  
Community Response ◽  
Limited Resources ◽  
Admission Criteria ◽  
Control Programs ◽  
Institutional Order

Abstract. Introduction: While alcohol treatment predominantly focuses on abstinence, drug treatment objectives include a variety of outcomes related to consumption and quality of life. Consequently harm reduction programs tackling psychoactive substances are well documented and accepted by practitioners, whereas harm reduction programs tackling alcohol are under-researched and met with resistance. Method: The paper is mainly based on key-person interviews with eight program providers conducted in Switzerland in 2009 and up-dated in 2015, and the analysis of reports and mission statements to establish an inventory and description of drinking under control programs (DUCPs). A recent twin program in Amsterdam and Essen was included to exemplify conditions impeding their implementation. Firstly, a typology based on the type of alcohol management, the provided support and admission criteria is developed, complemented by a detailed description of their functioning in practice. Secondly, the case studies are analyzed in terms of factors promoting and impeding the implementation of DUCPs and efforts of legitimize them and assess their success. Results: Residential and non-residential DUCPs show high diversity and pursue individualized approaches as the detailed case descriptions exemplify. Different modalities of proactively providing and including alcohol consumption are conceptualized in a wider framework of program objectives, including among others, quality of life and harm reduction. Typically DUCPs represent an effort to achieve public or institutional order. Their implementation and success are contingent upon their location, media response, type of alcohol management and the response of other substance-oriented stake holders in the treatment system. The legitimization of DUCPs is hampered by the lack of evaluation studies. DUCPs rely mostly – also because of limited resources – on rudimentary self-evaluations and attribute little importance to data collection exercises. Conclusions: Challenges for participants are underestimated and standard evaluation methodologies tend to be incompatible with the rationale and operational objectives of DUCPs. Program-sensitive multimethod approaches enabled by sufficient financing for monitoring and accompanying research is needed to improve the practice-oriented implementation of DUCPs. Barriers for these programs include assumptions that ‘alcohol-assisted’ help abandons hope for recovery and community response to DUCPs as locally unwanted institutions (‘not in my backyard’) fuelled by stigmatization.

Advances in critical care for the older patient

2013 ◽  
Vol 23 (2) ◽  
pp. 118-130 ◽  
Author(s):  
Diane Monkhouse
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Critical Illness ◽  
General Population ◽  
Acute Illness ◽  
Limited Resources ◽  
Care Practice ◽  
Older Patient ◽  
Life Sustaining Treatment

SummaryAs the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.

scholarly journals Pharmacoeconomics in Africa: needs, prospect and challenges

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Temitope Ben-Ajepe ◽  
Ifechukwu Benedict Nwogu ◽  
Damilola Quazeem Olaoye ◽  
Abdulhafeez Ayodele Mustapha ◽  
Theogene Uwizeyimana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Limited Resources ◽  
African Countries ◽  
Continuous Increase ◽  
Poverty Threshold ◽  
Therapy Choice ◽  
Medication Selection ◽  
Healthcare Interventions ◽  
The Cost

AbstractAfrica as a continent has experienced a continuous increase in the cost of healthcare as its demands increase. With many of these African countries living below the poverty threshold, Africans continue to die from preventable and curable diseases. Population increases have led to an increase in demands for healthcare, which unfortunately have been met with inequitable distribution of drugs. Hence, the outcomes from healthcare interventions are frequently not maximized. These problems notably call for some economic principles and policies to guide medication selection, procurement, or donation for population prioritization or health insurance. Pharmacoeconomics drives efficient use of scarce or limited resources to maximize healthcare benefits and reduce costs. It also brings to play tools that rate therapy choice based on the quality of life added to the patient after a choice of intervention was made over an alternative. In this paper, we commented on the needs, prospect, and challenges of pharmacoeconomics in Africa.

Intensive care and the elderly

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
The Elderly ◽  
Care Patient ◽  
Admission Criteria ◽  
Advanced Directives ◽  
Perceived Quality Of Life ◽  
Level Of Activity ◽  
Withdrawal Of Support

Age is not an independent predictor for poor outcome from intensive care. This chapter reviews admission criteria for the elderly and the assessment of likely outcome including the differences between traumatic or surgical admissions against medical ones. Pre-existing comorbidities all limit functional recovery, and only about 60% of elderly patients get back to their preadmission level of activity, although this may not detract from their perceived quality of life. Potential bias in the use of quality-of-life measures by clinical staff is discussed. Information on the identification of futility and the move to either palliation or withdrawal of support is discussed. Complications are common in the intensive-care patient population, and the reasons that they may be irreversible in the elderly are reviewed. The limitation of care, the use of advanced directives, and the assessment of legal capacity are reviewed.

scholarly journals The future approach

2017 ◽  
Vol 19 (3) ◽  
pp. 165-167
Author(s):  
Steven Woolf
Keyword(s):  
Quality Of Life ◽  
Local Authority ◽  
Green Spaces ◽  
Limited Resources ◽  
Local Authorities ◽  
New Approach ◽  
Injunctive Relief ◽  
The Future ◽  
Local Residents

This Opinion considers a new approach that has been adopted by various local authorities who have successfully applied for injunctive relief to prevent ‘persons unknown’ from setting up encampments on any green spaces identified on a local authority map. It is suggested that the ‘preventative injunction’ is a better way to deal with traveller encampments on green spaces, as it is proactive rather than reactive. It is of particular benefit, when having regard to the huge sums of money that councils have expended on addressing the arrival of travellers in their areas. Local authorities have limited resources (time and money) and it is argued that this approach could instead help them to obviously spend the money saved to enhance the ‘quality of life’ of their local residents.

Corporate Commitment to Quality of Life: Evidence from Company Mission Statements

2002 ◽  
Vol 10 (4) ◽  
pp. 69-87 ◽  
Author(s):  
Christie H. Amato ◽  
Louis H. Amato
Keyword(s):  
Quality Of Life ◽  
Mission Statements ◽  
Corporate Commitment

Economic Evaluation of Acupuncture

1996 ◽  
Vol 14 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Adrian White
Keyword(s):  
Quality Of Life ◽  
Economic Evaluation ◽  
Randomised Controlled Trials ◽  
Cost Benefit ◽  
Cost Utility ◽  
Limited Resources ◽  
Controlled Trials ◽  
Cost Minimisation ◽  
Randomised Controlled

Economic evaluation of treatments is essential to make the best use of limited resources. The methodology for this is established and there are four basic analyses: cost-minimisation compares different methods of achieving an overall result, cost-effectiveness measures the outcome of treatment in a natural endpoint, cost-utility attempts to measure the treatment's effect on the overall quality of life, and cost-benefit examines the benefits of treatment in monetary terms. Economic evaluation should ideally be performed alongside randomised controlled trials, preferably placebo-controlled. Other less rigorous designs may be easier to arrange but will generate less conclusive results. In such trials, costs must be measured accurately and as fully as possible. Some examples of economic analysis of acupuncture are discussed.

THE VALUATION OF INFORMAL CARE IN ECONOMIC APPRAISAL

1999 ◽  
Vol 15 (1) ◽  
pp. 147-160 ◽  
Author(s):  
Werner B. F. Brouwer ◽  
N. Job A. van Exel ◽  
Marc A. Koopmanschap ◽  
Frans F. H. Rutten
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Economic Evaluation ◽  
Informal Care ◽  
Outcome Measure ◽  
Evaluation Studies ◽  
New Drugs ◽  
Methodological Issues ◽  
Economic Appraisal

This article dicusses the individual's choice to engage in informal care as an issue for economic evaluation. Traditional methods used in economic evaluation studies for valuing time spent on informal care are discussed and an alternative method is put forward that incorporates the quality of life of caregivers as an outcome measure to represent the effects on caregivers. The methodological issues concerning the valuation of informal caregivers' time are becoming more important as new drugs and other health care technologies are introduced for patients with diseases that are typically associated with informal care.

scholarly journals Symptoms, Quality of Life and level of functioning of traumatized refugees at Psychiatric Trauma Clinic in Copenhagen

2018 ◽  
Vol 24 (1) ◽  
pp. 15
Author(s):  
Cæcilie Buhman ◽  
Erik Lykke Mortensen ◽  
Stine Lundstrøm ◽  
Jasmina Ryberg ◽  
Merete Nordentoft ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Isolation ◽  
Evaluation Studies ◽  
Correlation Coefficients ◽  
Treatment Modalities ◽  
Psychotic Symptoms ◽  
Physical And Mental Health ◽  
Level Of Functioning

Objective: To characterize physical and mental health in trauma-exposed refugees by describing a population of patients with regard to background, mental health history, and current health problems; and to identify pre- and post-migratory predictors of mental health. Method: All patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen from April 2008 to February 2010 completed self-rating inventories on symptoms of PTSD, depression, and anxiety as well as level of functioning and quality of life before treatment. Then, associations of pre and post-migratory factors with mental health were explored using linear and logistic regression and Pearson’s correlation coefficients. Results: Among the patients, the prevalence of depression, somatic disease, pain, psychotic symptoms co-existing with PTSD and very low level of functioning was high. Persecution, being an ex-combatant and living currently in social isolation were significantly associated with PTSD arousal symptoms and self-reported pain. Conclusions: New treatment modalities should seek to address all of the symptoms and challenges of the patients including psychotic and somatic symptoms and social isolation, and studies of treatment effect should clarify all co-morbidities so that comparable populations can be included in treatment evaluation studies.

Do Men in Prison Have Nothing to Lose but Their Manhood? Masculinities of Prisoners and Officers in a Ukrainian Correctional Colony

2017 ◽  
Vol 21 (5) ◽  
pp. 665-686 ◽  
Author(s):  
Anton Symkovych
Keyword(s):  
Quality Of Life ◽  
Limited Resources ◽  
The West ◽  
Prison Violence ◽  
Extant Literature ◽  
Prison Culture

The article sets out to show how power and identity intertwine. Its close look at Ukrainian prison culture complements a recent string of studies in the “West” by demonstrating the nuanced role of violence and masculinity in men’s prisons. Whereas much of the extant literature links prison violence to a hypermasculine culture, this article, based on a semiethnographic study in Ukraine, details how a masculine-centered, hierarchical prisoner structure curtails violence. Even so, prisoners are forced to exercise masculine agility, as their provisional manliness determines their place in the hierarchy and thus, by extension, their quality of life. I explore how prisoners and officers construct, prove, and maintain their masculine identities in a milieu of rigid structures and limited resources. I demonstrate how masculine models and discourses are diverse, dynamic, and contested and argue that men as agents tap into them to frame flexible identities to suit their needs.

HOUSING CONDITIONS OF RURAL HOUSEHOLDS IN POLAND COMPA RED WITH SELECTED COUNTRIES OF THE EUROPEAN UNION

2018 ◽  
Vol XX (6) ◽  
pp. 230-235
Author(s):  
Agnieszka Siedlecka
Keyword(s):  
Quality Of Life ◽  
European Union ◽  
Rural Areas ◽  
Statistical Data ◽  
Economic Life ◽  
Limited Resources ◽  
Housing Conditions ◽  
The European Union ◽  
European Union Countries

The aim of the paper was to analyze the housing conditions of households living in rural areas in Poland against a background in selected European Union countries. The household as a basic subject of economic life has limited resources. One of the elements of these resources is a flat. Both its area, equipment and infrastructure are an important element affecting the quality of life. The analysis of statistical data showed that worse conditions, described using the average number of rooms per person in households, were in Poland in comparison with other European Union countries. The statistical data for 2017 collected by the Statistical Office of the European Union (Eurostat) were used in the article.

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