Opioid Substitution: Critical Issues and Future Directions

1998 ◽  
Vol 28 (1) ◽  
pp. 243-263 ◽  
Author(s):  
John Marsden ◽  
Michael Gossop ◽  
Michael Farrell ◽  
John Strang
Keyword(s):  
Health Care Services ◽  
Dose Administration ◽  
Future Directions ◽  
Treatment Providers ◽  
Care Services ◽  
Critical Issues ◽  
Key Issues ◽  
Dose Levels ◽  
Injectable Form ◽  
Opioid Substitution

Opioid substitution with oral methadone is the most widely implemented treatment for heroin dependence. In Britain, a complex array of specialist and generic health care services have evolved to deliver this treatment modality. Several minority aspects of British substitution practices receive enduring international interest, including the use of heroin itself as a substitute and the prescribing of methadone in an injectable form. This paper focuses on six linked dimensions that characterize substitution services: (1) treatment providers and settings, (2) prescribing regimes and treatment goals, (3) substitute drugs, (4) dose administration, (5) dose levels, and (6) substitute formulations. Against a background of increasing central and local accountability for the quality and efficiency of specialist providers and critical attention toward their effectiveness, the strengths and weaknesses of the British approach are considered and key issues and future directions are discussed.

CURRENT CHALLENGES AND FUTURE DIRECTIONS FOR SUSTAINABLE HEALTH DEVELOPMENT

2021 ◽  
Vol 3 (4) ◽  
pp. 354-363
Author(s):  
Reham Ershaid Sami NUSAIR ◽  
Omar Jamil Ahmad MUQEDI
Keyword(s):  
Health Care Services ◽  
Health Development ◽  
Future Directions ◽  
Healthy Development ◽  
Care Services ◽  
Social And Economic Development ◽  
The Subject ◽  
Descriptive Approach ◽  
Sustainable Health ◽  
Shed Light

Health has become one of the most important concerns in the field of development in various societies, as it is one of the most important factors contributing to achieving sustainable development, because healthy development represents an important element in the process of social and economic development, where real development cannot be achieved without improving health conditions. This study aims to identify the concept of sustainable health development, and the factors that contribute to achieving it, and its future directions, as well as an add value research related to health service facilities and the challenges that prevent achieving sustainability. The two researchers adopted the descriptive approach and deductive analysis of sustainability indicators, by reviewing many scientific sources related to the subject of the study in order to shed light on the sustainable design of health care services

scholarly journals Critical issues for employees in inter-municipal health care services: a multiple case study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Elisabeth Holen-Rabbersvik ◽  
Tom Roar Eikebrokk ◽  
Rune Werner Fensli ◽  
Elin Thygesen ◽  
Åshild Slettebø
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Multiple Case Study ◽  
Care Services ◽  
Critical Issues ◽  
Multiple Case ◽  
Municipal Health

scholarly journals The changing context of public health in Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M McKee
Keyword(s):  
Public Health ◽  
Health Care Services ◽  
Common Ground ◽  
Scientific Evidence ◽  
Public Health Perspective ◽  
Care Services ◽  
Societal Challenges ◽  
Technological Developments ◽  
Key Issues ◽  
Changing Demographics

Abstract From a public health perspective there is much to celebrate. Europe enters the third decade of the 21st century with a population that has never been healthier. Advances in knowledge, from basic sciences to public health, have transformed our ability to tackle the diseases that afflict our populations. It would be easy to become complacent. Yet, at the same time, our world is transforming rapidly and profoundly. Changing demographics, globalization, technological developments, climate change, shifting public opinions on the value of scientific evidence, a political arena that increasingly seems to focus on highlighting differences rather than looking for common ground: all these trends result in massive and complex societal challenges, which will place great strain on our public health and health care services. In addition, deep and persistent health inequalities within and between countries continue to demand action. New threats (e.g. fake news) are surfacing, old threats (e.g. measles and TB) are coming back and EUPHA and its members need to adapt. This presentation will survey the changing public health landscape in Europe and globally, highlighting key issues for EUPHA to address.

scholarly journals Patients’ Satisfaction with Public Health Care Services in Bangladesh: Some Critical Issues

2016 ◽  
Vol 3 (1) ◽  
pp. 51-62
Author(s):  
Muhammed Muazzam Hussain ◽  
Mohammed Mojammel Hussain Raihan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Large Scale ◽  
Service Providers ◽  
Group Discussion ◽  
Public Health Care ◽  
Care Services ◽  
Health Service Providers ◽  
Critical Issues

This paper attempts to explore the experiences of Bangladeshi patient with public health care services, clients self-perception of health, understanding their expectation and demands of health care towards government health practitioners and service providers. The study points out the issues and difficulties they faced in treatment or getting other services and presents some recommendations to improve the public hospital services.The study was undertaken using the interpretivist paradigm and based on qualitative research method with various data collection procedures, such as interview, focus group discussion (FGD), documentation survey, etc. were employed to collect necessary information. The data highlight a continuous cycle of marginalisation resulting from the interplay of health service providers and their business counter-parts e.g. private pharmaceutical companies, diagnostic centres which reduce the opportunity of protecting patients’ consumer rights at large scale. Therefore, the study suggests that policy makers and service providers should be more responsive to initiate effective policy measures and programmes to combat marginalisation and exclusion of that poor patient groups.  

Reflections and future directions for psychological science in Prosthetics and Orthotics International

2020 ◽  
Vol 44 (6) ◽  
pp. 402-407
Author(s):  
Deirdre Desmond ◽  
Pamela Gallagher
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Assistive Technologies ◽  
Future Directions ◽  
Rehabilitation Psychology ◽  
Considerable Potential ◽  
Psychological Science ◽  
Care Services ◽  
Broad Interpretation

In the inaugural edition of Prosthetics and Orthotics International in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional prosthetic–orthotic practice. Since then, there have been substantial changes and developments in the complexity and capabilities of assistive technologies, greater emphasis on understanding the relationships between people and enabling technologies, growing recognition of the importance of the contexts and environments that support their use, and changes in both health care services and the professional development of prosthetists and orthotists. The aim of this narrative review is to reflect on the role of Prosthetics and Orthotics International in shaping the evolving understanding of psychology in prosthetics and orthotics. There remains considerable potential and opportunity for the development and application of psychology in addressing the challenges of disability globally. However, a broad interpretation and application of the principles of rehabilitation psychology are needed if we are to meaningfully incorporate psychological science into the knowledge that informs prosthetic and orthotic practice.

scholarly journals How far can systematic reviews inform policy development for “wicked” rural health service problems?

2009 ◽  
Vol 33 (4) ◽  
pp. 592 ◽  
Author(s):  
John S Humphreys ◽  
Pim Kuipers ◽  
Leigh A D Kinsman ◽  
Robert Wells ◽  
Judith Jones ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Systematic Reviews ◽  
Policy Development ◽  
Health Care Services ◽  
Wicked Problems ◽  
Care Services ◽  
Relevant Evidence ◽  
Primary Health Care Services ◽  
Key Issues

Policy makers and researchers increasingly look to systematic reviews as a means of connecting research and evidence more effectively with policy. Based on Australian research into rural and remote primary health care services, we note some concerns regarding the suitability of systematic review methods when applied to such settings. It suggests that rural and other health services are highly complex and researching them is akin to dealing with ?wicked? problems. It proposes that the notion of ?wicked? problems may inform our understanding of the issues and our choice of appropriate methods to inform health service policy. Key issues including the complexity of health services, methodological limitations of traditional reviews, the nature of materials under review, and the importance of the service context are highlighted. These indicate the need for broader approaches to capturing relevant evidence. Sustained, collaborative synthesis in which complexity, ambiguity and context is acknowledged is proposed as a way of addressing the wicked nature of these issues.

Health Care Services and the Coproduction Puzzle: Filling in the Blanks

2015 ◽  
Vol 49 (10) ◽  
pp. 1424-1449 ◽  
Author(s):  
Maddalena Sorrentino ◽  
Chiara Guglielmetti ◽  
Silvia Gilardi ◽  
Marta Marsilio
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Empirical Evidence ◽  
Health Care Services ◽  
Effective Practices ◽  
Critical Factors ◽  
Care Services ◽  
Critical Issues ◽  
Meaningful Engagement ◽  
Relationship Of

This qualitative study analyzes an Italian hospital’s endeavor to introduce a coproduction practice and the critical factors that affect its efficacy and efficiency. The empirical evidence shows that the meaningful engagement of the patient can be achieved only by factoring in the socioorganizational conditions of all stakeholders; that no divide exists between organizational production and client coproduction, rather, it is a relationship of interdependence that in turn raises critical issues; and that formalized and effective “practices-in-use” cannot work unless there is strong managerial commitment and enforcement of the new coproduction initiative.

It's not as Easy as just Walking in the Door': Interpretations of Indigenous People's Access to Health Care

1998 ◽  
Vol 4 (1) ◽  
pp. 66 ◽  
Author(s):  
David Paul
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Health Care Services ◽  
Royal Commission ◽  
Indigenous Australians ◽  
Care Providers ◽  
Health Seeking ◽  
Care Services ◽  
Key Issues

Discussion about the on-going poor health status of Aboriginal and Torres Strait Island peoples in Australia needs to be better informed about both history, and the nature of health determining factors. Access is only one of many factors of importance in health seeking behaviour. This paper explores how the cultural appropriateness of health care services is a determinant of whether they are accessed or not. Contemporary attitudes, and their historical roots, are key issues which need to be addressed by health care providers and services. The onus is on health care providers to be informed and to act appropriately in all their interactions with health care consumers. The Royal Commission into Aboriginal Deaths in Custody provides some useful suggestions for improving the quality of health care services for Indigenous Australians.

Double Jeopardy: Disadvantage and Drug Problems

2002 ◽  
Vol 8 (1) ◽  
pp. 70
Author(s):  
Charlotte de Crespigny
Keyword(s):  
Health Care Services ◽  
Community Services ◽  
Discussion Paper ◽  
Complex Issue ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Key Issues ◽  
Drug Problems ◽  
Drug And Alcohol

This discussion paper provides an overview of drug use and the inter-relationship between drug problems and social disadvantage. It may be of use for consumers and those working in community services, primary health care services and drug and alcohol services. The paper draws from the literature, key reports and anecdotal evidence as a way of raising and illustrating key issues relating to the vulnerability of people who are disadvantaged in our community. While this paper can only offer a partial exploration of this complex issue there may be some insights into how we can be more aware of, and effective in responding to, drug problems in the context of disadvantage. It may also stimulate further research into this so far poorly understood area of people's lives.

Sign in / Sign up

Export Citation Format

Share Document