scholarly journals Alcohol dependence and driving: knowledge of DVLA regulations

2015 ◽  
Vol 39 (1) ◽  
pp. 35-38
Author(s):  
Andrew Collier ◽  
Maggie Watts ◽  
Sujoy Ghosh ◽  
Peter Rice ◽  
Neil Dewhurst
Keyword(s):  
Alcohol Abuse ◽  
Alcohol Dependence ◽  
Medical Condition ◽  
General Medical Council ◽  
Alcohol Problems ◽  
Clinical Implications ◽  
Medical Council ◽  
Medical Practitioners

Aims and MethodsThe UK's Driver Vehicle Licensing Authority (DVLA) requires individuals to report if they have a medical condition such as alcohol dependence. General Medical Council guidance indicates that medical practitioners should ensure patients are aware of their impairment and requirement to notify the DVLA.ResultsIn a survey of 246 people with known alcohol dependence, none were aware of advice on driving given by medical practitioners and none had self-reported. In addition, 362 doctors, either attending a college symposium or visiting a college website, were asked about their knowledge of DVLA regulations regarding alcohol dependence: 73% of those attending the symposium and 63% of those visiting the website answered incorrectly. In Scotland, over 20000 people have alcohol dependence (over 1 million people with alcohol abuse), yet only 2548 people with alcohol problems self-reported to the DVLA in 2011.Clinical implicationsIf the DVLA regulations were implemented, it could make an enormous difference to the behaviours of the driving public.

Aetiology of alcohol problems

2012 ◽  
pp. 432-437
Author(s):  
Juan C. Negrete ◽  
Kathryn J. Gill
Keyword(s):  
Public Health ◽  
United States ◽  
Alcohol Abuse ◽  
Alcohol Dependence ◽  
The United States ◽  
Alcohol Problems ◽  
Harmful Drinking ◽  
Significant Public Health ◽  
Icd 10 ◽  
Health Complications

Approximately 8 out of every 10 persons living in Europe and the Americas would report consuming alcoholic beverages in their lifetime, and the norm is for drinking to start in adolescence: in 2003 the average age of first drink in the United States was 14 years old. Also in the year 2003, 79.3 per cent of persons aged 15 years or more in Canada reported to be current users of alcohol, and 22.6 per cent admitted to having exceeded the country's safe drinking guidelines (i.e. no more than 14 units/week for males and 12 units/week for females). The same survey elicited a rate of ‘hazardous drinkers’ of 13.6 per cent, defined as all respondents who scored 8+ on the AUDIT screening questionnaire.Epidemiological data in the United States indicates that roughly one in seven persons who start drinking will develop an alcohol dependence disorder in the course of their lives. The figure is higher among men when compared to women. Of course it is also higher if other clinical forms of alcohol misuse (i.e. alcohol abuse/harmful drinking) are included in the rates in addition to dependence. A moderate level of alcohol use appears to be relatively harmless; and there exist public health guidelines on ‘safe’ drinking practices. The recommendations vary considerably from country to country, but they all assume a greater vulnerability to alcohol effects in the female gender. In the United Kingdom, for instance, hazardous drinking is thought to start at 21 units/week for men and 16 units/week for women; and in the United States the equivalent guidelines are 14 and 7 drinks per week. It is among alcohol users who exceed such guidelines that the prevalence of dependence is the highest; up to 40 per cent of the more frequent violators. The expression ‘alcohol problems’ encompasses a wide range of untoward occurrences, from maladaptive, impaired, or harmful behaviour, to health complications and the condition of alcohol dependence. Alcohol problems are not incurred just by chronic excessive drinkers, but also by persons who drink heavily on isolated occasions (e.g. accidents, violence, poisoning, etc.). Given their high frequency and social costs, these consequences of acute inebriation represent the most significant public health burden of drinking. This section focuses rather on the causes of problems of a clinical nature, the ones presented by individuals who engage in patterns of repeated excessive drinking, i.e. ‘alcohol dependence’ and ‘alcohol abuse’ (DSM-IV nomenclature) or ‘harmful drinking’ (ICD-10 nomenclature).

scholarly journals Pre-registration house officer training in psychiatry: the London experience

2003 ◽  
Vol 27 (5) ◽  
pp. 192-194
Author(s):  
Joe Herzberg ◽  
Maryanne Aitken ◽  
Fiona Moss
Keyword(s):  
General Practice ◽  
General Medical Council ◽  
House Officer ◽  
Clinical Implications ◽  
Medical Council ◽  
Officer Training ◽  
Before And After ◽  
Target Skills ◽  
Structured Questionnaire

Aims and MethodTo evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees' satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements.ResultsTrainees' confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice.Clinical ImplicationsPRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees' confidence with core psychiatric skills improves after undertaking the placements.

scholarly journals Predicting persistent alcohol problems: a prospective analysis from the Great Smoky Mountain Study

2011 ◽  
Vol 42 (9) ◽  
pp. 1925-1935 ◽  
Author(s):  
W. E. Copeland ◽  
A. Angold ◽  
L. Shanahan ◽  
J. Dreyfuss ◽  
I. Dlamini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alcohol Abuse ◽  
Alcohol Dependence ◽  
Young Adulthood ◽  
Late Adolescence ◽  
Population Based ◽  
Alcohol Problems ◽  
Late Adolescents ◽  
Alcohol Disorders ◽  
Great Smoky Mountains

BackgroundRates of alcohol disorders peak in late adolescence and decrease substantially into the mid-20s. Our aim was to identify risk factors that predict alcohol problems that persist into the mid-20s.MethodData are from the prospective, population-based Great Smoky Mountains Study (GSMS; n=1420), which followed children through late adolescence and into young adulthood. Alcohol persisters were defined as subjects with an alcohol disorder (abuse or dependence) in late adolescence (ages 19 and 21 years) that continued to meet criteria for an alcohol disorder at the mid-20s assessment.ResultsThe 3-month prevalence of having an alcohol disorder (abuse or dependence) decreased markedly from late adolescence into the mid-20s. A third of late adolescents with an alcohol disorder continued to meet criteria for an alcohol disorder in young adulthood (37 of 144 who met criteria in late adolescence). Risk factors for persister status included multiple alcohol abuse criteria during late adolescence but no alcohol dependence criteria. Risk factors for persister status also included associated features of alcohol dependence such as craving alcohol and drinking to unconsciousness. Persister status was also associated with depression, cannabis dependence and illicit substance use, but not with other psychiatric disorders. More than 90% of late adolescents with three or more of the risk factors identified met criteria for a young adult alcohol disorder.ConclusionsSymptoms of alcohol abuse, not dependence, best predict long-term persistence of alcohol problems. The set of risk factors identified may be a useful screen for selective and indicated prevention efforts.

Suggestions for rendering Medico-Mental Science available to the better Administration of Justice and the more effectual Prevention of Lunacy and Crime

1868 ◽  
Vol 14 (67) ◽  
pp. 334-345 ◽  
Author(s):  
T. Laycock
Keyword(s):  
Medical Science ◽  
Modern Society ◽  
General Medical Council ◽  
Formal Proof ◽  
Medical Council ◽  
Medical Practitioners ◽  
Administration Of Justice ◽  
The Subject ◽  
The Law ◽  
The Government

That medico-mental science is often at variance with the doctrines and decisions of the courts of law is a fact too well known and too generally admitted to need formal proof. It is almost as generally assumed that the scandalous failures of justice, which too often result, must be attributed to the defective education and knowledge of the profession. It is alleged that, as a body, we are for the most part ignorant and theoretical in matters relating to insanity, and if not ignorant, then presuming, and often using the little knowledge we possess, rather with the intent to rescue thieves and murderers from the legal consequences of their crimes than to help the administration of justice. It is certainly a fact which many of us lament that the corporate bodies of the profession generally, including the general medical council, ignore the subject as a distinct department of medical education; and consequently medical practitioners, not being duly trained, do sometimes appear to great disadvantage in courts of law. Medical shortcomings are not, however, the subject of my paper, but certain fundamental defects in the principles and procedures of the law which render medico-mental science sometimes even worse than useless, and always less useful to the commonweal than it might be, if rightly adapted to the needs of modern society. Nor would it be difficult to show that some of the crime and folly which occupies our courts and fills our reformatories, prisons, workhouses, and lunatic asylums, is capable of prevention by a well-devised use of medico-mental science. As these matters are wholly beyond the powers of the profession, I shall ask leave to move at the close of the discussion that a committee be appointed, with power to take such steps as may be thought necessary to secure a thorough inquiry by the Government into the relations of medical science to the administration of the law in regard to all persons mentally disordered or defective, with a view to such improvements as may be practicable.

scholarly journals Clinical standards and the wider quality agenda

2000 ◽  
Vol 24 (3) ◽  
pp. 85-89 ◽  
Author(s):  
Paul Lelliott
Keyword(s):  
Medical Practice ◽  
General Public ◽  
Self Regulation ◽  
General Medical Council ◽  
Medical Council ◽  
Medical Practitioners ◽  
Professional Self ◽  
The Media ◽  
The Government

There is an unprecedented level of interest among the general public, the media and politicians in the quality of treatment and care provided by the NHS. Traditional methods for upholding the quality of medical practice, through professional self-regulation, are under attack. The General Medical Council (GMC) has responded by voting to introduce a process of revalidation for medical practitioners. If this is not seen to succeed, the Government could take this responsibility away from the GMC, and the Medical Colleges and Faculties.

Language (Knowledge of English)

2019 ◽  
Author(s):  
Kenneth Hamer
Keyword(s):  
English Language ◽  
General Medical Council ◽  
Medical Council ◽  
House Of Commons ◽  
Language Competence ◽  
Out Of Hours ◽  
Medical Practitioners ◽  
Language Tests ◽  
Briefing Paper ◽  
Language Knowledge

The requirement for the necessary standard of competence in the English language, initially for medical practitioners, was recommended by the House of Commons Health Committee as set out in the Committee’s Report, The Use of Overseas Doctors in Providing Out of Hours Services (5th Report, Session 2009–10). The report proposed that changes be made to legislation to allow the General Medical Council (GMC)—and subsequently other healthcare regulators—to test the English language competence of practitioners applying for registration. The report followed the death of a patient, Mr David Gray, in 2008 when the treating physician, Dr Ubani, administered ten times the recommended maximum dose of diamorphine. Dr Ubani, a German national, spoke minimal English. The incident occurred during his first shift as an out-of-hours doctor for a general practitioner (GP) service provider. Persons seeking registration in the healthcare and other professions may be required by their regulator to prove that they are proficient in English. Legislation provides for applicants to provide evidence of English language capability as part of the registration process and where concerns about language have been identified. Regulators will refuse a licence to practise in circumstances in which the necessary knowledge of English cannot be demonstrated. For further details, see Language Tests for Healthcare Professionals, Briefing Paper (House of Commons Library 2018, No. 07267, 7 March 2018).

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