Stigma and social barriers to accessing timely healthcare for alcohol dependence and misuse: a narrative review

2021 ◽  
Vol 19 (Sup10) ◽  
pp. S12-S17
Author(s):  
Carl Houghton ◽  
Ann Taylor

This narrative review looks at how alcohol misuse can be distinguished from unproblematic alcohol consumption, and it considers the extent of alcohol use in the UK, along with the cost of alcohol, financial and otherwise, to individuals and wider society. It focuses on the perceived public stigma and personal stigma associated with alcohol misuse and dependence and how this can discourage people from seeking help from healthcare services. This includes the negative impact of stigmatising language in reinforcing stereotypes and creating expectations. The article explores alcohol-related readmissions and the emotional consequences of ‘revolving-door syndrome’ for patients and professionals. Recommendations are made for hospital screening for risky lifestyle factors, as well as professional education on alcohol screening and interventions. The article concludes with recommendations for further study, to not lose sight of the patient and to destigmatise language to break down barriers to treatment access.

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256958
Author(s):  
Shafiun Nahin Shimul ◽  
Angi Alradie-Mohamed ◽  
Russell Kabir ◽  
Abdulrahman Al-Mohaimeed ◽  
Ilias Mahmud

Objectives In this study we compared two predictions of COVID-19 cases in the Kingdom Saudi Arabia (KSA) using pre–and post–relaxation of lockdown period data to provide an insight regarding rational exit strategies. We also applied these projections to understand economic costs versus health benefit of lockdown measures. Methods We analyzed open access data on COVID-19 cases from March 6 to January 16, 2021 in the KSA. To understand the epidemic projection during the pre- and post-lockdown period, we used two types of modeling: the SIR model, and the time series model. We also estimated the costs and benefits of lockdown- QALY gained compared to the costs of lockdown considering the payment threshold of the Government. Results Prediction using lockdown period data suggested that the epidemic might slow down significantly after 109 thousand cases and end on October 6, 2020. However, analysis with latest data after easing lockdown measures suggested that epidemic might be close to an end on October 28, 2021 with 358 thousand cases. The peak has also been shifted from May 18, 2020 to Jun 24, 2020. While earlier model predicted a steady growth in mid-June, the revised model with latest data predicted it in mid-August. In addition, we estimated that 4986 lives would have been saved if lockdown continued but the cost per life saved would be more than $378 thousand, which is way above not only the KSA threshold, but also the threshold of any other highly advanced economies such as the UK and the USA. Conclusions Our results suggest that relaxation of lockdown measures negatively impacts the epidemic. However, considering the negative impact of prolong lockdown measures on health and economy, countries must decide on the best timing and strategy to exit from such measures to safely return to normal life with minimum loss of lives and economy considering its economic and health systems’ capacity. Instead of focusing only on health, a balanced approach taking economy under consideration is recommended.


2017 ◽  
Vol 35 (2) ◽  
pp. 79-82 ◽  
Author(s):  
Andy Irving ◽  
Steve Goodacre ◽  
Joanne Blake ◽  
Davina Allen ◽  
Simon C Moore

Acute alcohol intoxication (AAI) has a long history of burdening emergency care services. Healthcare systems around the world have explored a variety of different services that divert AAI away from EDs to better manage their condition. Little formal evaluation has been undertaken, particularly in the UK where alcohol misuse is one of the highest in the world. In this article, we outline a brief history of diversionary services, introduce the concept of Alcohol Intoxication Management Services (AIMS) and describe examples of AIMS in the UK. We then describe Evaluating the Diversion of Alcohol-Related Attendances, a natural experiment including six cities with AIMS compared with six cities without, that involves an ethnographic study, records patient experiences in both AIMS and EDs, assesses impact on key performance indicators in healthcare and evaluates the cost-effectiveness of AIMS.


2021 ◽  
Vol 102 (2) ◽  
pp. 48-53
Author(s):  
N. Bissembayeva ◽  
◽  
S. Nurgaliyeva ◽  
P. Ishanov ◽  
◽  
...  

The authors explore a vital problem of our time, i.e., the professional ethics of teachers. Considering the relevance of this problem, the authors of this paper initiated a study devoted to a narrative review of scientific sources of foreign authors from far and near abroad on teaching professional ethics to future teachers, synthesizing points of view on key aspects of this problem. The research was carried out by the method of systematization and generalization of pedagogical experience in the aspect of the issue under study, thus the authors of this work tried to bring experimental facts of scientific views of authors from far and near abroad into the system of observation. According to the results of interviews with graduate students, the majority of respondents have low indicators of knowledge and skills in the field of professional ethics by the end of university, which will have a negative impact on their future professional activities. The results of research will expand scientific knowledge on the problem of forming professional ethics among students-future teachers and complement the main provisions of professional ethics and concepts of moral and professional development of the individual, enriching the theory and methodology of continuing professional education.


2019 ◽  
Author(s):  
Lea Barbett ◽  
Edward Stupple ◽  
Michael Sweet ◽  
Miles Richardson

The planet is facing an anthropogenic mass extinction of wildlife, which will have a grave impact on the environment and humans. Widespread human action is needed to minimize the negative impact of humans on biodiversity and support the restoration of wildlife. In order to find effective ways to promote pro-nature conservation behaviours to the general population, there is a need to provide a list of behaviours which will have worthwhile ecological impact and are worth encouraging. In a novel collaboration between psychologists and ecologists, 70 experts from practical and academic conservation backgrounds were asked to review and rate 48 conservation related behaviours. According to their judgement, this short paper presents a ranked list of pro-nature conservation behaviours for the public in the UK and similar landscapes. This includes behaviours people can engage in in their homes, their gardens, on their land, and in their roles as citizens.


2018 ◽  
Author(s):  
Lorraine Tudor Car ◽  
Bhone Myint Kyaw ◽  
Josip Car

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.


Author(s):  
David Whetham

Between 2007 and 2011, Wootton Bassett, a small Wiltshire town in the UK, became the focus of national attention as its residents responded to the regular repatriations of dead soldiers through its High Street. The town’s response came to symbolize the way that broader attitudes developed and changed over that period. As such, it is a fascinating case study in civil–military relations in the twenty-first century. Success may be the same as victory, but victory, at least as it has been traditionally understood, is not a realistic goal in many types of contemporary conflict. Discretionary wars—conflicts in which national survival is not an issue and even vital national interests may not be at stake—pose particular challenges for any government which does not explain why the cost being paid in blood and treasure is ‘worth it’.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 735
Author(s):  
Schoultz Mariyana ◽  
Leung Janni ◽  
Bonsaksen Tore ◽  
Ruffolo Mary ◽  
Thygesen Hilde ◽  
...  

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.


2020 ◽  
Vol 11 ◽  
pp. 215013272098062
Author(s):  
Sharon Attipoe-Dorcoo ◽  
Rigoberto Delgado ◽  
Dejian Lai ◽  
Aditi Gupta ◽  
Stephen Linder

Introduction Mobile clinics provide an efficient manner for delivering healthcare services to at-risk populations, and there is a need to understand their economics. This study analyzes the costs of operating selected mobile clinic programs representing service categories in dental, dental/preventive, preventive care, primary care/preventive, and mammography/primary care/preventive. Methods The methodology included a self-reported survey of 96 mobile clinic programs operating in Texas, North Carolina, Georgia, and Florida; these states did not expand Medicaid and have a large proportion of uninsured individuals. Data were collected over an 8-month period from November 2016 to July 2017. The cost analyses were conducted in 2018, and were analyzed from the provider perspective. The average annual estimated costs; as well the costs per patient in each mobile clinic program within different service delivery types were assessed. Costs reported in the study survey were classified into recurrent direct costs and capital costs. Results Results indicate that mean operating costs range from about $300 000 to $2.5 million with costs increasing from mammography/primary care/preventive delivery to dental/preventive. The majority of mobile clinics provided dental care followed by dental/preventive. The cost per patient visit for all mobile clinic service types ranged from $65 to $529, and appears to be considerably less than those reported in the literature for fixed clinic services. Conclusion The overall costs of all delivery types in mobile clinics were lower than the costs of providing care to Medicare beneficiaries in federally funded health centers, making mobile clinics a sound economic complement to stationary healthcare facilities.


Micromachines ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 882
Author(s):  
M. Munzer Alseed ◽  
Hamzah Syed ◽  
Mehmet Cengiz Onbasli ◽  
Ali K. Yetisen ◽  
Savas Tasoglu

Civil wars produce immense humanitarian crises, causing millions of individuals to seek refuge in other countries. The rate of disease prevalence has inclined among the refugees, increasing the cost of healthcare. Complex medical conditions and high numbers of patients at healthcare centers overwhelm the healthcare system and delay diagnosis and treatment. Point-of-care (PoC) testing can provide efficient solutions to high equipment cost, late diagnosis, and low accessibility of healthcare services. However, the development of PoC devices in developing countries is challenged by several barriers. Such PoC devices may not be adopted due to prejudices about new technologies and the need for special training to use some of these devices. Here, we investigated the concerns of end users regarding PoC devices by surveying healthcare workers and doctors. The tendency to adopt PoC device changes is based on demographic factors such as work sector, education, and technology experience. The most apparent concern about PoC devices was issues regarding low accuracy, according to the surveyed clinicians.


2021 ◽  
pp. 1-18
Author(s):  
CIARÁN MURPHY

Abstract The Munro Review of Child Protection asserted that the English child protection system had become overly ‘defensive’, ‘bureaucratised’ and ‘standardised’, meaning that social workers were not employing their discretion in the interests of the individual child. This paper reports on the results of an ethnographic case study of one of England’s statutory child protection teams. The research sought to explore the extent of social worker discretion relative to Munro’s call for ‘radical reform’ and a move towards a more ‘child-centred’ system. Employing an iterative mixed methods design – encompassing documentary analysis, observation, focus group, questionnaire, interview and ‘Critical Realist Grounded Theory’ – the study positioned the UK Government’s prolonged policy of ‘austerity’ as a barrier to social worker discretion. This was because the policy was seen to be contributing to an increased demand for child protection services; and a related sense amongst practitioners that they were afforded insufficient time with the child to garner the requisite knowledge, necessary for discretionary behaviour. Ultimately, despite evidence of progress relative to assertions that social worker discretion had been eroded, the paper concludes that there may still be ‘more to do’ if we are to achieve the ‘child-centred’ and ‘effective’ system that Munro advocated.


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