Search results

The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.

A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).

Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.

Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.

The involvement of patients or members of the public within public health, health and social care and addictions services is growing in the UK and internationally but is less common in gambling support services. The purpose of this study was to explore Patient and Public Involvement (PPI) infrastructures and engagement channels used in health and care services and debate their transferability to the gambling support sector (including research, education and treatment).

A narrative review examined data from six English language electronic databases, NHS evidence and grey literature covering the period 2007–2019. We identified 130 relevant items from UK literature. A workshop was held in London, England, with people with lived experience of gambling harm to seek their views on and applicability of the review findings to gambling services.

Synthesis of literature and workshop data was undertaken. Main themes addressed “What works” in relation to: building infrastructures and organising involvement of people with lived experience; what people want to be involved in; widening participation and sustaining involvement and respecting people with lived experience.

Examination of the literature about involvement and engagement of patients, service users and the public in public health, health and social care and addiction services provides potentially useful examples of good practice which may be adopted by gambling services.

The involvement of people with lived experience of gambling harms in gambling support services is under-explored, with little published evidence of what constitutes good practice amongst self-organising groups/networks/grassroots organisations or rights-based/empowerment-based approaches.

The purpose of this paper is to explore how a study of a practice can lay the foundation to describe this very practice whilst transformations of it were taken place. Descriptions of changes to the practice of social work which was observed empirically serve as a starting point for experimenting with how social scientists, though often exploring transformative study objects, can remain focused on describing the object, under study.

The study was done through circa one year of fieldwork conducted with participant observation in two Danish municipal units offering services to socially marginalized people and interviews with social workers and employees in drug/alcohol treatment and psychiatric units.

The object of study within social sciences, though changing, is able to be described. Through the theories of “Social Navigation” (Vigh) and “Strategy and Tactics” (de Certeau), the practice of social work can be described as one concrete bounded practice but one which is performed within a transformative/changeable environment that are capable of influencing it. In this case, the experience of a changeable seascape might serve as a metaphor for how study objects change within an environment of change; how they can be viewed as “motion within motion” (Vigh).

Even though fields such as anthropology and organizational studies seem to rid themselves from their objects of study (culture and organization, respectively) and dissociate themselves from descriptions thereof these objects might still be of value to us. Even though the objects of study in postmodern anthropology and organizational studies are defined as unbounded, anti-essential, ephemeral, ever-changing non-objects, this might not be the entire picture. Despite their ever-changing shape, we might still be able to study and describe them if we take their changeable form and environment into account.

This paper examines the contested value of healthy life and wellbeing in a context of severe austerity, exploring how the value of “Public Health” is constructed through and with material-discursive practices and accounting representations. It seeks to explore the political and ethical implications of constructing the valuable through a shared consensus over the “facts” when addressing complex, multi-agency problems with long time horizons and outcomes that are not always easily quantifiable.

The theorisation, drawing on science and technology studies (STS) scholars and Karen Barad's (2007) agential realism, opens up the analysis to the performativity of both material and discursive practices in the period following a major re-organisation of activity. The study investigates two case authorities in England and the national regulator through interviews, observations and documentary analysis.

The paper demonstrates the deeply ethical and political entanglements of accounting representations as objectivity, consensus and collective action are constructed and resisted in practice. It goes on to demonstrate the practical challenges of constructing “alternative accounts” and “intelligent accountabilities” through times of austerity towards a shared sense of public value and suggests austerity measures make such aims both more challenging and all the more essential.

Few studies in the accounting literature have explored the full complexity of valuation practices in non-market settings, particularly in a public sector context; this paper, therefore, extends familiar conceptual vocabulary of STS inspired research to further explore how value(s), ethics and identity all play a crucial role in making things valuable.

In this study, the authors report visitors' and personnel's safety experiences and concerns in order to understand the safety conditions of a library.

The analysis is based on answers from a small sample survey of library visitors, interviews with the personnel and incidents recorded in a library in Stockholm the capital of Sweden.

Dealing with visitors under influence of drugs/alcohol or feeling intimidated by groups of young individuals are examples of situations in which the staff feel most unsafe. Visitors declare witnessing problems of public disturbance and disorderly conduct, fights and other types of aggression. Although the vast majority of visitors declare feeling safe in the library, their perceptions vary according to the library's environment and their individual characteristics, including their previous victimization.

The study is novel because it indicates the importance of the environment to ensure the safety conditions of the library for both visitors and staff. Finally, research on safety in libraries is often from North America and Western European contexts, while this study contributes to the international literature by illustrating libraries in a Nordic European context.

The study indicates that more social control, both formal and informal, is at the top of the list of recommendations for visitors. Among personnel, recommendations include the need for cooperation with other local actors to solve problems in surrounding areas as well as better education for librarians in dealing with the current safety challenges of libraries as multifunctional public facilities.

Combine visitors' and personnel's safety experiences to better understand the safety conditions of a public library.

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.