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Article
Publication date: 7 January 2019

George Benson, Nicola Roberts, Jacqueline McCallum and Andrew McPherson

The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol…

Abstract

Purpose

The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS).

Design/methodology/approach

A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS).

Findings

Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies.

Research limitations/implications

Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies.

Originality/value

The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.

Details

Drugs and Alcohol Today, vol. 19 no. 4
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 18 June 2019

George Benson, Andrew McPherson, Jacqueline McCallum and Nicola Roberts

The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency…

Abstract

Purpose

The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department.

Design/methodology/approach

A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population.

Findings

The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively.

Research limitations/implications

The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score.

Practical implications

The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life.

Originality/value

The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.

Book part
Publication date: 4 September 2020

Jacqueline Briggs

This chapter provides a genealogy of the Gladue–Ipeelee principle of special consideration of Indigenous circumstances at sentencing. The principle is codified in the 1996…

Abstract

This chapter provides a genealogy of the Gladue–Ipeelee principle of special consideration of Indigenous circumstances at sentencing. The principle is codified in the 1996 statutory requirement that “all available sanctions other than imprisonment … should be considered for all offenders, with particular attention to the circumstances of Aboriginal offenders” (s. 718.2e of the Criminal Code of Canada). Using the Foucaultian genealogy method to produce a “history of the present,” this chapter eschews normative questions of how s. 718.2e has “failed” to reduce Indigenous over-incarceration to instead focus on how practices of “special consideration” reproduce settler-state paternalism. This chapter addresses three key components of the Gladue–Ipeelee principle: the collection of circumstances information, the characterization of those circumstances, and finally their consideration at sentencing. Part one focuses on questions of legitimacy and authority and explicates how authority and responsibility to produce Indigenous circumstances knowledge was transferred from the Department of Indian Affairs (DIA) to Indigenous Courtworker organizations in the late 1960s/early 1970s. Part two identifies how authority shapes problematization by examining the characterization of Indigenous circumstances in the two eras, finding that present-day Gladue reports articulate an Indigenous history and critique of colonialism as the root cause of Indigenous criminalization, whereas DIA reports prior to 1970 generally characterized this criminalization as a “failure to assimilate.” Part three focuses on the structural reproduction of power relations by exploring historical continuities in judicial and executive-branch consideration of Indigenous circumstances, suggesting that the Gladue–Ipeelee principle reinscribes a colonial “mercy” framework of diminished responsibility. The author discusses how the principle operates in the shadow of Indigenous over-incarceration as a form of state “recognition” and a technique of governance to encourage Indigenous participation in the settler justice system and suggests that the Gladue–Ipeelee principle produces a governing effect that reinforces settler-state authority by recirculating colonial practices and discourses of settler superiority.

Details

Studies in Law, Politics, and Society
Type: Book
ISBN: 978-1-83982-297-1

Keywords

Book part
Publication date: 6 February 2007

Howard L. Smith, J. Deane Waldman, Jacqueline N. Hood and Myron D. Fottler

This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for…

Abstract

This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for providers enabling them to focus on customer service. A case study of a large medical center examines how organization culture affects clinicians versus support and managerial staff while adversely impacting patient satisfaction and organizational costs associated with turnover and the cost of replacing personnel. An agenda for managing internal customers and organization culture is presented.

Details

Strategic Thinking and Entrepreneurial Action in the Health Care Industry
Type: Book
ISBN: 978-1-84950-427-0

Article
Publication date: 1 January 1954

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).

Abstract

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).

Details

Aslib Proceedings, vol. 6 no. 1
Type: Research Article
ISSN: 0001-253X

Article
Publication date: 31 October 2023

Maneo Maiketso, Jacqueline Wolvaardt, Margot Uys and Marolien Grobler

The study explored whether an asynchronous short online course in mental health well-being and resilience for healthcare workers (HCWs) showed improved self-reported results among…

Abstract

Purpose

The study explored whether an asynchronous short online course in mental health well-being and resilience for healthcare workers (HCWs) showed improved self-reported results among participants during the second wave of the COVID-19 pandemic.

Design/methodology/approach

A descriptive cross-sectional study evaluated the course outcomes using the 10-item Connor and Davison's Resilience Scale, the World Health Organization's WHO-five well-being index and self-developed questions. Data were collected via online questionnaires before and after course completion.

Findings

A total of 1 301 HCWs participated. The highest proportion of participants was from South Africa (SA) (93.7%) and females (78.7%). Analysed mean pre- and post-training scores showed increased scores in all five domains: knowledge, confidence in course outcomes, behaviour, resilience and well-being. Confidence in the course outcomes was the only common significant construct for both well-being and resilience. Mindfulness activities (β = 0.12, 95%CI [0.032, 0.213], p = 0.008) and self-care behaviours (β = 0.14, 95%CI [0.035, 0.241], p = 0.009) were significant predictors of participants' well-being. Coping mechanisms for stress (β = 0.12, 95%CI [0.036, 0.21], p = 0.006) and connecting with a social support network (β = 0.085, 95%CI [0.0007, 0.17], p = 0.048) were significant predictors of participants' resilience. Those working in the private sector, those working in clinical settings and those who were female showed significant associations with well-being and resilience.

Research limitations/implications

The results are self-reported data which may be susceptible to social desirability and acquiescent effects. There are no guarantees that positive effects observed during this study are sustained over time. The study sample was selective in that it excluded those who did not consent for the use of their data and those who did not complete the course.

Originality/value

The research is noteworthy as literature shows that female HCWs tend to have worse mental health outcomes than males in the same field. Online learning can enable HCWs to conveniently access mental health education, accommodate their work commitments and explore topics that are potentially stigmatising.

Details

Higher Education, Skills and Work-Based Learning, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-3896

Keywords

Book part
Publication date: 14 December 2010

Juan M. Pulhin, Rodel D. Lasco, Florencia B. Pulhin, Lawrence Ramos and Rose Jane J. Peras

Forests and the goods and services they provide are essential for human well-being (Seppälä, Buck, & Katila, 2009). Forests provide three types of ecosystem services that directly…

Abstract

Forests and the goods and services they provide are essential for human well-being (Seppälä, Buck, & Katila, 2009). Forests provide three types of ecosystem services that directly support human well-being: provisioning services such as food, fuelwood, medicine, etc.; regulating services such as water purification, climate regulation, erosion control, etc.; and cultural services, including recreation, spiritual, and religious values (Millennium Ecosystem Assessment, 2003). About 1.6 billion people live in predominantly forest ecosystems or in their vicinity. Forest communities include indigenous peoples (IPs) who have been living since time immemorial in forest areas and other local groups including the more recent settlers or immigrants. In the tropics, over 800 million people are living in forests and woodlands, which makes these areas a very important resource for the rural poor (Chomitz, Buys, De Luca, Thomas, & Wertz-Kanounnikoff, 2007). Based on ADB's (2009a) estimates, half of the world's poorest of the poor are IPs, and more than half live in Asia. Sixty million of these IPs are forest dependent.

Details

Climate Change Adaptation and Disaster Risk Reduction: Issues and Challenges
Type: Book
ISBN: 978-0-85724-487-1

Article
Publication date: 14 February 2024

Qing Wang, Xuening Wang, Shaojing Sun, Litao Wang, Yan Sun, Xinyan Guo, Na Wang and Bin Chen

This study aims to study the distribution characteristics of antibiotic resistance in direct-eating food and analysis of Citrobacter freundii genome and pathogenicity. Residual…

Abstract

Purpose

This study aims to study the distribution characteristics of antibiotic resistance in direct-eating food and analysis of Citrobacter freundii genome and pathogenicity. Residual antibiotics and antibiotic resistance genes (ARGs) in the environment severely threaten human health and the ecological environment. The diseases caused by foodborne pathogenic bacteria are increasing daily, and the enhancement of antibiotic resistance of pathogenic bacteria poses many difficulties in the treatment of disease.

Design/methodology/approach

In this study, six fresh fruits and vegetable samples were selected for isolation and identification of culturable bacteria and analysis of antibiotic resistance. The whole genome of Citrobacter freundii isolated from cucumber was sequenced and analyzed by Oxford Nanopore sequencing.

Findings

The results show that 270 strains of bacteria were identified in 6 samples. From 12 samples of direct food, 2 kinds of probiotics and 10 kinds of opportunistic pathogens were screened. The proportion of Citrobacter freundii screened from cucumber was significantly higher than that from other samples, and it showed resistance to a variety of antibiotics. Whole genome sequencing showed that Citrobacter freundii was composed of a circular chromosome containing signal peptides, transmembrane proteins and transporters that could induce antibiotic efflux, indicating that Citrobacter freundii had strong adaptability to the environment. The detection of genes encoding carbohydrate active enzymes is more beneficial to the growth and reproduction of Citrobacter freundii in crops. A total of 29 kinds of ARGs were detected in Citrobacter freundii, mainly conferring resistance to fluoroquinolones, aminoglycosides, carbapenem, cephalosporins and macrolides. The main mechanisms are the change in antibiotic targets and efflux pumps, the change in cell permeability and the inactivation of antibiotics and the detection of virulence factors and ARGs, further indicating the serious risk to human health.

Originality/value

The detection of genomic islands and prophages increases the risk of horizontal transfer of virulence factors and ARGs, which spreads the drug resistance of bacteria and pathogenic bacteria more widely.

Details

World Journal of Engineering, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1708-5284

Keywords

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