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The purpose of this study is to develop and test the causal relationships between alcohol consumption, social support, illness perception, fatigue and functional status among persons with liver cirrhosis. The hypothesized model was developed based on the theory of unpleasant symptoms.

A cross-sectional study was conducted among 400 persons with liver cirrhosis by stratified random sampling. Data were collected at outpatient departments from four public hospitals across three regions in Thailand. Six self-report questionnaires were utilized to collect data from March to August 2020. The developed model was verified via a structural equation modeling analysis.

The proposed model fit with the empirical data considering from χ²/df = 2.397 (p = 0.061), root mean square error of approximation (RMSEA) = 0.056, comparative fit index (CFI) = 0.985, Tucker–Lewis index (TLI) = 0.981, and standardized root mean square residual (SRMR) = 0.048. The model explained 71.30% of the total variance in functional status. Social support was the most influential factor affecting functional status both directly and indirectly through illness perception. Illness perception had a negative direct effect on functional status and a positive indirect effect on functional status through fatigue. Fatigue had a negative direct effect on functional status. Alcohol consumption was found as the lowest influential factor affecting functional status.

This is the first study that explores the characteristics of functional status among persons with liver cirrhosis comprehensively. A causal relationship among various variables found in this study would shed light as important fundamental data for developing interventions to enhance functional status among this population.

This paper reports drinking patterns among minority ethnic groups from the UK literature over the past 15 years, and considers the evidence for service provision and support. Findings show that drinking remains low among minority ethnic groups, though with evidence of increases in consumption, particularly among Indian women and Chinese men. South Asian men, particularly Sikh men, are over‐represented for liver cirrhosis, and some ethnic groups have higher than national average alcohol‐related deaths. People from black and minority ethnic backgrounds have similar rates of alcohol dependency as the white population; however services do not appear to be responsive enough to the needs of minority ethnic groups as they are under‐represented in seeking treatment and advice for drinking problems. Help‐seeking preferences vary for drinking problems between and within groups suggesting that drinking problems need to be addressed within both mainstream and specialist services. Greater understanding of cultural issues is needed in the development of alcohol services in mainstream and specialist settings.

While many studies have shown that liver diseases (LD) can be caused or exacerbated by substance use disorders (SUD), few have examined the proportion of adults with LD and SUD who receive mental health and addiction treatment or correlates of such use.

Using national Fiscal Year (FY) 2012 data from the United States Veterans Health Administration (VHA), the authors studied all 43,246 veterans diagnosed with both LD and SUD in FY 2012 and compared those who received mental health treatment (n = 30,456; 70.4%) to those who did not (n = 12,790; 29.6%).

Veterans who received mental health treatment were less like to be older than 75 years of age, more likely to have served during recent Middle East conflicts (Operation Iraqi Freedom or Operation Enduring Freedom), more likely to have been recently homeless and to have drug dependence as contrasted with alcohol dependence when compared with those who did not receive mental health treatment. Although the majority, 70.4%, received mental health treatment, only 30.6% of the total received specialized addiction treatment, and these veterans were more likely to experience homelessness and have drug dependence diagnoses.

This is the first study as per the authors’ best knowledge that broadly examines mental health and addiction treatment received by veterans with LD and SUD. High rates of mental health treatment in this population likely reflect the integrated nature of the VHA and its emphasis on providing comprehensive services to homeless veterans. Further research is needed to identify barriers to specialized addiction treatment in this population.

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations for prisons within the Welsh Government's Blood Borne Viral Hepatitis Action Plan for Wales.

A task and finish group was established to ensure multidisciplinary engagement between healthcare and custody staff. A service improvement package was developed focusing on awareness raising and/or development of clinical services for prisoners, prison officers and prison healthcare staff.

Prison healthcare staff have undergone training in BBVs and are being supported to deliver clinical services to prisoners. Training has been delivered in pre/post test discussion and dried blood spot testing; care pathways have been established between prison and community specialists for treatment referrals. An e‐learning module is being rolled out to raise awareness amongst custody staff and encourage occupational hepatitis B vaccination. Literature on “liver health” has been produced to be given to every prisoner across Wales.

It is envisaged that BBV services will become a routine part of prison care in Wales. Data on activity are being collected for evaluation and it is hoped that tackling BBVs in prisons will help reduce rates of infection both within prisons and in the wider community.

This paper describes new initiatives that have been established to tackle BBVs across Welsh prisons and will be relevant to any prison healthcare staff looking to develop similar services.

Hepatitis C virus (HCV) is highly prevalent in the United States, yet is largely culturally invisible. This study examines what people know about their illness, both before and after diagnosis, and the relationship to race. The data are from in-depth interviews in 2004 with 53 persons, mostly white or African American, with HCV in the southeastern United States. The respondents have varying educational backgrounds, family incomes, and possible modes of transmission of HCV. Regardless of whether the diagnosis of HCV came as a surprise, respondents had a range of reactions including fear, shock, sadness, and ambivalence. Knowledge of the disease postdiagnosis varies as some people have expert knowledge, moderate knowledge, or inaccurate to no knowledge of the disease. Minority respondents have less knowledge of HCV than whites. This racial disparity in knowledge has profound implications for people with HCV and the larger society.

New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health priority-setting. The purpose of this paper is to examine the role of public participation in addressing these considerations.

The paper employs a comparative case study approach. It explores the experience of four countries – Brazil, England, South Korea and the USA – in making coverage decisions about the antiviral sofosbuvir and involving the public and patients in these decision-making processes.

Issues emerging from public participation ac tivities include the role of the universal right to health in Brazil, the balance between innovation and budget impact in England, the effect of unethical medical practices on public perception in South Korea and the legitimacy of priority-setting processes in the USA. Providing policymakers are receptive to these issues, public participation activities may be re-conceptualized as processes that illuminate policy problems relevant to a particular context, thereby promoting an agenda-setting role for the public.

The paper offers an empirical analysis of public involvement in the case of sofosbuvir, where the relevant considerations that bear on priority-setting decisions have been particularly stark. The perspectives that emerge suggest that public participation contributes to raising attention to issues that need to be addressed by policymakers. Public participation activities can thus contribute to setting policy agendas, even if that is not their explicit purpose. However, the actualization of this contribution is contingent on the receptiveness of policymakers.

Over the past 30 years there has been a steady increase in the availability and affordability of alcoholic drinks in the UK. This has been associated with a dramatic increase in alcohol‐related harm, involving premature death, chronic health problems and social ills. These adverse outcomes are not inevitable. They could be avoided by rational policy‐making that followed the scientific evidence. Efforts to directly influence drinking culture and to encourage ‘responsible drinking’ have failed. Sharply increasing the price and restricting the availability of alcohol would be likely to have major benefits for the well being of the UK population.

Since the Jellinekian Foundation of modern alcohol studies 75 years ago, no one has yet systematically studied the role of his ethnographic studies, his university attendance and engagement in psychoanalytic work leading to the birth of his first book (published in 1917), which applied an ethnographic approach. The purpose of this paper is to uncover and show the ethnographic, experimental psychological and psychoanalytic roots in Jellinek’s different models of alcohol problems, from the conventional medical one, though the Alcoholics Anonymous-inspired concept, to the species of alcoholism theory.

Using the data from their research in the archives of Budapest, Berlin, Leipzig and Grenoble, the authors examine Jellinek’s scientific output in alcohol studies. They focus on data related to Jellinek’s activity in statistics, ethnography including field work and the business model of psychoanalysis.

Drawing from various traditions of science, Jellinek acquired considerable sources of knowledge with the help of his friends and teachers during his formative years, which later led him to renew and transform his models of alcohol problems. New data on Jellinek’s personal history, a by-product of the archival research, is also presented.

The Jellinekian heritage, including his cross-fertilisation approach, represents a vast reserve for addiction science.

This paper not only adds to the understanding of the history of addiction, but might also lead to a rearranging of our knowledge about the founder of the field.

Many researchers who have studied drinking in Ireland have worked under the assumption that the Irish have a particularly acute problem with alcohol. Through an investigation of historical and contemporary writings on the subject I demonstrate that the problem is more complicated than traditional images would lead one to believe. Generally it is not known that Ireland has one of the lowest rates of alcohol consumption in Europe and one of the highest percentages of abstainers, although it is also true that Ireland has one of the highest hospital admission rates for alcohol‐related illnesses. In an attempt to understand the complex variety of drinking behaviours in Ireland, I advocate the reinterpretation and use of the concept of ambivalence in the context of Irish drinking, adapting ideas of Barth (originally applied to Bah) in the process.

The new authorities created by this Act, probably the most important local government measure of the century, will be voted into existence during 1973 and commence functioning on 1st April 1974. Their responsibilities and the problems facing them are in many ways quite different and of greater complexity than those with which existing councils have had to cope. In its passage through the Lords, a number of amendments were made to the Act, but in the main, it is a scheme of reorganization originally produced after years of discussion and long sessions in the Commons. Local government reorganization in Scotland takes place one year later and for Northern Ireland, we must continue to wait and pray for a return of sanity.