ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03091.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractAn alcohol intake of more than 35 units per week will predispose to alcoholic liver disease, although not all patients with alcohol‐induced liver damage have a dependency syndrome and only about 20% of those with an unremitting heavy alcohol intake will develop liver disease. In those with evidence of chronic liver disease, a liver biopsy is the most important investigation because it confirms the diagnosis and is indicative of the prognosis. Abstinence remains the mainstay of treatment and a multi‐disciplinary approach is the best way to achieve this in most cases. In patients with severe alcoholic hepatitis, specific therapies such as high dose corticosteroids and propylthiouracil have shown promising results but are still under evaluation. Liver transplantation has been used successfully in patients with recurrent complications arising from portal hypertension, but whether a minimum period of abstinence should be a requirement remains the subject of deb

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03092.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractIn Spain there is a high prevalence of smokers: 39.2% in the general population, 61.9% of the working population, and 35% of doctors. At the same time, health education on smoking is inadequate, and tobacco is cheap. As a result, it is difficult to implement legislation which bans or restricts smoking in some areas. It is clear that more education on smoking and health is needed at every level of the Spanish population.

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03093.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThe smoking control, policy implemented at a Barcelona hospital over a 3‐year period resulted in a reduction of smoking in the hospital and a raised awareness of the exemplary role health professionals can have. However, participation by health professionals in the project decreased over the 3‐year period. Although reduced, the smoking rate in the hospital still is at a high level; this should trigger health professionals to further exploit their potential in smoking reduction effo

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03094.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractHealth services should be taking a lead in implementing smoking policies which promote smoke‐free environments for patients, visitors and staff, and ensure that patients and staff are provided with information and advice about smoking and how to give it up. Yet the evidence suggests that the implementation of such policies is patchy, particularly in countries where there are high smoking rates amongst health workers, including doctors. This article discusses, in the light of experience from Spain and the UK, some of the factors which are important in determining the success of such programmes. It is argued that such programmes will be of benefit to the future health of both patients and staf

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03095.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThere are three themes in this paper of interest to a UK audience. The first draws attention to the importance of congruity between the hospital environment and education about the harmfulness of smoking. A smoking policy is an integral part of the education process. Secondly, there are clear benefits to accrue from combining several educational elements in one smoking control programme, which has a synergistic effect. Thirdly, hospital staff are health promoters, too, and their training should reflect the importance of their public health role.

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03096.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThis paper presents the results of a smoking control programme carried out in Sant Jaume i Santa Magdalena Hospital in Mataró (Barcelona, Spain) involving the entire hospital staff. The. general objective; of the programme were: (1) to reduce tobacco consumption among hospital staff and (2) to create an awareness of their exemplary role as health professionals. In order to achieve these aims, different activities were carried out: lectures on the consequences of smoking; restrictions on smoking in hospital areas; and smoking cessation kelp for those who wished to give up smoking. To measure the effectiveness of the intervention, a survey of smoking habits and attitudes among the hospital staff was conducted before the start of the programme in 1986 and repeated two and a half years later in 1989. The population studied in both surveys (n=298 and n=304) was similar by sex, age, and professional status. Regarding tobacco consumption there was the same proportion of never smokers, while the percentage of current smokers was reduced by 11 between the two surveys (51 to 40%), and the ex‐smokers group showed an increase (16 to 23%). These differences were significant. There was also a remarkable change in attitudes among the health professionals, especially with regard to their disposition to give advice to stop smoking. The results show a reduction of the prevalence of smoking among the hospital staff and a positive change in their attitudes towards smoki

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03097.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to determine whether alcoholics with a co‐existing anxiety disorder (dual‐diagnosed group) experienced different withdrawal symptomatology from alcoholics without an anxiety disorder (alcohol‐only group). Symptoms of alcohol withdrawal were measured on admission to an in‐patient treatment program and throughout treatment (days 0, 2, 7, 14 and 21) using the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA‐Ar) scale. The dual‐diagnosed group exhibited more severe alcohol withdrawal, as indicated by higher total CIWA‐Ar scores, at all time points than the alcohol‐only group. The possibility that anxiety disorders and alcohol withdrawal share a common neurochemical basis and that the CIWA‐Ar scale may be useful as a screening instrument for anxiety disorders in alcoho

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03098.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThis paper provides an overview of the first study in Switzerland on spontaneous remission from substance abuse, conducted in 1988. After a rigorous screening process, 60 practically treatment‐free remitters could be identified. While 14 of the 30 alcohol cases reduced their consumption almost to abstinence, all but two heroin remitters stopped their consumption altogether. No selection bias could be detected when comparing the groups studied with clinic populations, survey data and police records. The qualitative analysis of the collected extensive life histories led to a typology of the autoremission process. The motivation to change, the implementation of the decision, the maintenance and the negotiation of a new identity or meaning in life represent the three major stages. This paper focuses on the first stage and the role of negative vs positive experiences in setting off subsequent changes in alcohol or heroin consumption. The variation in the motivational background is illustrated by a close look at the rich life history accounts as well as by quantitative data on life events and cognitive prerequisites of change. Methodological drawbacks of this first exploratory study, such as recall problems and a narrow definition of addiction excluding psychological problems, are discussed and the necessity of future prospective studies is underline

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03099.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThis paper examines the association between the smoking and drinking behaviours of parents and their adolescent children, and the effect of gender and social class upon this association. It is based on data collected from a cohort of young people and their parents, resident in the west of Scotland. Both social class and parental smoking behaviour were independently associated with young people's smoking, with young people from lower social class households or whose parents smoked being most likely to smoke. Social class and gender were independently associated with young people's drinking, with males and young people from non‐manual households being most likely to drink. Parental drinking behaviour was associated positively with young people's drinking only in non‐manual classes and among daughters. We conclude that it is important to take social class and gender into account since it may influence whether or not there is an association between the behaviour of young people and that of their parents, and it may influence young people's behaviour in addition to influences from parental behavi

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb03100.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY