ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02674.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThis paper gives a personal and practice based account by one of the Team Leaders of the opening of a high‐care hostel for problem drinkers in North London. The hostel, Rugby House, was set up to provide detoxification and assessment facilities for thirteen residents. It was pan of the Rugby House Project, an alcohol agency in the voluntary sector. The paper explores the processes involved in setting up a new project; how the new paid employees turn a committee's vision into practice; how a group of individuals become a team; the importance of clarity about boundaries and underlying values and assumptions; the need for openness about negative as well as positive feelings; and the recognition that some of the experiences of staff will resonate with those of the residents for whom giving up drinking is a major life chang

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02675.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractTo estimate the impact of intravenous drug use (IVDU) on mentality in the general population of young adults in Rome, Italy, the Population Attributable Risk (PAR) was calculated for the overall and cause‐specific mortality in the 15–34 years age group. Relative risks were derived from a previous historical cohort study on mortality among 4200 intravenous drug users (IVDUs) in Rome, in which increased mortality from cardiovascular, respiratory, and gastrointestinal diseases as well as from violence, overdose and AIDS had been observed. The prevalence of the risk factor (i.e. the proportion of IVDUs) in the general population was estimated using the ‘multiplier formula’ and ‘capture‐recapture’ methods. The proportion of all deaths attributable to IVDU in the 15–34 age group in the Roman population was 16% and 9% in males and females, respectively. The cause‐specific attributable proportions were 66% for endocarditis and 37% for cirrhosis in males, and 36% for endocarditis and pneumonia in females. These findings further document the relevant health consequences of IVDU on the general population of a large

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02676.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractWe used data from different sources to estimate the extent and the trend of the epidemic of drug use in Italy in the second half of the ‘80s. During the study period, the number of subjects attending drug dependency units increased from 13 905 to 61 689. Mortality and morbidity indicators showed an increase in both drug related deaths (mainly from overdose) and AIDS cases reported in injecting drug users, particularly among older subjects. However, the number of young adults detected as drug users at the army recruitment remained virtually stable from 1986 on. These findings suggest that both demand and availability of treatment increased through the years 1985–89, and that clinical consequences of drug use related behaviour have become an important public health prior

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02677.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe investigators examined survey data of lifetime and recent drug use in national samples of 2036 senior medical students and 1772 resident physicians to lest whether patterns of lifetime drug use could be characterized adequately by a single underlying dimension of ‘drug involvement’. The data analysis was based on a two parameter normal item response theory (IRT) model using the marginal maximum likelihood estimation method. The result! showed that a single latent dimension of ‘drug involvement’ characterized individual drug use differences on the following measures: substances ever used, substances used in the previous year or previous month, and the sequential order of first use for each substance. The dimension was equivalent for students and resident physicians, and for both genders. Those who professed ‘no religion’ tended to be more drug involved. Physicians‐in‐training with a higher drug involvement score based on lifetime use were more likely: (a) to have used higher‐ranking drugs (such as LSD and prescription opiates) in the past year; and (b) to have used a greater number of different drugs during the past month. Subjects first began to use each of the substances in a relatively invarient sequence corresponding to that predicted by the model. The implications of this model for evaluating the drug use histories of physicians‐in‐craining, for identifying subgroups at greater risk for continued drug involvement after the beginning of medical training, and for further psychological, biological, and sociocultural research on the nature of ‘drug inv

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02678.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractTo date, no cure has been found for HIV/AIDS. Prevention has therefore been the immediate principal aim and a didactic approach has been given a primary role. Studies from the USA indicate that knowledge level may be dictated by membership of particular subcultural groups and the perceived relevance of HIV/AIDS to these groups. This study investigates knowledge among four groups: homosexual; single heterosexual; IV drug users; and a ‘married’ group. Results indicate some gaps in knowledge and a greater knowledge base among one of the high risk groups, the homosexual gr

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02679.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractTwo possible risk factors for drug addiction were weighed against each other: (1) perinatal factors associated with obstetric medication at time of birth; and (2) factors associated with familial socio‐economic conditions at time of birth. The subjects comprised 200 amphetamine addicts and 200 opiate addicts born in Stockholm 1945–1966. In a matched case control study, addicts were compared to their siblings with regard to possible obstetric risk factors by means of conditional logistic regression controlling for socio‐economic level and civil status. Administration of opiates, barbiturates and nitrous oxide to mothers during labour was associated with drug addiction in offspring, hence confirming results from earlier studies. In a cohort study the risk associated with birth at a given hospital and familial socio‐economic level was analysed by means of loglinear analysis using 7100 controls from the general population. For amphetamine addicts, a low socio‐economic level at time of birth might be of importance for the infant subsequently becoming an addict. This could not be demonstrated for the opiate addicts. An uneven distribution of births among the hospitals, most pronounced for the amphetamine addicts, is in agreement with the hypothesis that obstetric practices may be risk factors for adult drug

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02680.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe occurrence of alcoholism is clustered within families, but the detrimental effect of a positive family history may vary with the degree of family impairment involved. In this study we assessed the effects of family history and family environment on alcohol misuse. From ongoing studies we recruited parents who had a child aged 18–30, 20 with a DSM‐III‐R alcohol dependence diagnosis, 20 without. The child then completed a multidimensional assessment. The young‐adult participants included 20 men and 20 women (mean age=24.8). Differences by family history were restricted to substance abuse behaviors. While a high level of alcohol problems occurred in both groups, those with an alcohol‐dependent parent were more likely to be heavy drinkers and showed more symptoms of alcohol dependence. Overall psychological adjustment did not differ between the groups, however. Alcohol misuse measures did correlate moderately with symptoms of poor emotional health. The most important correlates of alcohol misuse measures in this study were exposure to parental alcoholism, abusive punishment, and psychological symptoms, with some separation of effects in the two subgroups. Psychological symptoms had a stronger relationship with misuse in subjects with social‐drinking parents, while abuse was more associated in the group with an alcohol‐dependent parent. These results confirm the importance of environmental interactions with familial risk. A biological vulnerability from an alcohol‐dependent parent was not sufficient or necessary for the participants in this study to develop alcohol dependence as a young adult, although there was an increased risk. There appear to be strong protective effects of positive family relationships on the potential negative effects of a family histor

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02681.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractResults are reported of a study in which 547 general hospital medical in‐patients were screened, using a computer‐administered questionnaire, for alcohol consumption, problems and concerns. Of males, 22.5% were classified as “risk drinkers”, of women 6.5%. Rates of risk were particularly high amongst younger male patients. It was concluded that certain screening questionnaire items were more useful than others in the general hospital context, and that standard questionnaires developed for other populations should not automatically be used in general hospitals. Comparisons with items relating to other health behaviours suggested that the medical profession, the general public and the patients themselves might be relatively insensitive to the risks associated with heavy drinking in comparison to those associated with smoking, weight and lack of exercise. Data from initial screening and from 75% of patients who were asked to repeat the questionnaire six months later, were used to test certain assumptions of a model of change based in part upon that of Prochaska&DiClemente (1986). Results suggested that processes of change were more complex than the model s

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02682.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractLittle is known about alcohol consumption and the efficiency of alcohol questionnaires among women. In the present study 40‐year‐old (n= 90) and 45‐year‐old (n= 75) women participating in a health screening gave a self‐report about their alcohol consumption and filled out the Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST) and the CAGE questionnaires. Teetotallers comprised 11% of the 40‐year‐old group and 8% of the 45‐year‐old women. CAGE, but not Mm‐MAST ‐worked with the traditional cut‐off point of two recommended for men. When the criterion for heavy drinking was a self‐reported consumption ≥140g of absolute alcohol per week or a positive (≥ 2) finding in the CAGE or ≥4 ‘yes’ answers in the Mm‐MAST, 20% of the 40‐year‐old and 17% of the 45‐year‐old group (together 19%) proved positive. Neither of the two questionnaires nor self‐report atone worked perfectly for identifying eke heavy drinker group (n = 3l) screened. Using the three above criteria; of the heavy drinkers 52% were detected by self‐report, 55% by CAGE, and 45% by Mm‐MAST. CAGE in combination with self‐report detected 90% and this combination, being sh

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02683.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY