ISSN:0959-5236    

DOI:10.1080/09595239600185601

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractKreitman's discussion of the preventive paradox in relation to the prevention of alcohol problems has had profound implications for alcohol policy and has generated considerable controversy [1]. It is argued here that although Kreitman should be credited with the important observation that alcohol‐related harm is not confined to a few dependent drinkers, none the less an apparent paradox is not an ideal platform from which to recommend policy. Furthermore, Kreitman's own data and data from an Australian survey of drinking are used to demonstrate that a commonplace truth underlies his apparently paradoxical findings. It is shown that the preventive paradox disappears when consideration is given to the amount of alcohol consumed on either (i) the day of highest alcohol intake out of the last four, or (ii) the day on which acute alcohol‐related harm occurred. Episodic heavy consumption by people whose average alcohol intake can be classified as ‘low’ or ‘medium’ risk contributes to the bulk of such experiences of harm. It is suggested that the importance of intoxication as a public health and safety issue has been neglected. This neglect is compounded when public education campaigns and prevention policy are only based on average rates of alcohol consumption. Advice regarding the low risk levels of consumption for different types of harm should form one component of a comprehensive harm reduction policy. Other elements of such a policy should include a variety of other measures of proven effectiveness in relation to reducing levels of intoxication and relat

ISSN:0959-5236    

DOI:10.1080/09595239600185611

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0959-5236    

DOI:10.1080/09595239600185621

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA telephone survey of domestic Australian tourists was conducted to determine the relative contribution they make to estimates of per capita alcohol consumption. The overall drinking patterns of interstate tourists were examined, along with contrasts between those who visit the Northern Territory and those who visit other parts of the country. The results show that drinking generally increased when people were on holiday. Amount of alcohol consumed did not differ by destination, but destination did distinguish the prevalence of holiday drinkers and the amounts of alcohol usually consumed by tourists when they are at home. The self‐reported reasons for increased or decreased drinking by people when they are on holidays are also presented. The implications of these various findings for the calculation of per capita consumption estimates for the Northern Territory and other jurisdictions are discusse

ISSN:0959-5236    

DOI:10.1080/09595239600185631

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractAlthough the prevalence of heavy alcohol consumption among patients of general hospitals is well documented, no study has yet reported an effect of counselling on the ward in reducing the level of consumption among such patients after discharge. This study was designed to evaluate brief counselling to reduce alcohol consumption among male heavy drinkers identified on general hospital wards. Male patients were screened on wards of four teaching hospitals in Sydney, Australia. Identified heavy drinkers (n=174) showing predominantly low levels of alcohol dependence were allocated to one of two forms of brief counselling (skills‐based counselling or brief motivational interviewing) or to a non‐intervention control group. Blind follow‐up for 123 patients (71%) was carried out approximately 6 months after discharge from hospital and self‐reports of alcohol consumption were compared with collateral sources of information. Patients who received counselling showed a significantly greater mean reduction in a quantity‐frequency measure of weekly alcohol consumption than controls but there were no significant differences in reduced consumption between the two intervention groups. However, patients who were deemed “not ready to change” showed greater reductions if they had received brief motivational interviewing than if they had received skills‐based counselling. The implications of these findings for counselling male in‐patients to reduce alcohol consumpt

ISSN:0959-5236    

DOI:10.1080/09595239600185641

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe decision to drink and drive may involve the subjective process of weighing the perceived risks of adverse consequences of the behaviour against perceived utility components. Deterrence theory proposes that an individual will refrain from drink‐driving if the perceived chances of experiencing negative outcomes associated with the behaviour are high. Previous research has demonstrated that there may be a mechanism of judgemental bias which influences individuals' perceived probabilities of rarely occurring events. In general driver age and gender have been shown independently to be both indicative and non‐indicative for the operation of the bias in terms of subjective perceptions of driver skill, safety and accident involvement. Little evidence has been presented to describe the nature of the bias in the specific domain of drink‐driving. Responses from more than 1000 UK drivers were examined to establish whether a system of bias operated for judgements of the likelihood of experiencing several possible adverse consequences of drink‐driving across males/females, age groups and offenders/non‐offenders. In general drivers were found to perceive themselves as less likely than theaveragedriver to be accident involved while impaired and non‐impaired by alcohol. Drivers reporting previous drink‐driving behaviour indicated the greatest bias. The age and gender of the driver, independently and in interaction, were not shown to be important in the operation of these perceptual inconsistencies. Findings are discussed for implications of deterrence based drink‐driving c

ISSN:0959-5236    

DOI:10.1080/09595239600185651

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThere is current concern about the level of excessive gambling in a number of countries, but problem gambling still occupies an uncertain place in the addictions field. The present paper presents results from a pilot study comparing 16 problem gamblers and 16 problem drinkers. Results from a new Attachment Questionnaire suggested that gamblers were just as strongly attached to gambling as drinkers to drinking, although they were significantly less likely to experience withdrawal symptoms. Interviews with the problem gamblers suggested that excessive attachment to gambling was maintained by cyclical processes involving strong, negative feelings associated with gambling losses, shortage of money and the need to keep the extent of gambling secret. It is proposed that these ‘secondary’ processes, along with primary incentive motivation and the tertiary effects of losses associated with excessive behaviour, are sufficient to explain addiction. It is further suggested that neuroadaptation, tolerance and withdrawal, often thought to be central to the process of addiction, may in fact be of comparatively little importa

ISSN:0959-5236    

DOI:10.1080/09595239600185661

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe development of standardized instruments to evaluate treatment outcome for opioid dependence is necessary to determine individual patients' progress within a particular treatment programme and to compare treatment outcomes across programmes. This paper reports the results of an inter‐rater reliability study utilizing the Opiate Treatment Index (OTI). The OTI questionnaire is a standardized opiate treatment evaluation tool developed within a research setting. The main aim of this study was to determine within the clinical setting of a Methadone Treatment Programme (MTP), whether information given by patients differed significantly according to whether the OTI questionnaire was administered by clinicians working within the service, or by an unknown research assistant. Results indicated that overall there were few differences between the information given to clinicians compared with that given to the research assistant and that in general, inter‐rater reliability was good. A number of issues related to the development and use of treatment outcome measures in clinical settings are highlighted and it is proposed that for MTPs a shorter questionnaire, based on the OTI, be develo

ISSN:0959-5236    

DOI:10.1080/09595239600185671

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe Opiate Treatment Index (OTI), an instrument designed to monitor treatment outcome of opioid users, is becoming increasingly popular among clinicians and researchers in the United Kingdom. This study was designed to examine how the OTI would perform when administered by clinic staff compared to externally contracted researchers in clinical settings. In a confidential setting, the OTI was administered twice to 55 opioid users from two London clinics, in a random fashion, once by trained clinic staff and once by researchers within a 2‐week period. The data generated by both groups were similar with respect to social functioning, physical health and psychological adjustment. Where differences occurred, in almost all the cases they were not statistically significant. Clients reported slightly higher levels of drug use episodes, injecting behaviour and criminal activity to researchers. In both groups, none of the clients admitted to paid sex, and low levels of criminal activity and illicit drug use were reported—findings which are most probably related to the stability of these patients rather than systematic under‐reporting. Although this cross‐sectional study showed that the OTI could be applied equally effectively by clinic staff and researchers in clinical settings, further research is needed to examine whether the situation would hold true in routine outcome monitoring. To ensure that reliable and valid data are generated in routine monitoring of treatment programmes, several issues relating to clinic staff (e.g. motivation, time); clients (e.g. co‐operation, confidentiality) and researchers (e.g. cost) need to be

ISSN:0959-5236    

DOI:10.1080/09595239600185681

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIn this paper we present a review of practices surrounding the consumption ofkhat(Catha edulis) within recent migrant communities in Melbourne from East Africa. Cultures in East Africa and the Arabian Peninsular have usedkhatas a stimulant since the seventh century and the practice of coming together to chew the leaves of thekhatplant has acquired unique cultural importance. Based on focus‐group interviews the research examines transformations taking place in the meaning ofkhatfor East African communities within their experiences of displacement and considers how the arrival ofkhatmight be managed in the Australian context. Emphasis is given to indigenous models and the cultural context of practices surroundingkhat. This anthropology ofkhatuse in Melbourne summarizes issues such as who chews it, traditional settings forkhatgatherings, culturally defined effects of the leaf, health effects, beliefs and attitudes, levels of use, gendered attitudes and questions of dependence. These issues raise questions regarding the reception of indigenous substance use within a state that claims to be multicultura

ISSN:0959-5236    

DOI:10.1080/09595239600185691

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY