Impact of a University Alcohol Policy Change on Bystander Responses to Alcohol-Related Medical Emergencies

2018 ◽  
Vol 48 (3-4) ◽  
pp. 103-117
Author(s):  
Amie L. Haas ◽  
Nicholas C. Welter

Two studies evaluated the implementation of a stricter campus underage drinking policy on service utilization and bystander helping behaviors for alcohol-related medical emergencies. A program evaluation (Study 1) examined campus emergency medical service logs assessing changes in call volume and service utilization, finding a 30% reduction in call volume postpolicy change. Study 2 provided a qualitative data summarizing campus first responder ( N =  35) accounts of off-duty alcohol-related emergency calls. Off-duty calls increased postpolicy change and thematic analyses indicated they were (a) motivated by fear of campus sanctions, (b) often yielded delays or failures to contact campus emergency staff, and (c) resulted from student misunderstandings of policy implications for bystander helpers. Findings highlight potential challenges in executing environmental strategies to reduce college drinking.

2020 ◽  
Vol 18 (6) ◽  
pp. 436-442
Author(s):  
Xiangjun Zhang ◽  
Roy F. Oman ◽  
Trudy A. Larson ◽  
Elizabeth J. Christiansen ◽  
Michelle L. Granner ◽  
...  

Background: Comorbidity rates and service needs are high among people living with HIV/AIDS (PLWHA). The effects of service utilization and unmet service needs on antiretroviral therapy (ART) adherence are not well understood. The purpose of this study was to investigate associations among PLWHA’s service utilization, unmet service needs, and ART adherence. Methods: PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment project in 2016. Participants completed a self-administered questionnaire on paper or online. The independent variables were service utilization and unmet service needs. The outcome variable was ART adherence. Multivariable logistic regression analyses were conducted to examine associations between the amount of utilized services and unmet service needs with ART adherence. Results: Only 12 (7.5%) participants reported they received all needed services. The ART non-adherence group showed significantly higher unmet medical service needs compared to the ART adherence group (p=0.007). Unmet medical service needs (Adjusted Odds Ratio (AOR) 0.69, CI 0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were negatively associated with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART adherence. Conclusion: The results of this study indicate that health promotion programming should focus not only on introducing new services at the community level, but also work to optimize the availability and awareness of current services. Furthermore, health promotion programs should focus on filling service coverage gaps and improving the facilitation of services.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duncan Gillespie ◽  
Jenny Hatchard ◽  
Hazel Squires ◽  
Anna Gilmore ◽  
Alan Brennan

Abstract Background To support a move towards a coordinated non-communicable disease approach in public health policy, it is important to conceptualise changes to policy on tobacco and alcohol as affecting a single interlinked system. For health economic models to effectively inform policy, the first step in their development should be to develop a conceptual understanding of the system complexity that is likely to affect the outcomes of policy change. Our aim in this study was to support the development and interpretation of health economic models of the effects of changes to tobacco and alcohol policies by developing a conceptual understanding of the main components and mechanisms in the system that links policy change to outcomes. Methods Our study was based on a workshop from which we captured data on participant discussions on the joint tobacco–alcohol policy system. To inform these discussions, we prepared with a literature review and a survey of participants. Participants were academics and policy professionals who work in the United Kingdom. Data were analysed thematically to produce a description of the main components and mechanisms within the system. Results Of the people invited, 24 completed the survey (18 academic, 6 policy); 21 attended the workshop (16 academic, 5 policy). Our analysis identified eleven mechanisms through which individuals might modify the effects of a policy change, which include mechanisms that might lead to linked effects of policy change on tobacco and alcohol consumption. We identified ten mechanisms by which the tobacco and alcohol industries might modify the effects of policy changes, grouped into two categories: Reducing policy effectiveness; Enacting counter-measures. Finally, we identified eighteen research questions that indicate potential avenues for further work to understand the potential outcomes of policy change. Conclusions Model development should carefully consider the ways in which individuals and the tobacco and alcohol industries might modify the effects of policy change, and the extent to which this results in an unequal societal distribution of outcomes. Modelled evidence should then be interpreted in the light of the conceptual understanding of the system that the modelling necessarily simplifies in order to predict the outcomes of policy change.


2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Lakshmi Rajeswaran ◽  
Valerie J. Ehlers

Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources. The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana’s hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years’ nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts.Die slagoffers van padongelukke, asook persone wat hart- en ander mediese noodtoestande ervaar, kan hulle lewens verloor omdat daar nie opgeleide personeel met funksionele toerusting en voldoende hulpbronne beskikbaar is om effektiewe kardiopulmonale resussitasie (KPR) te doen nie. Die studie het ten doel gehad om eenheidsbestuurders se persepsies te bepaal oor uitdagings wat hulle in die gesig staan wanneer KPR-tussentredes plaasvind in die twee openbare hospitale in Botswana wat as verwysingshospitale dien. Die bevindings kan gebruik word om effektiewer KPR-strategieë vir Botswana se hospitale aan te beveel. Onderhoude bestaande uit twee kwantitatiewe afdelings met geslote vrae en een kwalitatiewe afdeling met semi-gestruktureerde vrae is met 22 eenheidsbestuurders gevoer. Die kwantitatiewe data het aangedui dat alle eenheidsbestuurders minstens agt jaar se verpleegervaring het en dat hulle die tekortkomings sover dit KPR in hulle hospitale aangaan, kon identifiseer. Slegs een persoon het nog nooit KPR toegepas nie. Die ontleding van die kwalitatiewe data dui daarop dat hospitaaleenhede soms te min personeel het en dat hulle nie ten volle toegeruste noodtrollies en/of toerusting het nie. Geen KPR-spanne en geen KPR-beleid of -riglyne bestaan nie. Verpleegkundiges en dokters het volgens die onderhoude ‘n gebrek aan KPR-kennis en -vaardighede. Geen ontlontingsdienste is na KPR-voorvalle vir die personeel beskikbaar nie. Die deelnemende hospitale behoort die uitdagings aan te spreek wat KPR-uitkomste kan beinvloed. Hierdie uitdagings sluit in personeeltekorte, oorbesetting in hospitaaleenhede, tekortkomings in die noodtrollies en toerusting, die gebrek aan KPR-beleid en -riglyne, die afwesigheid van KPR-spanne, dokters en verpleegsters se beperkte KPR-vaardighede en die feit dat ontlontingsdienste nie na KPR-pogings vir personeellede beskikbaar is nie.


2021 ◽  
Author(s):  
Jenna J. Albiani

The current research was designed to examine health anxiety among individuals with Lynch syndrome; a genetic predisposition to adult onset cancers. This research had two aims: 1) To examine the severity of health anxiety in Lynch syndrome patients and identify predictors and consequences associated with health anxiety, and 2) To examine the additional impact health anxiety has on parents with Lynch syndrome. Two studies were conducted. In Study I, 209 individuals with Lynch syndrome, selected from a genetic cancer registry, completed self-report measures assessing health anxiety, medical and psychological variables, and medical service utilization. Results indicated that 30% of participants reported clinically significant levels of health anxiety. Regression analyses revealed that younger age, greater depression, anxiety, worry interference and emotional preoccupation coping were predictive of increased health anxiety. Increased health anxiety was associated with greater overall medical service utilization; specifically, visits to gastroenterologists and emergency departments. In Study II, purposive sampling was used to identify parents from Study I who reported the highest and lowest health anxiety. Twenty-one individuals completed semi-structured telephone interviews about their experience of being a parent with Lynch syndrome, their concerns of potentially passing down the genetic mutation to their children, and their perceptions of their children’s health. Qualitative content analysis using a template coding approach was used to examine the differences between parents with high and low health anxiety. Findings revealed that the most prevalent difference was in relation to parent’s perceptions of their personal health. Those with high health anxiety experienced worries that were more extreme, demonstrated a hypervigilance towards physical symptoms, discussed the emotional and psychological consequences of Lynch syndrome as more negative and severe, and had a tendency to engage in more dysfunctional coping strategies. Unexpectedly, with regards to their perceptions of their children, the parents in the high and low health anxiety groups exhibited similar worries. Taken together, the findings from Studies I and II suggest that health anxiety is of clinical significance for individuals with Lynch syndrome. Accurately identifying and treating health anxiety among this population may be one avenue to reduce the distress experienced by Lynch syndrome carriers.


2004 ◽  
Vol 27 (4) ◽  
pp. 284-288 ◽  
Author(s):  
G BERG ◽  
E THOMAS ◽  
S SILVERSTEIN ◽  
C NEEL ◽  
M MIRELES

2020 ◽  
pp. 073401682095252
Author(s):  
Natalie Goulette ◽  
Andrew S. Denney ◽  
Matthew S. Crow

Prior research finds that correctional officers (COs) often report high levels of stress, poor mental and physical health and are at an increased risk of suffering work-related injuries. However, little is known about the causes of such injuries. In an attempt to fill this large gap in the literature, the current study used qualitative data to explore the perceived causes of work-related injuries according to COs and their executive staff. Officers identified the reasons for injuries as either within their control or outside of their control. Injuries resulting from factors within CO’s control were perceived to be related to complacency and corruption. Injuries stemming from circumstances outside of CO’s control were perceived to be related to the nature of the job, the mental health of inmates, minor events escalating, and what are known as inmate “check-ins.” In consideration of these findings, policy implications and directions for future research are also reviewed.


2020 ◽  
Vol 10 (14) ◽  
pp. 5006 ◽  
Author(s):  
Marc J. Addison ◽  
Michael O. Rivett ◽  
Peaches Phiri ◽  
Prince Mleta ◽  
Emma Mblame ◽  
...  

Consumption of groundwater containing fluoride exceeding World Health Organization (WHO) 1.5 mg/L standard leaves people vulnerable to fluorosis: a vulnerability not well characterised in Malawi. To evaluate geogenic fluoride source and concentration, groundwater fluoride and geology was documented in central Malawi where groundwater supplies are mainly sourced from the weathered basement aquifer. Lithological composition was shown as the main control on fluoride occurrence. Augen gneiss of granitic composition posed the greatest geological fluoride risk. The weathered basement aquifer profile was the main factor controlling fluoride distributions. These results and fluoride-lithology statistical analysis allowed the development of a graded map of geological fluoride risk. A direct link to human health risk (dental fluorosis) from geological fluoride was quantified to support science-led policy change for fluoride in rural drinking water in Malawi. Hazard quotient (HQ) values were calculated and assigned to specific water points, depending on user age group; in this case, 74% of children under six were shown to be vulnerable to dental fluorosis. Results are contrary to current standard for fluoride in Malawi groundwater of 6 mg/L, highlighting the need for policy change. Detailed policy recommendations are presented based on the results of this study.


2012 ◽  
Vol 40 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Timothy D. Nelson ◽  
Tori R. Smith ◽  
Robert Pick ◽  
Michael H. Epstein ◽  
Ronald W. Thompson ◽  
...  

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