Service user involvement in drug treatment programs: Barriers to implementation and potential benefits for client recovery

Service user forums have the potential for improving awareness of services, empowering service users and strengthening community partnerships within an inclusive treatment and rehabilitation framework. The research aimed to investigate perspectives about service user involvement in order to inform the development of effective service user forum(s) in west Ireland. A total of 30 interviews with key service providers and 12 interviews with service users were conducted, with interview questions focusing on: (1) awareness of the Service User Support Team and (2) barriers to service user involvement and the development of service user forums in the region. An integrated data collection and thematic analysis was undertaken. Current levels of service user involvement were low, restricted by one-way communication and appeared grounded in user-provider power differentials and stigma relating to drug dependency. Service providers queried the actual terms of reference, capacity and training that would be needed for service user forums to advocate and lobby for service users. The use of existing support groups, creation of internet user forums and rotation of rural meetings were recommended to promote engagement among service users. The research underscores the need for transparency, resources and a framework for good practice that reflects a participatory approach


Read More: http://informahealthcare.com/doi/abs/10.3109/09687637.2012.671860

Cognitive, global, and functional benefits of donepezil in Alzheimer's disease and vascular dementia:results from large-scale clinical trials

Alzheimer's disease (AD) and vascular dementia (VaD) are both associated with deficits in cholinergic neurotransmission that are amenable to therapeutic intervention. The cholinesterase inhibitor, donepezil, is clinically effective in both AD and VaD. Results from a 10-study metaanalysis of donepezil (5 or 10 mg/day) in AD and a two-study combined analysis of donepezil (5 or 10 mg/day) in VaD are presented to compare patient characteristics and donepezil treatment outcomes. The analyzed studies were randomized, placebo-controlled, and of up to 24 weeks duration. In both AD and VaD, donepezil provided significant benefits compared with placebo on measures of cognition and global function. Placebo-treated AD patients showed a decline in cognition and global function, whereas placebo-treated VaD patients remained stable, suggesting treatment effects of donepezil in VaD were driven by improvement rather than stabilization or reduced decline. More VaD patients than AD patients received concomitant medications. Cardiovascular adverse events were more common in VaD than AD patients but were not increased by donepezil. In conclusion, although there are differences between AD and VaD patients in comorbid conditions and concomitant medications, donepezil is effective and well tolerated in both types of dementia.

Does Job Search Monitoring Intensity Affect Unemployment? Evidence from Northern Ireland

Because unemployment benefit reforms typically package together a number of changes, few existing evaluations have been able to isolate the effects of changes in job search monitoring intensity on benefit recipient stocks or flows. Those few studies that do so draw mixed conclusions. This paper provides new estimates of monitoring impacts by exploiting plausibly exogenous periods where search monitoring has been temporarily withdrawn - with the regime otherwise unchanged - during a series of benefit office refurbishments in Northern Ireland. As we would expect from search theory, withdrawal of monitoring significantly increases the stock of unemployment benefit recipients via reduced outflows. © The London School of Economics and Political Science 2008.

Job search monitoring intensity, unemployment exit and job entry: Quasi-experimental evidence from the UK

Because unemployment benefit reforms tend to package together changes to job search requirements, monitoring and assistance, few existing studies have been able to empirically isolate the effects of job search monitoring intensity on the behaviour of unemployment benefit claimants. This paper exploits periods where monitoring has been temporarily withdrawn during a series of Benefit Office refurbishments - with the regime otherwise unchanged - to allow such identification. During these periods of zero monitoring the hazard rates for exits from claimant unemployment and for job entry both fall. © 2008 Elsevier B.V. All rights reserved.

Youth unemployment and psychological distress in the Republic of Ireland

Unemployment is the most significant influence on the levels of psychological dis tress of young adults. Unlike the situation for the adult population, social class and income are not contributory factors. Social class of origin, however, does have a contributory effect. Feelings of lack of control and attribution of responsibility for employment solely to structural or political factors increase the impact of unemployment. Evidence in relation to employment commitment does not support ''culture of poverty'' type explanations. Unemployed youth appear to be ''people with a problem'' rather than ''problem people''. (C) 1997 The Association for Professionals in Services for Adolescents.

Social class, unemployment, and psychological distress

Attempts to explain variation in rates of psychological distress by social class have included reference to social selection, differential exposure to stress, and differential vulnerability arising from inequalities in access to resources. Our analysis draws on data from a national survey of the Republic of Ireland in order to examine these hypotheses. No evidence to support the social selection hypothesis was found. In addressing the issue of differential responsiveness, attention was focused on the interaction between unemployment and social class in their impact on psychological distress. While rather weak support for the hypothesis of differential vulnerability was found among women, our examination of the impact of husband's unemployment provided no evidence leading in this direction. Among men unemployment actually had a stronger impact for men in higher social classes. The major factors leading to social class differences in psychological distress are greater exposure to unemployment and economic deprivation. © 1994 Oxford University Press.

Welfare risk assessment:The benefits and common pitfalls

Risk is defined as a situation involving exposure to danger. Risk assessment by nature characterises the probability of a negative event occurring and quantifies the consequences of such an event. Risk assessment is increasingly being used in the field of animal welfare as a means of drawing comparisons between multiple welfare problems within and between species and identifying those that should be prioritised by policy-makers, either because they affect a large proportion of the population or because they have particularly severe consequences for those affected. The assessment of risk is typically based on three fundamental factors: intensity of consequences, duration affected by consequences and prevalence. However, it has been recognised that these factors alone do not give a complete picture of a hazard and its associated consequences. Rather, to get a complete picture, it is important to also consider information about the hazard itself: probability of exposure to the hazard and duration of exposure to the hazard. The method has been applied to a variety of farmed species (eg poultry, dairy cows, farmed fish), investigating housing, husbandry and slaughter procedures, as well as companion animals, where it has been used to compare inherited defects in pedigree dogs and horses. To what extent can we trust current risk assessment methods to get the priorities straight? How should we interpret the results produced by such assessments? Here, the potential difficulties and pitfalls of the welfare risk assessment method will be discussed: (i) the assumption that welfare hazards are independent; (ii) the problem of quantifying the model parameters; and (iii) assessing and incorporating variability and uncertainty into welfare risk assessments. © 2012 Universities Federation for Animal Welfare.

Communicating the benefits of wholegrain and functional grain products to European consumers

In order to increase the consumption of wholegrain products or grain products with functional properties, it is important to understand consumer beliefs about such products and the impact of health claims. In a series of consumer studies several differences were found between countries. While consumers in Finland, Italy and the UK saw wholegrain products as having positive attributes, those in Finland had more negative beliefs about refined grain products. Health claims and wholegrain labels increased perceived healthiness but had a less positive impact on likelihood of buying, and in Italy both health claims and wholegrain labels even decreased the likelihood of buying.