George Benson, Andrew McPherson, Jacqueline McCallum and Nicola Roberts
The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency…
Abstract
Purpose
The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department.
Design/methodology/approach
A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population.
Findings
The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively.
Research limitations/implications
The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score.
Practical implications
The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life.
Originality/value
The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.
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George Benson, Nicola Roberts, Jacqueline McCallum and Andrew McPherson
The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol…
Abstract
Purpose
The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS).
Design/methodology/approach
A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS).
Findings
Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies.
Research limitations/implications
Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies.
Originality/value
The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.
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At the turn of the 20th-century railroad regulation was hotly debated in the United States. Railways were accused of abusing of their monopolistic position, in particular by…
Abstract
At the turn of the 20th-century railroad regulation was hotly debated in the United States. Railways were accused of abusing of their monopolistic position, in particular by discriminating rates. Public opinion’s pressure for tighter regulation led to the 1906 enactment of the Hepburn Act, which strengthened the powers of the Interstate Commerce Commission. American economists actively participated in the debate. While most of them sided with the pro-regulation camp, the best economic analysis came from those who used the logic of modern law and economics to demonstrate how most railroads’ practices, including rate discrimination, were simply rational, pro-efficiency behavior. However, as relatively unknown Chicago University economist Hugo R. Meyer would discover, proposing that logic in public events could at that time cost you your academic career.
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This chapter explores the way teaching music lends itself to the inclusive pedagogical approach in action framework, focusing on four key areas: working outside of ability groups…
Abstract
This chapter explores the way teaching music lends itself to the inclusive pedagogical approach in action framework, focusing on four key areas: working outside of ability groups, using what learners can do as their starting point, engaging in learning at their own level whilst contributing to a collaborative outcome and developing the whole creative child rather than just a skillset.
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Nicolas Papadopoulos, Mark Cleveland, Boris Bartikowski and Attila Yaprak
This study focuses on an inventory and typology of consumer dispositions towards “place” and relates it to the underlying theories, inputs and outcomes of place images and…
Abstract
Purpose
This study focuses on an inventory and typology of consumer dispositions towards “place” and relates it to the underlying theories, inputs and outcomes of place images and attitudes, aiming to unclutter a crowded research landscape by providing a holistic perspective of product/brand place associations.
Design/methodology/approach
The paper draws on extant literature to identify, analyze and discuss the consumer dispositions, theories and other elements related to place.
Findings
In total, 32 dispositions, 10 inputs to image formation, 28 permutations that complicate the understanding of place images, and 18 outcomes are discussed, providing a comprehensive perspective of the images of, and behaviours towards, various types of places from neighbourhoods to countries and beyond.
Research limitations/implications
Of the large number of constructs and combinations among them that are discussed, some have been studied fairly extensively, but most comprise “the road(s) less travelled”. The paper identifies relevant research gaps and numerous opportunities for new research.
Practical implications
Managers are aware and act upon some of the inventoried dispositions but can benefit by considering the complete array of constructs and concepts that are discussed.
Social implications
Individuals’ dispositions towards various places help to shape their self and social identities and are important in their daily life and consumption behaviour.
Originality/value
The study brings together for the first time a complete inventory of place-related dispositions alongside a wide range of related theories and concepts, thus advancing our knowledge of the nature and role of the country and other place-related images of products and brands.