Electronic medical case files of male prisoners in a category B prison in London were studied to establish a prevalence during an eight-month period of the use of and the reasons…
Abstract
Purpose
Electronic medical case files of male prisoners in a category B prison in London were studied to establish a prevalence during an eight-month period of the use of and the reasons for prescribing gabapentinoids in prison and also to establish prescribing standards in prison and compliance with these. In addition, the prevalence of co-prescription of gabapentinoids with opioids and antidepressants, particularly tricyclic antidepressants such as amitriptyline, was also assessed in light of the increased risk of respiratory depression resulting in death when these drugs are used in combination. The paper aims to discuss these issues.
Design/methodology/approach
A retrospective, SystmOne case-file based survey was undertaken searching by SNOMED CT supplemented by examination of free text, in a category B prison for males (Capacity 1,500 prisoners; Average turnover of prisoners up to 6,000 per year), to establish practice standards related to the prescription of Gabapentinoids in the prison and determine compliance with these.
Findings
In total, 109 cases were identified of prisoners having been prescribed gabapentinoids, pregabalin in 66 cases (61 per cent) and gabapentin in 43 cases (39 per cent). In 36 cases (33 per cent) prescriptions were for unlicensed indications. This in fact represented 50 per cent of the cases where the indications were documented. In 51 cases (47 per cent) gabapentinoids were prescribed with an opioid substitute. In 14 cases (13 per cent), prescribed gabapentinoids were diverted to other prisoners.
Practical implications
The initiation of gabapentinoids in prison should be avoided. For prisoners who are also receiving opioid substitutes or are abusing opiates, it may be unsafe to continue on gabapentinoids. Issues raised by this study are likely to apply to other prisons, secure forensic psychiatric facilities and indeed community mental health and primary care as well.
Social implications
Risk of dependance on gabapentinoids including risk of mortality when taken with opioids and opioid substitutes.
Originality/value
This is an original study conducted at a category B prison in London.
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Vivianna Fang He and Gregor Krähenmann
The pursuit of entrepreneurial opportunities is not always successful. On the one hand, entrepreneurial failure offers an invaluable opportunity for entrepreneurs to learn about…
Abstract
The pursuit of entrepreneurial opportunities is not always successful. On the one hand, entrepreneurial failure offers an invaluable opportunity for entrepreneurs to learn about their ventures and themselves. On the other hand, entrepreneurial failure is associated with substantial financial, psychological, and social costs. When entrepreneurs fail to learn from failure, the potential value of this experience is not fully utilized and these costs will have been incurred in vain. In this chapter, the authors investigate how the stigma of failure exacerbates the various costs of failure, thereby making learning from failure much more difficult. The authors combine an analysis of interviews of 20 entrepreneurs (who had, at the time of interview, experienced failure) with an examination of archival data reflecting the legal and cultural environment around their ventures. The authors find that stigma worsens the entrepreneurs’ experience of failure, hinders their transformation of failure experience, and eventually prevents them from utilizing the lessons learnt from failure in their future entrepreneurial activities. The authors discuss the implications of the findings for the entrepreneurship research and economic policies.
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Eric Blaauw, Gytha Strijker, Yentl Boerema, Eric Veersma, Margreet van der Meer-Jansma and Gabriel Anthonio
– The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders.
Abstract
Purpose
The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders.
Design/methodology/approach
All case files of female systematic offenders who had been subjected to a special court order for systematic offenders in the period 2004-2014 were studied. A total of 81 fairly complete case files were selected for the study. These were all systematic offenders as they had been sentenced for at least 25 offences with an average of 102 offences over a period of 17.5 years.
Findings
All except one woman were addicted to substances in the past year, with an average duration of addiction of 21 years. In addition, 53 per cent were diagnosed with another DSM Axis I disorder and 73 per cent were diagnosed with a personality disorder. Furthermore, 32-59 per cent were found to have intellectual dysfunctions. In total, 12 per cent had one type of the above disorders, 43 per cent two types, 31 per cent three types and 14 per cent all four types. The prevalence rates of these disorders were higher than those reported in other prison studies.
Research limitations/implications
It is concluded that female systematic offenders can be characterised as problematic in many respects. Even in such a problematic group treatment can be provided.
Originality/value
The present study is the only study that provides prevalence data of mental disorders among female systematic offenders.
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John M Majer, Hannah M Chapman and Leonard A Jason
– The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.
Abstract
Purpose
The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.
Design/methodology/approach
A randomized clinical trial examined treatment conditions among justice involved persons with substance use disorders who reported high baseline levels of psychiatric severity indicative of diagnosable psychiatric comorbidity. Participants (n=39) were randomly assigned to one of three treatment conditions upon discharge from inpatient treatment for substance use disorders: a professionally staffed, integrated residential treatment setting (therapeutic community), a self-run residential setting (Oxford House), or a treatment-specific aftercare referral (usual care). Levels of psychiatric severity, a global estimate of current psychopathological problem severity, were measured at two years as the outcome.
Findings
Participants randomly assigned to residential conditions reported significant reductions in psychiatric severity whereas those assigned to the usual care condition reported significant increases. There were no significant differences in psychiatric severity levels between residential conditions.
Research limitations/implications
Findings suggest that cost-effective, self-run residential settings such as Oxford Houses provide benefits comparable to professionally run residential integrated treatments for justice involved persons who have dual diagnoses.
Social implications
Results support the utilization of low-cost, community-based treatments for a highly marginalized population.
Originality/value
Little is known about residential treatments that reduce psychiatric severity for this population. Results extend the body of knowledge regarding the effects of community-based, residential integrated treatment and the Oxford House model.
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Hattie Catherine Ann Moyes, Joshua James Heath and Lucy Victoria Dean
The purpose of this paper is to review the literature on offenders with a dual diagnosis and discuss how prison-based services can improve to better meet the needs of prisoners…
Abstract
Purpose
The purpose of this paper is to review the literature on offenders with a dual diagnosis and discuss how prison-based services can improve to better meet the needs of prisoners with co-occurring substance misuse and mental health disorders.
Design/methodology/approach
A comprehensive literature search of PsycINFO, JSTOR, PubMed and Google Scholar, reviewing international studies on dual diagnosis amongst offender and community samples spanning the last three decades, supplemented by international policy, guidance papers and reports was conducted to explore how services can be improved.
Findings
It was found that research into dual diagnosis amongst prisoners internationally was scarce. However, from the evidence available, several consistent factors emerged that led to the following recommendations: integrated treatment needs to be coordinated and holistic, staged and gender-responsive; increased availability of “low level”, flexible interventions; transitional support and continuity of care upon release with the utilisation of peer mentors; comprehensive assessments in conducive settings; mandatory dual diagnosis training for staff; and increased funding for female/gender-responsive services.
Practical implications
The recommendations can inform commissioners, funders and service providers of areas where support must be improved to address the needs of prisoners with a dual diagnosis.
Social implications
Improved outcomes for prisoners with a dual diagnosis would likely have a positive effect on society, with improvements in mental health and substance misuse treatment impacting on rates of reoffending.
Originality/value
This paper brings originality and value to the sector because it reviews relevant research on dual diagnosis and translates it into practical implications for policy makers.
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Vanessa Melton and Sue Ledwith
The purpose of this paper is to evaluate the use of node-link mapping (NLM) on the effectiveness of a structured treatment for dual diagnosis for men living in a low-secure…
Abstract
Purpose
The purpose of this paper is to evaluate the use of node-link mapping (NLM) on the effectiveness of a structured treatment for dual diagnosis for men living in a low-secure environment.
Design/methodology/approach
In total, 15 participants were recruited and randomly allocated to one of two conditions. The control group, treatment as usual (TAU) or the treatment group, TAU with NLM. Outcome measures used were: a qualitative evaluation form, The Alcohol and Illegal Drugs Decisional Balance Scale and the Brief Situational Confidence Questionnaire.
Findings
Results indicate no statistically significant difference for either group on the pre- and post-treatment outcome measures used. Qualitative data indicated that those using NLM reported the intervention as useful and instructive more often.
Research limitations/implications
The results gained were only a snapshot of the intervention straight after treatment and did not take into account any long-term benefits of therapy such as substance use relapse rates. The outcome measures used may not have been properly understood by all respondents, or reflect practical change. The NLM tool may not have been used as confidently as TAU. The TAU condition needs to be reviewed to improve effectiveness, and NLM to be included to improve the accessibility. A study comparing other outcome tools needs to be completed. Training for staff using NLM may require coaching.
Originality/value
This paper has a high/low originality. It highlights a number of advantages to NLM when comparing this to TAU.
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The purpose of this paper is to understand a spontaneous movement of social mobilization and protest known as the yellow vests and their unrelenting demand for increased buying…
Abstract
Purpose
The purpose of this paper is to understand a spontaneous movement of social mobilization and protest known as the yellow vests and their unrelenting demand for increased buying power.
Design/methodology/approach
A capsule history of France and the universal struggle for a living wage lead to a post-Marxian process of intensified civic action to support the universal aims of well-being and fair play.
Findings
The yellow vests appear to be assuming the proportions of an unorthodox labor fraternity, a novel pressure network transcending the usual time-and-money quests of integrated trade unions.
Research limitations/implications
Little attention is paid to the changing nature of employment, work itself and labor competitiveness. These require further research.
Originality/value
Internal and external factors are identified, combining to explain the lack of discipline and orderly evolution by both animators and demonstrators.
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The purpose of this paper is to analyse the evolution of “push” marketing in the confectionery industry in Britain during the 1930s. It examines the interplay between a…
Abstract
Purpose
The purpose of this paper is to analyse the evolution of “push” marketing in the confectionery industry in Britain during the 1930s. It examines the interplay between a manufacturer and advertising agency in creating advertising for cocoa and chocolate.
Design/methodology/approach
A survey of the literature examines the uses of health and well-being in the design of advertising in Britain between the wars. The records of Rowntree and its main advertising agency, J Walter Thompson, are used to examine the themes and tactics used in advertising for cocoa and Aero chocolate bars during the 1930s.
Findings
The paper emphasises the different ways in which health and nutrition was used in advertising for the two products. The campaigns of the 1930s built on earlier use of these themes. J Walter Thompson looked for ways of presenting commodities as “new and improved” and their role extended into pressing for changes to production methods and the nature of products. Themes of modernity, sexuality and lifestyles all featured, confirming conclusions of earlier studies. However, targeting of mothers and of different age and gender groups indicated that market segmentation was used extensively via print media and tailored advertising messages.
Originality/value
Although Cadbury, Rowntree and confectionery have been studied in depth before, this paper emphasises their role in applying new advertising ideas to everyday items. It points to the influence of advertising on the mass of consumers compared to the middle- and upper-income groups targeted in the marketing of houses, motor-cars and new consumer durables.