Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

<p>Abstract</p> <p>Background</p> <p>Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care.</p> <p>Method</p> <p>All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735). Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication.</p> <p>Results</p> <p>Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care.</p> <p>Conclusions</p> <p>While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.</p

Dietary Advice on Prescription: A novel approach to dietary counseling

This article describes a novel approach to giving dietary advice, which is called “Dietary Advice on Prescription” (DAP; Matordning på Recept [MoR] in Swedish). It is the same principle as prescription on medicine and “Physical Activity on Prescription” (PAP; Fysisk aktivitet på Recept [FaR] in Swedish). The main idea is that a written prescription will strengthen the oral advice and emphasize certain aspects of the dietary recommendation. The DAP is on the brink of being tested in a planned study

Disciplined into good conduct : Gender constructions of users in a municipal psychiatric context in Sweden

Aims and objectives To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long‐term municipality psychiatric care. Focus is on the staff’s use of language in relation to gender constructions. Background Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users’ needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long‐term psychiatric care in municipalities have problematised the care and how staff, through language, construct users’ gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users. Design The content of speech derived from audio recordings were analysed using Foucauldian discursive analysis. The COREQ checklist was used in this article. Results The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, Doing different femininities. Conclusion The community psychiatric context generates a discourse of conduct in which staff, via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.Peer reviewe

East Asian Welfare States in Transition

Summaries After the spectacular economic crisis of late 1997, there has been a call for social welfare reform as well as economic restructuring in East Asia. Covering Japan, South Korea and Taiwan, this article first seeks to identify the strengths and weaknesses of the East Asian welfare states. Second, it examines the pressures for reform of the welfare systems. Finally, it addresses the question of whether the low spending East Asian welfare regimes will be maintained in the future. The strength.of the East Asian welfare states mainly lies in their promotion of an ideology of developmentalism and their relatively low cost; while their weakness is that they tend to reinforce socio?economic inequalities. Economic recession and socio?economic pressures as well as inefficiencies within the welfare states create pressure for change. The governments in Japan, South Korea and Taiwan have responded with reform measures appropriate to these nations' social and political context. Despite different policy responses, the welfare states in these countries will become more expensive, although they will remain low spenders among the developed nations