114 research outputs found
Modelling patterns of polydrug use in the population of Great Britain:A latent class approach
EThOS - Electronic Theses Online ServiceGBUnited Kingdo
How do naloxone-based interventions work to reduce overdose deaths: a realist review
BACKGROUND: Naloxone-based interventions as part of health systems can reverse an opioid overdose. Previous systematic reviews have identified the effectiveness of naloxone; however, the role of context and mechanisms for its use has not been explored. This realist systematic review aims to identify a theory of how naloxone works based on the contexts and mechanisms that contribute to the success of the intervention for improved outcomes. METHODS: Pre-registered at PROSPERO, this realist review followed RAMESES standards of reporting. Keywords included 'naloxone' and ' opioid overdose'. All study designs were included. Data extraction using 55 relevant outputs based on realist logic produced evidence of two middle-range theories: Naloxone Bystander Intervention Theory and Skills Transfer Theory. RESULTS: Harm reduction and/or low threshold contexts provide a non-judgemental approach which support in-group norms of helping and empower the social identity of the trained and untrained bystander. This context also creates the conditions necessary for skills transfer and diffusion of the intervention into social networks. Stigma and negative attitudes held by first responders and stakeholders involved in the implementation process, such as police or GPs, can prohibit the bystander response by inducing fear in responding. This interferes with skills transfer, naloxone use and carriage of naloxone kits. CONCLUSIONS: The findings provide theoretically informed guidance regarding the harm reduction contexts that are essential for the successful implementation of naloxone-based interventions. Peer-to-peer models of training are helpful as it reinforces social identity and successful skills transfer between bystanders. Health systems may want to assess the prevalence of, and take steps to reduce opioid-related stigma with key stakeholders in contexts using a low threshold training approach to build an environment  to support positive naloxone outcomes. TRIAL REGISTRATION: PROSPERO 2019 CRD42019141003. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12954-022-00599-4
Disentangling the Symptom-Level Nuances in Comorbid Posttraumatic Stress Disorder and Problematic Alcohol Use in Northern Irish Military Veterans: A Network Analysis
Posttraumatic stress disorder (PTSD) and alcohol use are highly prevalent among military veteran populations. Several theories have been proposed to account for the comorbidity between PTSD and problematic alcohol use, but research examining the symptomâlevel associations between the two is limited. The current study used network analysis to examine the associations between PTSD and problematic alcohol use. Data were collected through a crossâsectional survey of veterans of the United Kingdom Armed Forces living in Northern Ireland. The sample comprised 511 (91.2% male) veterans with a history of trauma exposure and current alcohol use. A network consisting of PTSD symptoms from the PTSD Checklist for DSMâ5 (PCLâ5) and items from the Alcohol Use Disorders Identification Test (AUDIT) was constructed, and the bridge centrality of all items was estimated to identify items with the highest number of associations and the strongest associations between the two constructs. The PTSD symptom âreckless behaviorâ (2.43) had the highest bridge centrality values and thus the strongest connections and most connections to the alcohol use items. For the alcohol use items, ânot being able to stop drinkingâ (2.31) and ânumber of drinksâ (1.24) demonstrated the strongest bridge connections to the PTSD items. These results highlight the role of specific PTSD symptoms involved in the interaction between PTSD and problematic alcohol use
A systematic review of Positive Psychology Interventions (PPIs) to improve the health behaviours, psychological wellbeing and/or physical health of police staff
© 2023 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/This review aimed to assess the use of positive psychology interventions (PPIs), such as using positive mantras, expressive writing, or gratitude diaries, to improve the health behaviours, psychological wellbeing and/or physical health of police staff. The review was registered on PROSPERO before 16 electronic databases were searched for published articles between January 1999 and February 2022. Included studies offered PPIs to improve the physical health (body mass index, blood pressure), psychological well-being (stress, anxiety, mood, emotion, depression, self-efficacy), or health behaviours (physical activity, sitting times, dietary habits, alcohol, or tobacco use) of police staff. The mixed methods appraisal tool (MMAT) was used to assess the risk of bias of included papers. The initial search yielded 4560 results; with 3385 papers remaining after duplicates were removed. Of these, 15 studies were included in the final review. Intervention types included mindfulness-based resilience training (n = 11), physical or wellness practice classes (n = 1), role-play and scenario-based interventions (n = 2) and expressive writing (n = 1). Mindfulness-based interventions improved many psychological wellbeing facets such as anxiety, depression, negative affect and quality of life. Limited improvements were observed for some health behaviours such as alcohol consumption and in self-reported general health. Expressive writing and role-play-based interventions were effective in reducing stress and anxiety, however, improvement in depression scores were inconsistent across studies. Positive psychology interventions are promising to support the health and wellbeing of police staff. Future research should investigate their mechanisms of action to support future innovation in support for police wellbeing.Peer reviewe
What roles does physical activity play following the death of a parent as a young person? A qualitative investigation
© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Background: Physical activity benefits physical and mental health. However, limited research investigates if physical activity can improve outcomes from the grieving process following the death of a parent. Methods: Semi-structured interviews were conducted with 14 individuals (n = 8 female; age M = 31.2 years), who had experienced the death of a parent when they were aged between 10 and 24 years old, using retrospective recall. Data were analysed inductively using thematic analysis. Results: Six themes were identified. Physical activity was seen as; 1) âTherapeuticâ; providing an 2) âEmotional Outletâ and created a strong sense of 3) âSocial Supportâ. Alongside it 4) âBuilds Confidenceâ, and led to 5) âFinding Yourselfâ and 6) âImproved Health and wellbeingâ (physical and psychological). Conclusion: Physical activity has the potential to provide positive experiences following a parental bereavement. It can provide a sense of freedom and was seen to alleviate grief outcomes, build resilience, enable social support and create a stronger sense of self. Bereavement support services for young people who have experienced death of a parent should consider physical activity as a viable intervention to support the grieving process.Peer reviewe
Reflections on Experiencing Parental Bereavement as a Young Person: A Retrospective Qualitative Study
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Background: It is estimated that approximately 41,000 children and young people experience the death of a parent each year. Grief responses, such as anxiety and depression, can follow. This research investigated the adult reflections of experiencing parental death as a young person. Methods: Semi-structured interviews were conducted with adults (N = 14; female n = 8) who experienced parental death as a young person, which occurred over 5 years ago (time since death, M = 12.9 years; age at death, M = 16.4 years; age at interview, M = 30.9 years). The data were analysed inductively using thematic analysis. Results: Seven themes revealed that parental bereavement can lead to (1) âDistance and isolationâ and is an (2) âEmotional journeyâ with (3) a âPhysical impactâ. Many experienced (4) âPost-traumatic growthâ but acknowledged that (5) âLife will never be the sameâ, highlighting the importance of (6) âSupport and understandingâ and triggers for (7) âRe-griefâ. Conclusions: Parental bereavement has significant emotional and physical consequences, but can also lead to personal growth. Talking therapies were rarely accessed, often due to a lack of awareness or desire to engage, revealing a translational gap between existing support services and uptake. Enabling open conversations about grief and identifying suitable support is a public health priority. This need has been amplified since the start of the COVID-19 pandemic, which may be a trigger for grief empathy and re-grief in those who have already been bereaved.Peer reviewedFinal Published versio
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