Damien John Williams

An Experimental Trial Exploring the Impact of Continuous Transdermal Alcohol Monitoring upon Alcohol Consumption in a Cohort of Male Students

Objective To examine the impact of continuous transdermal alcohol monitoring upon alcohol consumption in male students at a Scottish university. Method Using a within-subject mixed-methods design, 60 male university students were randomly allocated into three experimental conditions using AUDIT score stratified sampling. Participants in Conditions A and B were asked not to consume alcohol for a 14-day period, with those in Condition A additionally being required to wear a continuous transdermal alcohol monitoring anklet. Condition C participants wore an anklet and were asked to continue consuming alcohol as normal. Alcohol consumption was measured through alcohol timeline follow-back, and using data collected from the anklets where available. Diaries and focus groups explored participants’ experiences of the trial. Results Alcohol consumption during the 14-day trial decreased significantly for participants in Conditions A and B, but not in C. There was no significant relative difference in units of alcohol consumed between Conditions A and B, but significantly fewer participants in Condition A drank alcohol than in Condition B. Possible reasons for this difference identified from the focus groups and diaries included the anklet acting as a reminder of commitment to the study (and the agreement to sobriety), participants feeling under surveillance, and the use of the anklet as a tool to resist social pressure to consume alcohol. Conclusions The study provided experience in using continuous transdermal alcohol monitors in an experimental context, and demonstrated ways in which the technology may be supportive in facilitating sobriety. Results from the study have been used to design a research project using continuous transdermal alcohol monitors with ex-offenders who recognise a link between their alcohol consumption and offending behaviour.

Television Viewing Habits of Preclinical UK Medical Undergraduates: Further Potential Implications for Bioethics

Background: Medical television programs are popular among medical students. It is believed that these programs contribute to the hidden medical curriculum, which can influence the beliefs, attitudes, and perceptions of bioethical issues. However, the context of such programs is also an important consideration as they often portray health care contexts that are incongruent with the health system in which the students are being trained and raise specific bioethical issues. Methods: Preclinical medical undergraduates at a UK medical school completed a cross-sectional survey. The survey involved a partial replication of the study by Czarny et al. (2008); United Kingdom-based medical television programs were added to explore viewing habits and impressions of bioethical issues depicted in such programs. Results: Three hundred and thirty-seven (211 women; 126 men) preclinical medical undergraduates completed the survey. All respondents watched medical TV programs, with the four most popular being United States-based. A sizeable proportion of the participants viewed the medical programs in the company of others. Moreover, half of participants reported discussing ethical issues depicted in the medical television programs with others. The top three reported sources of bioethics information were medical school, family, and scholarly articles. There were, however, few differences in gender, year of study, first language, and nationality with respect to each questionnaire item. Conclusions: The study demonstrates the ubiquity with which medical TV programs are viewed by a sample of United Kingdom-based medical students. The popularity of these often unrealistic programs and the widespread viewing of United States-based medical television programs by the United Kingdom-based sample raise issues for bioethics education in the United Kingdom through the contribution to the hidden curriculum. In order to ensure the values of the formal curriculum and bioethics education are reinforced, it will be necessary to first acknowledge the role of the hidden curriculum and then understand the contribution made by medical television programs and their influence on medical students.

Association Between Old Firm Football Matches and Reported Domestic (Violence) Incidents in Strathclyde, Scotland

Media reports have suggested that the number of reports of domestic violence may increase when Scotland’s two largest, Glasgow-based football (soccer) clubs, Rangers and Celtic (traditionally referred to as the “Old Firm”) play one another. This study considers the number of domestic (violence) incidents reported to Strathclyde Police between 2008 and 2011 in the 24 hours following these matches, and compares it with the number reported during two appropriate comparator periods. There is a statistically significant increase in the number of reports following Old Firm matches compared with the comparator periods. This preliminary analysis confirms previous speculation concerning the association between Old Firm matches and reports of domestic violence, and highlights the need to better understand the factors leading to such violence to inform preventive interventions.

Testing a method to develop preliminary cost estimates of homicide in Glasgow : a research note

By European standards Scotland is a violent country with a disproportionate number of its homicides occurring in Glasgow. In addition to its devastating health and social impact, homicide imposes a considerable financial burden. The extent of the cost has been based on 2003 estimates for England and Wales. This study aimed to test a method for developing preliminary estimates of the cost of homicide in Glasgow from 2002 to 2009, based on four cost categories: lost output, incarceration cost, investigation cost, and cost of physical and emotional impact. Findings suggested that the previous cost estimate of £1.46 million underestimated the cost of homicide in Glasgow for the same year (2003, £1.52 million) and each subsequent year up to 2009 (£1.55 million-£1.68 million). Appropriate costing information is crucial in informing violence prevention policy, practice, and evaluation. A number of methodological considerations have been identified that will enable more thorough cost estimates in the future.

Qualitative evaluation of the Mentors in Violence Prevention pilot in Scottish high schools

Objective: The Mentors in Violence Prevention (MVP) program originated in the United States and adopts a bystander approach to gender-based violence prevention by harnessing group processes using a peer-learning model. This paper presents the first qualitative evaluation, within a European context, of a pilot application of MVP within a Scottish high school setting. Method: The evaluation comprises a series of interviews and focus groups with school staff, and pupils (‘mentors’ and ‘mentees’) at 3 participating schools. The study’s research purposes are to explore (a) experiences of participating in MVP, (b) participants’ perceived impact of MVP (with regards attitudinal and behavioral change with a particular emphasis on social norms), and (c) participants’ opinions on the relevance and sustainability of MVP. Results: All 3 categories of participant reported generally positive experiences of MVP in terms of recruitment, training, and implementation. The peer-learning model was particularly useful in engaging mentees, and facilitating support networks outside the classroom. Moreover, positive attitudinal and behavioral change regarding gender-based violence was reported by all 3 participant categories, but was particularly prevalent among mentors. However, participants highlighted the importance of ensuring MVP is culturally relevant, and the need for integration into school life to ensure its sustainability. Conclusions: An initial qualitative analysis of MVP within Scottish High Schools suggests the peer-learning program was experienced positively, with self-reported impact on gender-based violence attitudes and behaviors (including bystander intervention). A number of recommendations have been made to inform future implementation of MVP, and the need for robust, ongoing evaluation.

Preliminary research informing policy on remote alcohol monitoring in criminal justice: the Scottish experience

ObjectivesTo explore the views of Scottish offenders on the impact of alcohol on their experience of offending and their lives in general. Furthermore, to explore their views on the concept of remote alcohol monitoring (RAM) as a way to address alcohol misuse upon liberation from prison.MethodsA convenience sample of 12 serving offenders participated in one of three focus groups. Data were analysed using the principles of thematic analysis.ResultsAnalysis of the data revealed the significant impact of alcohol on the lives of the participants. Key themes included the amount and frequency of alcohol consumption; the association of alcohol with harm; the association of alcohol with offending; the previous attempts to reduce alcohol consumption and possible reasons for failure; and the views of participants on the utility of RAM in relation to crime prevention.ConclusionsParticipants had significant issues with alcohol misuse prior to incarceration that had impacted on their offending and resulted in both health and social harms. Participants were generally positive but pragmatic about RAM, recognising that technology alone may not be enough to change deeply ingrained and addictive behaviours.

User-Centred Design as a Risk Management Tool

Numerous risks have been identified to and from the design process. The most prominent approach to address design shortcomings is user-centred design (UCD); however, current implementations of UCD tend to overemphasise differences between users which make it less acceptable as a viable approach to the process of design and the goal of risk management. Three cases are discussed that illustrate a progression of design approaches from a lack of consideration of the user (accommodation; Control room design) to a more limited consideration of user needs through the consultation of guidelines (e-commerce website design) to an attempt to consider user needs through detailed study (assimilation; Consumer product design). It is proposed that the assimilation of user task behaviour in the design life-cycle will ensure the inclusion of usability considerations, thereby enabling UCD to be utilised as a risk management tool.

Brief interventions for reducing violence: a rapid review of evaluations and recommendations

Abstract Background Interpersonal violence among young men is a major public health problem in Scotland, UK. Treatment for violent injury might represent a teachable moment to provide a brief intervention for reducing violence. To inform development of such an intervention, a review was undertaken to examine existing models of brief intervention, and to assess evidence of their effect. Methods We searched three databases (Web of Knowledge, PubMed, and PsycINFO) for articles published in English before March 11, 2013, using the following criteria: violence (Violen* OR Agress* OR Assault* OR Homicide OR Murder OR GBH OR Grievous Bodily Harm OR ABH OR Actual Bodily Harm), intervention (Interven* OR Program* OR Initiative), intervention length (Brief OR Rapid OR Short), and sex of participants (Male* OR man OR boy* OR men). After removal of duplicates, 553 articles were retrieved. Titles and abstracts were independently appraised with prespecified inclusion and exclusion criteria by three authors resulting in 50 full texts. Articles were most commonly excluded for describing interventions that were group-based or part of a long-term programme. Full texts were reviewed by the first author, identifying eight distinct brief interventions for reducing violence. Findings The key findings of the review included: the use of brief motivational interviewing for engaging with at-risk participants; the value of social norms approaches for correcting peer norm misperceptions; the benefit of working with victims of violence in medical settings (particularly oral and maxillofacial surgeries); the importance of addressing alcohol in violent encounters; the advantages of computer-therapist hybrid models of delivery; and the need for adequate follow-up evaluation as part of a randomised controlled trial. Interpretation The review was a valuable exercise in assessing the existence of brief interventions for reducing violence and summarising their key characteristics. It was, however, constrained by the potentially overly restrictive search criteria, which limited the number of included interventions and follow-up data for some interventions, thereby preventing assessment of effectiveness. Nonetheless, brief interventions are potentially useful in the prevention of interpersonal violence among young men. The findings of the review will inform the development of a brief intervention for reducing violence with young men in Scotland who have sustained injuries through interpersonal violence. Funding Violence Reduction Unit (Police Scotland).