Lucy Webb

Review of deaths related to taking ecstasy, England and Wales, 1997-2000

The lack of data about the lethal consequences of taking ecstasy has led to high profile reports of deaths in the media and also the idea that ecstasy is safe. The United Kingdom accounts for most of the ecstasy tablets—normally containing methylenedioxymethamphetamine (MDMA) or 3,4-methylenedioxyamphetamine (MDA)—seized in the European Union.1 The rate of deaths related to taking ecstasy in people aged 15–24 during 1995 and 1996 in England was 18 and between 1995 and 1997 in Scotland was 11.2 The risk of using ecstasy varies between one death in 2000 first time users to one death in 50 000 first time users.2 The National Programme on Substance Abuse Deaths was established after the …

Counting girls out: A review of suicide among young substance misusers and gender difference implications in the evaluation of risk

This literature review examines the evidence of suicide risk among young female substance misusers in comparison with their male counterparts, and considers arguments that suicide risk is underestimated for this group due to the methodological difficulties presented by small cohort numbers. Existing evidence indicates significant gender differences in comorbidities associated with young suicidal substance misusers, with a greater prevalence of depressive symptoms and psychological distress among female substance misusers. Suicide trajectories suggest that young female substance misusers are likely to present more often, and to a more marked degree, with comorbid disorders that would increase assessed suicide risk among a general youth population. An examination of methodological problems indicates that female gender may be overestimated as a protective factor for suicide among young substance misusers in the context of other factors associated with young female substance misuse. It is proposed that it is no longer good enough to accept female gender as a protective factor without a female-specific evidence base.

The utility and impact of information communication technology (ICT) for pre-registration nurse education: A narrative synthesis systematic review

OBJECTIVES To evaluate and summarise the utility and impact of information communication technology (ICT) in enhancing student performance and the learning environment in pre-registration nursing. DESIGN A systematic review of empirical research across a range of themes in ICT health-related education. DATA SOURCES Science Direct, Cinahl, AMED, MEDLINE, PubMed, ASSIA, OVID and OVID SP (2008-2014). Further date parameters were imposed by theme. REVIEW METHODS Evidence was reviewed by narrative synthesis, adopting Caldwells appraisal framework and CASP for qualitative methods. Selection and inclusion was grounded in the PICOS structure, with language requirements (English), and further parameters were guided by theme appropriateness. RESULTS Fifty studies were selected for review across six domains: reusable learning objects, media, audience response systems, e-portfolios, computer-based assessment and faculty adoption of e-learning. Educational ICT was found to be non-inferior to traditional teaching, while offering benefits to teaching and learning efficiency. Where support is in place, ICT improves the learning environment for staff and students, but human and environmental barriers need to be addressed. CONCLUSION This review illuminates more advantages for ICT in nurse training than previously. The key advantage of flexibility is supported, though with little evidence for effect on depth of learning.

The Recovery Model and Complex Health Needs: What Health Psychology can Learn from Mental Health and Substance Misuse Service Provision

This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

Care pathways to in‐patient alcohol detoxification and their effects on predictors of treatment completion

Aims: This study aimed to (i) test the hypothesis that stable housing, older age, gate‐kept admission route and female gender are predictive of completion of in‐patient detoxification treatment, and (ii) compare two care pathways into treatment. Methods: Multiple logistic regression of 6,745 cases of admission to an independent sector in‐patient detoxification service between January 1995 and March 2003. Findings: Factors predictive of treatment completion were found to be older age, female gender, employment and undergoing a process of gate‐keeping for admission. A comparison of treatment completers between gate‐kept and non‐gate‐kept admissions indicated that while gate‐keeping is sensitive to potential completers by favouring people with stable housing it may also be excluding a proportion of clients among younger males with unstable housing who would otherwise benefit from admission. Conclusions: In developing care pathways that ensure effective and appropriate use of services careful consideration must be given to the impacts upon some client groups who may be disadvantaged by the process.

Tools for the job: Why relying on risk assessment tools is still a risky business

This theoretical review paper examines the applicability of assessment tools, guidelines and protocols in mental health and substance use care on the basis of the construction of such tools and their reliance on aggregate and actuarial methodologies. Evidence-based practice leads clinicians to increasing reliance on tools for assessment of health status, risk and prediction for a range of clinical needs for individual clients. In the longer-term management of people with enduring and chronic mental health and substance misuse problems, clinicians are often dealing with complex and unstable health needs. The tools available, however, are developed on the basis of majority population evidence and on presumptions of similarity and stability over time. This paper provides explanation of the basis for the development of such tools and argues that clinicians need to be able to evaluate the applicability of tools used for their clients and not just evaluate the internal validity of the tools used to make individual and contextual decisions about individual clients.

Personal resilience and identity capital among young people leaving care: enhancing identity formation and life chances through involvement in volunteering and social action

ABSTRACT This study explored identity capital and personal resilience among care leavers and young people in care engaging in social activities through volunteering. Care leavers and young people in care are disadvantaged developmentally by lack of identity resources and an accelerated transition to independence. This study analysed material from semi-structured interviews to explore the Identity Capital Model and theories of individualisation, agentic identity development and resilience in explaining the identity resources of young people transitioning out of care. The analysis identified links between the exploration opportunities of volunteering with the development of agentic individualisation and enhanced identity capital. The findings indicate that developmental processes may be enhanced through supported and personalised volunteering opportunities to aid vulnerable young people transitioning out of care. Young people leaving care can make substantial gains particularly in social capital, personal resilience and identity capital. This study indicates that volunteering opportunities for this group of vulnerable young people may assist in compensating for the lack of resources often experienced by care leavers when transitioning to adulthood.

A safe place to reflect on the meaning of recovery: a recovery community co-productive approach using multimedia interviewing technology

Purpose – The purpose of this paper is to develop further the understanding of co-productive methodological practice for substance use research by demonstrating the use of a mobile, multimedia interviewing aid by members of a UK recovery community. Design/methodology/approach – A co-productive approach to data collection was piloted using a bespoke, audio-visual booth located in a range of recovery and community-focused social events. Audio-visual data were collaboratively selected, curated and analysed by recovery community partners and researchers. Findings – Findings illustrate how a mobile audio-visual booth can be used successfully within co-productive research. This approach facilitated a better understanding of the experiences and practices of self-reflection within the recovery community as they worked together to create a meaningful recovery largely independent of conventional recovery services. Research limitations/implications – This research was performed with one cohort of co-production membe...

Hitting the Target and Missing the Point Is the United Nations Playing Games with the World's most Vulnerable?

This article examines the policy of using target-setting and measurement to deliver on the United Nations’ (UN) development goals. Using evidence from similar monitoring and management strategies in the United Kingdom (UK), we question the purpose of using process and outcome targets and suggest that this approach can be counter-productive. It can also lead to a situation where maintaining public relations and image is prioritised at the expense of making real impacts on key development issues. While the UNs aims are praiseworthy, we suggest that the somewhat simplistic methodology adopted is damaging to the very people that the UN is seeking to help.

Exploring the characteristics of effective communicators in healthcare

Nurses require effective communication and interpersonal skills to provide optimal care, and to ensure that patients and their families and carers have a positive experience of receiving care. The new Nursing and Midwifery Council standards of proficiency for registered nurses, and for nurse education and training, published in May 2018, recognise that future nurses will be practising in increasingly complex roles and environments. This article identifies the essential communication skills that will be required by nurses in the future, summarising the characteristics of a modern nurse communicator. It also suggests various approaches that nurses can use to develop their communication skills.