institutional alcohol treatment Dotaz Zobrazit nápovědu
OBJECTIVE: Drawing on qualitative analysis of selected historical documents, the paper seeks to provide a definition of the general characteristics of the first institutional alcohol treatment facilities in today's Czech Republic and Slovakia, taking into account the historical context of the first half of the 20th century. An additional aim was to point out the importance of archival research and its contribution to understand the determinants of alcohol-related agenda and alcohol treatment. METHODS: The basic data platform was generated by analysis of historical documents pertaining to the subject matter under study and to institutional processes in different periods. The data was processed using the open coding method (as part of the grounded theory approach) and other specific methods based on the matching of data from scientific and professional literature and archives in different periods. Over 1,100 pages of text from relevant archival materials were analysed. This research is original, no such systematic analysis of historical documents on this subject matter has been conducted on such a scale with the intention of identifying the general correlates of the historical development of an alcohol-related agenda and alcohol treatment. RESULTS: The establishment of the first institutional facilities intended to provide treatment for alcohol dependency was based on the notion of addiction as a disease, which needs to be treated in dedicated facilities applying an individualised approach. The circumstances of the establishment of the facilities under analysis were similar. Their existence was made possible by distinguished personalities rather than a general belief and social pressure that the issue of alcohol addiction should be addressed. This also explains the fact that the occupancy of these facilities never reached their full capacity, that they were not self-reliant in economic terms, and that they did not readily resume their operation after 1945. CONCLUSIONS: The analysis of the establishment, operation, and dissolution of these facilities at the time reveals the discontinuity in the approach to alcohol abuse and its treatment in the context of the historical development and perception of alcohol-related problems in Czech and Slovak society in the first half of the 20th century. Significant social changes occurred after 1948. New legislative instruments were used to enforce treatment based on a principle that was different from the previous approaches. The results of our study also make it possible to reveal the intensity of apparent individual and institutional motives in the process of the development of alcohol treatment in historical terms and its projection into different post-war periods. The understanding of these correlates will help in designing additional trajectories of research into the effects of social and political changes on addiction treatment and thus identifying the intensity of the historical development and its influence on the perception of addiction treatment at present. These findings will also be of great importance for a historical comparative analysis, including overlaps with the development of recent theories, and will support the emergence of new areas of study for the social sciences.
- Klíčová slova
- Czech Republic, Slovak Republic, alcohol, institutional alcohol treatment,
- MeSH
- alkoholismus terapie MeSH
- centra pro terapii drogových závislostí dějiny MeSH
- dějiny 20. století MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- Check Tag
- dějiny 20. století MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
The authors describe the current drug and alcohol scene in Czechoslovakia, with references to historical developments. Drug abuse is divided into nine groups: from drugs most frequently abused (opiates and speed) to illegally cultivated hemp (hashish and marijuana). In 1985 there were 9,900 registered drug addicts and 720 are added to this number annually. There are approximately 15 nonregistered drug addicts for every registered one. In the consumption of alcoholic beverages, Czechoslovakia holds 13th place in the world (average annual per capita consumption is in the vicinity of 9.5 litres of 100% alcohol). In 1985 there were 239,385 registered alcoholics (of this number, 18,746 were women). In conclusion the authors describe the Czechoslovak system of treatment of addictions: detoxification departments, outpatient treatment, and institutional care, as well as treatment for prisoners and forced treatment. They also mention the effectiveness of these treatment programs.
- MeSH
- alkoholismus epidemiologie rehabilitace MeSH
- incidence MeSH
- lidé MeSH
- poruchy spojené s užíváním psychoaktivních látek epidemiologie rehabilitace MeSH
- průřezové studie MeSH
- psychotropní léky * MeSH
- srovnání kultur * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- srovnávací studie MeSH
- Geografické názvy
- Československo epidemiologie MeSH
- Názvy látek
- psychotropní léky * MeSH
INTRODUCTION: Alcohol consumption is the seventh leading risk factor for disability-adjusted life years in the world, according to the Global Burden of Disease Study 2017. As the largest developing country, China has a substantial population of alcohol consumers who suffer from related health risks. Despite having made significant advancements in eradicating absolute poverty, many people still live in relative poverty, which suggests that the adverse health effects caused by alcohol consumption among vulnerable populations in China warrant more attention. This paper aims to provide an overview of alcohol consumption among ethnic populations in China and test the feasibility and efficacy of a brief advice intervention with a small financial incentive in reducing harmful drinking behaviours. METHODS: This study is a three-arm, single-blinded, pragmatic, individually randomised controlled trial with follow-ups at 1,2 and 3 months after randomisation. A total of 440 daily drinkers living in Xichang will be recruited and divided into three groups: brief intervention group, financial incentive group and control group. All participants will receive a urine ethyl glucuronide (EtG) test, which detects alcohol consumption in the past 80 hours. Additionally, participants in the brief intervention group will receive three free counselling sessions alongside multimedia messages on the topic of alcohol consumption after each session. The participants in the financial incentive group will receive the same interventions as well as cash incentives according to the results of the EtG test. The primary outcomes are the self-reported drinking quantity, binge drinking frequency, drinking intensity and the proportion of participants who pass the EtG test. ETHICS AND DISSEMINATION: This protocol was approved by the Peking University Health Science Center Institutional Review Board (IRB00001052-20049). Findings will be published in peer-reviewed journals and presented at local, national and international conferences to publicise and explain the research to key audiences. TRIAL REGISTRATION NUMBER: NCT04999371.
- Klíčová slova
- alcohol disorder, health economic, rural China,
- MeSH
- alkoholismus * MeSH
- krizová intervence * MeSH
- lidé MeSH
- motivace MeSH
- pití alkoholu epidemiologie prevence a kontrola MeSH
- poradenství MeSH
- randomizované kontrolované studie jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- protokol klinické studie MeSH
OBJECTIVES: This article deals with the comparison of excise tax revenues from alcoholic beverages and tobacco products with public spending that are spent on treating diseases occurring in consumers of these commodities. METHODS: Based on available data, the study estimates direct public expenditures on the treatment of tobacco-related diseases and very frequent alcohol consumption-related diseases in the Czech Republic. These partial results are evaluated in the context of tax revenues from consumption of the mentioned commodities. The analysis works with the data from 1998-2017, which was obtained from the Ministry of Health of the Czech Republic, the National Institute of Public Health, the Customs Administration of the Czech Republic, the Ministry of Finance of the Czech Republic, and the Czech Statistical Office. RESULTS: Medical treatment costs of smoking-related diseases were 18.35-48.19 billion CZK per year in the analysed period. These expenditures in the period 1998-2011 exceeded the annual revenues from the tax on tobacco products (in 2002 by 12.08 billion CZK). Since 2012, the balance has been positive in favour of public spending. Expenditures on the treatment of alcohol-related diseases amounted to 9.66-25.36 billion CZK per year in the given period, the expenditures, except the year 1998, exceeded the revenues from alcoholic beverages taxes (by 14.63 billion CZK in 2009). CONCLUSIONS: The study shows that the excise tax revenues for tobacco products do not reach the level of healthcare spending for tobacco-related disease in the most of the analysed period, and this difference increases with the length of consumption, which can be interpreted in such a way that current excise tax revenues potentially mean public healthcare expenditures, which cumulatively exceed revenues from the relevant excise duties.
- Klíčová slova
- alcohol, excise taxes, health financing, tax revenue, tobacco,
- MeSH
- daně MeSH
- lidé MeSH
- prevence kouření MeSH
- tabákové výrobky * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- alkoholismus komplikace farmakoterapie terapie MeSH
- disulfiram terapeutické užití MeSH
- ezofageální a žaludeční varixy komplikace MeSH
- fyzioterapie (techniky) MeSH
- lidé MeSH
- nemocnice speciální * MeSH
- peptický vřed komplikace MeSH
- tělesná námaha MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
- Názvy látek
- disulfiram MeSH
Building upon the tradition of the oldest specialized programs, the "Apolinar model" of alcohol treatment influenced the emergence and development of residential treatment programs in what is now the Czech Republic and Slovakia. Similarly to the socialist concept of unitary economy, this approach was applied in all emerging treatment programs until the Velvet Revolution. To identify and describe the key factors determining the origin and development of residential alcohol treatment and what became known as the Apolinar model in the context of the development of the addiction-specific institutional infrastructure. Qualitative content analysis of retrieved historical documents was used to identify and establish the sources and data. The relevant documents were identified and compiled according to their thematic relationship with the focus of the research in terms of their place and time of origin and authorship. The Apolinar model represented a compact and unique treatment approach. This was owed to both foreign and local experience, ideas and inspiration, which the program drew on. The key figure behind the Apolinar model was Jaroslav Skála. In addition to achieving the maximum that was possible at the time and creating a homogeneous, original, and successful residential alcohol treatment model, Skála succeeded in establishing valuable international links and kept his facility and the emerging Czechoslovak addiction professional community in contact with the latest international trends and leading institutions.
- Klíčová slova
- Apolinar, Apolinar treatment model, Arnoštka Maťová, Jaroslav Skála, Psychiatric clinic,
- MeSH
- lidé MeSH
- ústavní terapie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Evropa MeSH
- Slovenská republika MeSH
Based on the examination of 238 patients having institutional sexuological treatment, the author assessed the basic differences between homosexual sexual delinquents, sexual aggressors, polymorphic sexual delinquents, paedophiliacs and exhibitionists as regards the number of sentences on account of sexual delicts in the case-history, the presence of alcohol during the sexual delict, antialcoholic treatment in the past, the number of sexuological treatments received, age when the first sexual abnormal manifestations occurred, the age when first prosecuted on account of sexual delinquency and the diagnosis of the deviation.
- MeSH
- alkoholismus komplikace MeSH
- dospělí MeSH
- homosexualita MeSH
- lidé MeSH
- parafilie komplikace terapie MeSH
- recidiva MeSH
- sexuální delikty * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
Alcohol, other addictive substances and gambling are economically clearly disadvantageous. The financial losses caused by addictive problems should be more compensated by taxation. There are also compelling health reasons for higher taxation. Uncontrolled and accessible financial resources and also poverty represent the risk factors especially for adolescents. Poverty also limits the affordability of psychotherapeutic and medical services for the large segments of population. Material and financial aspects often motivate people to seek treatment for their addictive problems. We also mention the fact that the treatment and especially prevention are economically profitable for individuals, families and societies.
- MeSH
- daně MeSH
- kouření ekonomika MeSH
- lidé MeSH
- návykové chování ekonomika MeSH
- osobní újma zaviněná nemocí MeSH
- pití alkoholu ekonomika prevence a kontrola MeSH
- prevence kouření MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
UNLABELLED: This analysis is focused on use of addictive substances among women hospitalised during delivery or puerperium. Analysed data come from National Registry of Mothers at Childbirth and from National Registry of Newborns, which are managed by the Institute of Health Information and Statistics. GOAL: To describe the prevalence of addictive substances use among women during gestation and to study its relation to health complications during pregnancy, delivery or puerperium and to health status of foetus and newborns. METHODS AND MATERIALS: The reporting to registries is provided in the Report on mother at childbirth and in the Report on newborn. Both registers provide basic socio-demographic information about mother, information about previous pregnancies and abortions, about current pregnancy, course of delivery, birth and neonatal treatment and health of newborn during hospitalization of mother during delivery or puerperium. Use of addictive substances is monitored in the National Registry of Mothers at Childbirth since 2000. Addictive substances are divided to tobacco, alcohol and drugs. Descriptive analysis of data was performed and binary logistic regression was used to test association of substance use with education and marital status (adjusted for age), analysis of variance was used to test association of substance use with selected health complications of pregnancy, delivery or puerperium and with health status of foetus/newborns (adjusted for age, education, marital status and interaction between addictive substances). RESULTS: In 2000-2009, 1,008,821 mothers were reported of whom 60,502 women were registered as cigarette smokers, 1,528 used alcohol and 1,836 used other (illegal) drugs. Total of 1,027,200 newborns were reported. The average age of mothers using addictive substances were about 0.5-3 years lower in comparison with nonusers, in average mothers using illegal drugs were the youngest. Mothers using addictive substances were more often unmarried and had lower education than nonusers - almost 2/3 of mothers using addictive substances were unmarried or didn't live in permanent partnership and more than 82% of mothers-users have lower education (primary or secondary school without a diploma). The association between substance use and induced and spontaneous abortions was observed only in smokers. Serious complications of pregnancy were associated with all monitored addictive substances - in mothers-smokers, a probability of serious complications were about 40 %, in users of illicit drugs about 13 % and in alcohol users about 5 % higher as compared to nonusers. Substance use showed almost no association with problems during childbirth. Alcohol and illegal drugs use increased probability of complications in puerperium. Health status of foetus/newborn was negatively significantly altered mainly in those born to mothers-smokers in almost all observed characteristics. Mothers alcohol use during pregnancy was associated primarily with the overall health status of foetus immediately after delivery, congenital anomalies, stillbirth or need for treatment of newborn in the theatre. Infants of mothers using addictive substances had higher probability of consequent hospitalization after discharge from the neonatal department, transfer to infant home and death of infant. CONCLUSION: Association between complications during pregnancy, delivery and puerperium and health status of newborns and substance use of mothers during pregnancy was found mainly in cigarette smoking. Alcohol use was found significant in some (but serious) health problems of mothers and newborns. The association between illegal drugs and monitored indicators wasn't found. Following the results of this work, criteria for reporting of illegal drug use in mothers during pregnancy should be improved.
- MeSH
- dospělí MeSH
- komplikace těhotenství epidemiologie etiologie MeSH
- kouření škodlivé účinky epidemiologie MeSH
- lidé MeSH
- narození mrtvého plodu epidemiologie MeSH
- nemoci novorozenců epidemiologie etiologie MeSH
- novorozenec MeSH
- pití alkoholu škodlivé účinky epidemiologie MeSH
- poruchy spojené s užíváním psychoaktivních látek komplikace epidemiologie MeSH
- poruchy v puerperiu epidemiologie etiologie MeSH
- těhotenství MeSH
- vrozené vady epidemiologie etiologie MeSH
- zpožděný efekt prenatální expozice MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
UNLABELLED: Similarly to the prevalence of disorders related to the use of addictive substance, the system of medical care for patients with addictive disorders, including the residential treatment, has changed dramatically in the Czech Republic in the last 50 years. GOAL: To perform descriptive analysis of historical data gathered, analysed and published by the Institute for Health Information and Statistics since 1959 on the inpatient psychiatric facilities, and numbers and characteristics of patients hospitalised due to addictive disorders in 1959-2008. RESULTS: The number of episodes of hospitalisation due to alcohol-related conditions was increasing throughout the whole monitored period since the end of the 1950s. After a short decrease at the turn of the 1980s and 1990s, the alcohol-related hospitalisations increased again to the historical peak of 11,691 episodes in 2005. As compared to alcohol-related admissions, the number of hospitalisations due to other (non-alcoholic) addictive disorders was 5-10 times lower until 1993 (60-1,000 episodes annually); however, a sharp increase was observed since 1994, to 5,264 episodes in 2008. The proportion of males among hospitalised alcohol users is currently about 70% in comparison with approximately 95 % at the very beginning of the study period, with most hospitalised persons being aged 40-49 years. Users of sedatives and hypnotics are more often females (approximately 65%), with the highest proportion of them being also aged 40-49 years. From 70 to 90% of hospitalised users of other addictive substances, i. e. illicit drugs and volatile substances, the percentage varying with the substance, are males and the highest proportion of cases is reported in the age group 20-29 years. In the last 15 years, the highest relative rates of hospitalisations for alcohol-related conditions were recorded in the Zlin, Olomouc and Moravian-Silesian Regions and for non-alcohol substance abuse in Prague and the Ustí Region. The inpatient psychiatric bed capacity considerably decreased after 1989, which contrasts with the increasing number of alcohol-related and particularly non-alcohol substance-related hospitalisations since the 1990s. CONCLUSION: The data on hospitalised users of addictive substances are a valuable contribution to the body of information about drug use and its consequences in the Czech Republic and are complementary to the description of the epidemiological situation and trends seen in other data sources. They are of crucial relevance to the study of alcohol abuse due to the scarcity of other data sources in the Czech Republic.
- MeSH
- alkoholismus rehabilitace MeSH
- dospělí MeSH
- hospitalizace statistika a číselné údaje trendy MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- poruchy spojené s užíváním psychoaktivních látek rehabilitace MeSH
- ústavy pro duševně nemocné MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH