Alcohol Issues Research Articles

Can Doctors Be Divided Into Groups Based on Their Attitudes to Addressing Alcohol Issues in Their Patients? Analyses From a Survey of Portuguese General Practitioners

ABSTRACTBackground: The effectiveness of interventions to increase general practitioners' management of alcohol problems is affected by their attitudes toward at-risk drinkers. Tailoring training programs to general practitioners' attitudes may be useful in increasing alcohol screening and brief advice. Objectives: to determine whether general practitioners could be divided into distinct groups based on their attitudes toward at-risk drinkers. Another aim of this study was to develop and validate a model for classifying general practitioners into distinct groups. Methods: A total of 234 general practitioners answered the questionnaire. Physicians' attitudes toward patients with hazardous or harmful alcohol use were measured with the Short Alcohol and Alcohol Problems Perception Questionnaire. Cluster analysis was performed to identify distinct general practitioner groups based on their attitudes toward at-risk drinkers. Logistic regression analysis was used to develop a model for predicting group membership. Results: Cluster analysis identified two distinct groups of general practitioners, one with more positive attitudes (adequacy = 10.8 ± 1.6, legitimacy = 11.8 ± 1.7, motivation = 9.8 ± 1.7, satisfaction = 8.1 ± 1.9, and self-esteem = 9.7 ± 2.1), the other with more negative attitudes (adequacy = 8.9 ± 1.8, legitimacy = 11.0 ± 1.8, motivation = 7.8 ± 1.6, satisfaction = 5.7 ± 2.0, and self-esteem = 6.8 ± 1.7). The predictors in the final model were self-esteem, motivation, and adequacy. The model predicted general practitioner groups on the training set with 90.4% accuracy (area under receiver operating characteristic [ROC] curve = 0.96), and maintained its predictive performance when applied to the test set (accuracy 93.6%, area under ROC curve = 0.97). Conclusions: General practitioners could be divided into distinct groups based on their attitudes toward at-risk drinkers. These findings may prove useful in designing alcohol-specific training programs for general practitioners.

Reply to ''Alcohol and Liver Transplantation''.

We thank Drs Testino and Leone for their interest in our manuscript publication entitled ‘Alcohol use after liver transplantation is independent of liver disease etiology’ in the recent issue of Alcohol and Alcoholism (Russ et al ., 2016). We read with interest the letter and agree on their comment regarding concern for higher risk for development of non-alcoholic fatty liver disease and malignancy …

A school-based health promotion programme to increase help-seeking for substance use and mental health problems: study protocol for a randomised controlled trial.

BackgroundAdolescence is a high-risk time for the development of mental health and substance use problems. However, fewer than one in four 16–24 year-olds with a current disorder access health services, with those experiencing a substance use disorder being the least likely to seek professional help. Research indicates that young people are keeping their problems to themselves or alternatively, turning to peers or trusted adults in their lives for help. These help-seeking preferences highlight the need to build the mental health literacy of adolescents, to ensure that they know when and how to assist themselves and their peers to access support. The MAKINGtheLINK intervention aims to introduce these skills to adolescents within a classroom environment.Methods/designThis is a cluster randomised controlled trial (RCT) with schools as clusters and individual students as participants from 22 secondary schools in Victoria, Australia. Schools will be randomly assigned to either the MAKINGtheLINK intervention group or the waitlist control group. All students will complete a self-report questionnaire at baseline, immediately post intervention and 6 and 12 months post baseline. The primary outcome to be assessed is increased help-seeking behaviour (from both formal and informal sources) for alcohol and mental health issues, measured at 12 months post baseline.DiscussionThe findings from this research will provide evidence on the effectiveness of the MAKINGtheLINK intervention for teaching school students how to overcome prominent barriers associated with seeking help, as well as how to effectively support their peers. If deemed effective, the MAKINGtheLINK programme will be the first evidence-informed resource that is able to address critical gaps in the knowledge and behaviour of adolescents in relation to help-seeking. It could, therefore, be a valuable resource that could be readily implemented by classroom teachers.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12613000235707. Registered on 27 February 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1510-2) contains supplementary material, which is available to authorized users.

The impact of alcohol care teams on emergency secondary care use following a diagnosis of alcoholic liver disease - a national cohort study

BackgroundThe increasing mortality rates from alcohol-related liver disease (ARLD) are a public health concern. To address this, alcohol care teams (ACT) case-find and lead management of alcohol issues for these patients. Local assessments of ACTs have shown reductions in emergency admissions and emergency department attendances. We examine the impact of ACTs on emergency hospital activity following a diagnosis of ARLD.MethodsAdministrative Hospital Episode Statistics (HES) data were extracted. Information on ACT provision at English NHS hospital trusts and sites in 2009/10 was taken from a survey by Public Health England. We undertook a difference-in-difference analysis to compare emergency hospital activity for a cohort of individuals diagnosed with ARLD who presented to hospitals either with or without an ACT in the one year before and after a first ARLD diagnosis during 2009/10.ResultsOver the study period, 9,165 individuals eligible for inclusion in our study had a first diagnosis of ARLD. 4,768 presented to one of 41 hospital trusts with an ACT (59 sites) and 4,397 presented to one of 50 non-ACT hospital trusts (65 sites). Whilst age and sex demographics were similar between the two cohorts, the ACT hospital cohort had a higher proportion of individuals in the most deprived quintile (41.6 % v 28.5 % p < .0001). In the difference-in-difference analysis, the presence of an ACT at a hospital trust was not associated with a change in all-cause emergency admissions (0.020 (95 % CI −0.070, 0.111), p = 0.656), alcohol-related emergency admissions (−0.025 (95 % CI −0.104, 0.054), p = 0.536) or all-cause emergency department attendances (0.042 (95 % CI −0.087, 0.171), p = 0.521). Sensitivity analyses by sex and hospital site did not affect the study findings.ConclusionsIn this study, the presence of an ACT at the NHS hospital trust where individuals have their first recorded diagnosis of ARLD does not appear to be associated with subsequent emergency hospital activity within these populations. Further analysis focussing on the components and specific effects of ACT interventions on individuals and systems both pre- and post-diagnosis of ARLD may reveal important avenues to improve care.

Drink wisely Australians, but keep drinking: does the alcohol industry in Australia frame the discourse on alcohol to maintain hegemony?

Public health literature proposes that the Australian alcohol industry–funded organisation DrinkWise is a Social Aspects Public Relations Organisation (SAPRO) that favours industry over public interests by deploying ineffective alcohol harm reduction strategies. This research addresses a gap in the critical public relations literature by investigating these claims through an examination of DrinkWise’s source media content. Content and rhetorical framing analysis revealed how the organisation framed the alcohol issue, as well as identifying the messages and message audiences of their media releases. Results supported extant research suggesting that DrinkWise is insulating the alcohol industry against evidence-based public health harm reduction strategies, by engaging in agenda building through industry-friendly framing of the alcohol issue, and dissemination of information subsidies to elites and policy-makers. We discuss the conclusions through a lens of hegemony and develop an argument that DrinkWise media relations is a strategy to maintain a hegemonic individual responsibility ideology.

Global outreach and user preferences of a smartphone application developed for drinkers.

Alcohol use disorders has been known and recently highlighted by the World Health Organization as a major worldwide problem. Harmful usage of alcohol has been linked to increased morbidity and mortality arising from common alcohol related disorders, such as liver disease, hypertension and violent deaths. Looking at the current literature, there have been previous peer reviewed publications about how technology has helped alcohol users. Of significance, a previous content analysis showed that the vast majority of the applications catered for alcohol use disorder which are currently available on the stores are not only not supported by evidence-base, but some of them seemed to be promoting drinking instead. Zhang et al. have described how they have attempted to overcome the limitations of current alcohol applications in their video feature recently published. The objective of this article is to evaluate (a) the receptiveness of the general population toward an alcohol tracker application and to determine (b) user preferences with regards to the different features present in an alcohol tracker. Android Java Developmental kit (ADK) was utilized to program the core functions of the applications. The entire developmental process took approximately 6 weeks to complete and the android version of the application was launched and offered for free download on the android play store since the 4th of February 2015. The utilization of the application was then monitored and recorded using Google analytics. User perspectives with regards to the individual features of the application were collated via an application feedback survey embedded within the application. Based on the analytics, a total of 339 users have had access to the application. A cumulative total of 2029 downloads of the application have been made to date. Most of the participants are male (66%) and are of the age group of 30-39 years old (34%). The vast majority of the participants (94%) do not have any prior treatment for alcohol. Interestingly, the vast majority of the users have indicated that they have a drink 4 or more times a week (61%) and tend to drink between 3 to 4 drinks on a typical day they are out drinking. the vast majority reported that they were slightly and moderately comfortable with managing their alcohol use problem (25%). After the usage of the application, 27% of the individuals were moderately comfortable with managing their alcohol use problems and 20% of individuals were extremely comfortable with managing their alcohol use problems. In conclusion, this is perhaps one of the first few studies to demonstrate the receptiveness of an alcohol tracker that has included other behavioral change methods within as well as a variant of the conventional methodology of tracking alcohol consumption. The current study shows the receptiveness of global users as well as how such an intervention could help them gain more control about managing their underlying alcohol issue.

The Occupational Role of the Lay Health Trainer in England: A Review of Practice

Health Trainers constitute an emergent occupational group in the Public Health system in England with the key purpose to reduce health inequalities by helping or ‘nudging’ people in local communities to adopt healthier lifestyles. Whilst primarily supplying health-related information and support regarding smoking cessation, diet, alcohol, physical activity and mental wellbeing issues, the role also requires awareness of, and sensitivity toward the specific needs of local communities. This literature review charts current research on the occupational context of the Health Trainer role since its implementation in the English Public Health system. It provides a critical examination of current literature whilst highlighting the theoretical basis of Health Trainers’ roles, the potential boundary-crossing nature of their work, along with professional development issues.

Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study

Opioid-dependent patients show a high rate of psychiatric comorbidities. The prevalence and characteristics of patients with dual diagnosis have not been well established in Spanish opioid agonist treatment (OAT) programmes. Thus, 621 opioid-dependent patients enrolled in OAT programmes were assessed, using the EuropASI questionnaire, for psychiatric comorbidities, which were detected in 67% of patients (anxiety 53%, mood disorders 48%, sleep disorders 41%, substance-related disorders 36%). In addition, compared with patients without a dual diagnosis, patients with dual pathology were significantly older, used benzodiazepines and cannabis in significantly greater percentages, and showed significantly more frequent infectious and non-infectious comorbidities, worse overall working status, a lower proportion of drivers and higher levels of severity regarding medical, employment, alcohol, legal, family and psychological issues. Therefore, the data showed a very high prevalence of psychiatric comorbidity in opioid-dependent patients receiving OAT in Spain and several problems frequently associated with patients with dual diagnosis. Physicians treating opioid-dependent patients should be aware of these facts to correctly identify and manage patients with a dual diagnosis.

Duszpasterstwo parafialne wobec Dorosłych Dzieci Alkoholików

Being raised in a family with an alcohol issue becomes a source of difficult, even traumatic experiences and frustration of children’s needs, which has an effect on their lives as adults. A distorted picture of reality experienced by Adult Children of Alcoholics can also manifest itself in a distorted way of experiencing faith and spiritual life. People who face such difficulties and issues need pastoral help, and effective action needs to be taken in parishes as part of ordinary pastoral activities.

Troubled families and individualised solutions: an institutional discourse analysis of alcohol and drug treatment practices involving affected others.

Research shows that members of the families with patients suffering from alcohol and other drug-related issues (AOD) experience stress and strain. An important question is, what options do AOD treatment have for them when it comes to support? To answer this, we interviewed directors and clinicians from three AOD treatment institutions in Norway. The study revealed that family-oriented practices are gaining ground as a 'going concern'. However, the relative position of family-orientation in the services, is constrained and shaped by three other going concerns related to: (i) discourse on health and illness, emphasising that addiction is an individual medical and psychological phenomenon, rather than a relational one; (ii) discourse on rights and involvement, emphasising the autonomy of the individual patient and their right to define the format of their own treatment; and (iii) discourse on management, emphasising the relationship between cost and benefit, where family-oriented practices are defined as not being cost-effective. All three discourses are connected to underpin the weight placed on individualised practices. Thus, the findings point to a paradox: there is a growing focus on the needs of children and affected family members, while the possibility of performing integrated work on families is limited.

Examining the pathways for young people with drug and alcohol dependence: a mixed-method design to examine the role of a treatment programme

IntroductionYoung people with drug and alcohol problems are likely to have poorer health and other psychosocial outcomes than other young people. Residential treatment programmes have been shown to lead to...

Regulation of Alcohol Outlets: Experiences of the First and Second Republic of Lithuania

In 1928-1931, annual consumption of legal pure alcohol per capita was just 1.17 litres, while in 2014 the alcohol consumption per capita was 12.7 litres. The alcohol outlet density is one of the most significant factors for the indicators of alcohol consumption. The aim of this paper is to compare the characteristics of the regulation of retail alcohol outlets in the First (1918-1940) and Second (1990-2015) Republic of Lithuania. The goals are the following: to evaluate the aspects of alcohol outlet density, expiration dates and issue conditions of seller licences, and the maintenance of public order of seller licence usage as well as assurance of safety in the neighbourhoods, and to determine the period of Seimas (governing parties) ruling during which fundamental changes occurred in the liberalization or prohibition with regards to regulation of alcohol outlets. The paper is based on the method of document analysis. It was determined that the regulation of alcohol outlets was much stricter in the period of the First Republic of Lithuania than in the period of the Second Republic. In the First Republic of Lithuania, the regulation of the density of alcohol outlets was connected to the assurance of public safety and prevention of noise, the community was involved in the regulation of the density of alcohol outlets, the density of alcohol outlets was regulated, the prohibited distances were defined between alcohol outlets and places of worship, cemeteries, healthcare and education establishments or other institutions significant to the public, the issued licences were short-term, for the period of one year. Even though in the period of the ruling of Antanas Smetona in 1934 the alcohol outlet regulation was liberalized, eliminating the influence of residents and municipalities on the issuing of licences, alcohol outlet regulation still remained stricter than in the period of the Second Republic of Lithuania. In 2002, the social-democratic coalition, which had the majority in the government, strongly liberalized the alcohol outlet regulation: it abolished any regulation of alcohol outlet density, eliminated short-term licences and authorised alcohol sales in sanatoriums, kiosks and petrol stations. Only the political group of Homeland Union-Lithuanian Christian democrats, which had the majority in the Seimas of 2008-2012, managed to prohibit sales in kiosks and petrol stations, but the density remained unregulated, the licences were still short-term, the licencing was unconnected to public safety and assurance of public order, and the community’s influence was restricted only to expression of opinion on the issuing of new alcohol seller licences in the blocks of flats they reside in. It is recommended to connect alcohol outlet regulation with public safety and assurance of public order, to regulate outlet density, to issue short-term licences, and to empower the residents to participate in the alcohol outlet regulation.DOI: http://dx.doi.org/10.5755/j01.ppaa.15.1.14691

‘I'm there to play music not break up fights': gigging entertainers’ experiences of alcohol-related misbehaviour by audiences and its impact on performance

AbstractDespite the fact that drinking and music often share a space, the relationship between alcohol-related misbehaviour and live music has received little academic attention. Music has been demonstrated to influence drinking behaviour and entertainers have been observed influencing (‘soft-policing’) drunken misbehaviour by audiences. However, to date research has not given voice to those providing this musical entertainment. Are they aware of the effects they have on audiences' drinking behaviour and does this impact on performances? Our qualitative research fills this lacuna by drawing on the experiences of gigging entertainers to explore how they deal with intoxicated audiences. Interviews conducted as part of this research highlighted a lack of preparation on the part of performers for dealing with disorderly crowds and/or the unwanted attentions of drunken individuals; they usually have to learn appropriate responses ‘on the job’. Success as a gigging entertainer was felt to be only partly founded upon artistic merit, with an ability to engage the (often inebriated) public being equally important. Although none had received formal training in alcohol issues as musicians, some utilised people skills (e.g. conflict resolution techniques) acquired via other employment. The authors ask if there is a place for training in alcohol-related issues to be offered by or integrated into music curriculums.

Alcohol issues prior to training in the United States Air Force

The negative impact of alcohol is a significant concern to the US military given the costs associated with alcohol-related offenses. Despite considerable research in active duty personnel, relatively little is known about the current extent of alcohol use among incoming recruits. We examined the history of alcohol use and harmful patterns of alcohol consumption among recruits entering the United States Air Force (USAF; N=50,549) over the span of 4years (2010–2014). Across all years, drinking rates reflected national average trends for those aged 18–24 (NIDA, 2014). However, when abstainers were excluded, those under 21 (n=10,568) reported an average of 18.4 drinks per week, whereas those age 21 and over (n=14,188) reported an average of 14.1 drinks per week, suggesting that for those who drink, those under 21 are exhibiting more risky drinking rates. Alcohol Use Disorders Identification Task (AUDIT) scores for drinkers reflected these same trends. For those under 21, 58% scored in risk categories of 2 or higher (risky drinking warranting attention), compared with 40% for those age 21 and over. These scores indicate that for recruits in the USAF, approximately half report alcohol use immediately prior to basic training, resulting in the inheritance of these potential alcohol related issues for those conducting training of these recruits. Based upon these numbers, brief alcohol interventions could have a potential positive impact on individuals in their initial training stages of the USAF to prevent these baseline issues from resulting in problems later in their military careers.

Treating substance abuse and mental health issues as 'mutually-exclusive' entities: Best practice or an outmoded approach to intervention?

Addressing the psychological distress of individuals experiencing substance use disorders has too often been relegated to the 'too hard basket', leaving those affected with little choice but to receive treatments aimed solely at addressing their drug and alcohol issues. Conversely, individuals receiving support for psychological issues are often underdiagnosed with regards to any comorbid substance misuse problems. In fact, to date, no definitive treatment model exists that gives equal focus to the treatment of both psychological well-being and substance-related addictions. This is not to suggest, however, that existing treatment programmes for substance misuse are not impacting positively on clients' mental health, rather that further research is needed in order to determine what it is that is supporting such improvements. The aim of this study, therefore, was to address this imbalance by examining the correlation between substance dependence and psychological well-being. Using a descriptive correlation design, the Severity of Dependence and Kessler 10 scales were administered to 37 inpatient and outpatient clients at a rural drug and alcohol rehabilitation service, at intake and 2 months into treatment. Data were analysed using descriptive statistics and paired-samples t-tests. Positive correlative factors of improvement between substance dependence and psychological well-being were found for both groups. In light of these findings, the authors recommend that future research be undertaken to investigate the causal factors for this correlation.

Consumers' and their supporters' perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings.

Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings. Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings. Results All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes. Conclusions Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices. What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies. What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature. What are the implications for practitioners? This paper will give healthcare services a deeper insight into how to reduce or eliminate restraint or seclusion from the perspective of those with lived experience.

Factors associated with anti-retroviral therapy adherence among people living with HIV visiting IRT Perundurai medical college hospital link ART centre, Perundurai, Tamilnadu, India

Background: National AIDS control organisation aims to provide wholesome management to PLHIV. This is ensured by universal access to free and comprehensive care, support and treatment in health delivery facilities across the country by dynamic linkages and referral mechanism for monitoring, mentoring, decentralization and specialized care and treatment. Objective of the study was to analyse factors associated with ART adherence among PLHIV visiting IRT Perundurai Medical College Hospital link ART centre, Tamilnadu, India. Methods: A prospective observational study was conducted during June 2015 to May 2016. All PLHIV receiving ART drugs as per protocol from LAC were included. Results: 139 clients were registered for treatment and follow up till May 2016 in our centre. 31 were transferred to nearby ART, link ART centres. Currently 98 (38 male; 60 female) were utilizing our services. Majority of the patients were on ZLN followed by TLE and ZLE. Most of clients were from rural areas belonging to low or low middle income group. Common occupation was found to be farming and cattle rearing. Most women were housewives. The average age in present study was 38.3 years. Oldest was 73 years old male and youngest 10 years old female. Family support and benefits of ART drugs tops the list of facilitators; supply chain, alcohol issues, family issues were commonly observed barriers. Conclusions: Our results supported the measurement of multiple dimensions of medication-taking behaviours in order to avoid overestimating adherence to ART. Investigation of factors associated with long term adherence would require elaborate and constant follow-ups than in this study period.

Urban Educated Women as Marginalized Mainstream in China: Wei Hui’s Shanghai Baby and Mian Mian’s Candy

Urban Educated Women as Marginalized Mainstream in ChinaWei Hui’s Shanghai Baby and Mian Mian’s Candy Jing Song (bio) introduction When Wei Hui’s Shanghai Baby (Shanghai Baobei) was published in China in 1999, it was officially deemed distasteful, immoral, and harmful and, for a while, was banned.1 Mian Mian’s Candy, published in 2000, got a similar reception.2 But official prohibitions could not dampen the interest the novels sparked across the country, and pirated versions and unauthorized copies of both novels appeared on the street. Sales flourished throughout China. In April 2000 the government officially banned Candy, but hundreds of thousands of pirated copies had already circulated through small private bookstores and street vendors.3 Soon afterward the novels were translated into English, French, and German, generating a range of controversies with international and domestic influence. The novels take as their subject matter the forbidden issues of sexuality, drugs and alcohol, violence, and prostitution, issues traditionally considered taboo, disclosing the full spectrum of challenges on the turbulent and troubling side of contemporary Chinese society. In exposing these socially ignored political and social realities, Shanghai Baby and Candy have drawn their readers’ attention to conflicts that may be hidden from the surface of urban Chinese women’s lives underneath their economic prosperity, but that are nevertheless manifested within their newly materialist lives characterized by high-rise buildings, international clubs and hotels, luxury cars, and fashionable people rushing down globalized urban streets. Through unconventional narratives on forbidden topics, the novels offer rich sources of material for understanding the invisible experiences of Chinese urban educated women as participating agents in pursuit of personal [End Page 109] space, dreams, and opportunities in the changing social topography confronting Chinese women. By analyzing such issues as sexuality, family relations, and materialism embedded in the protagonists’ lives, this article maps the desire of urban educated women to break the silence of female desire, exploring their ideological understanding of the self and of otherness and the dilemma of their identity as participants in a marginalized mainstream in a changing China. I argue that enmeshed in different but overlapping forces of capitalism, traditional culture, and national politics, Chinese urban educated women attempt simultaneously to resist, cooperate, retaliate, and negotiate the meanings of being a woman. This article begins with a brief introduction to the political, historical, and cultural context in which urban educated Chinese women have been situated. Then the article moves to the discussion of the intricate connection of Wei Hui and Mian Mian as writers and Coco from Shanghai Baby and Hong from Candy and the subjects with which to identify urban educated women’s experiences through the writers’ literary productions. Next, through examination of the protagonists’ attitudes to their bodies, to sexuality, to gender relationships, and to materialism, I attempt to make visible these women’s dilemma of performing their femininity and being part of the mainstream culture while simultaneously being discontented with the current male-dominated social order. urban educated women in china In this article both Wei Hui and Mian Mian, as professional writers, are considered as urban educated women who have engaged in writing to express and release their stress, confusion, and struggles.4 Urban educated women in China are generally portrayed as a privileged group of women who have specific training in the systematic application of knowledge that makes them suitable for contributing to the urban global exchange.5 Their education and appropriate knowledge give them access to economic opportunities enabling them to be successful in both the public and private realms.6 However, these urban educated women are also expected to demonstrate their femininity, support their husband’s work, understand a man’s physical and psychological needs, become educated in the arts and sciences, and be willing to assume responsibility for housework.7 Such images of urban educated women have their roots in a resurgence of the notion of femininity from post-1978 China, the beginning of China’s “open door” policy. Historically, notions of womanhood were rooted in the cult of female chastity and feminine virtue.8 To perform feminine virtue, women were discouraged from cultivating talents and were defined as naturally inferior [End Page...

Are Immigrants More Likely to Be Involved in Criminal Activity in Saudi Arabia?

This paper aims to explain the effects of immigration on the overall crime rate and in the six most significant categories of crime in Saudi Arabia, being drugs activity, theft, murder, assault, alcohol and outrageous issues, during a ten-year period from 2003 to 2012, in all thirteen administrative provinces, as well as establish the provinces most affected by criminal activities of immigrants during this period. In our finding, no positive association between immigrants and criminal cases was noted. It is clearly visible that the highest rate of overall criminal activities is in the south, north and Makkah areas, where there is high probability of illegal immigrants, supporting the basic criminological theory that areas with high levels of immigrants also experience high rates of crime. The study provides suggestions to the Saudi government, policy and decision makers, and immigration authorities, which could assist in reducing crimes perpetrated by immigrants.

Article Commentary: Ireland's financial crisis and its influence on alcohol and drug issues

Budget 2009 (announced in December 2008) increased tax on alcohol, resulting in a drop in consumption; Budget 2010 decreased tax and consumption increased; Budget 2013 increased tax and, again, consumption decreased. Prior to the crash of 2008, a shift in the pattern of alcohol purchasing, from pub or ‘on-premise’ to supermarket or ‘offlicence’ purchasing had already emerged; this was a shift which had been facilitated by the introduction in the year 2000 of more liberal licensing regulations (Hope, 2014). What this meant in practice was that the number of pubs declined while, between 2002 and 2009, the number of off-licence retail outlets doubled (Revenue Commissioners Annual Reports). One key influence on the expansion of the off-licence sector was the abolition in 2006 of the Groceries Order. This meant that, for the first time, Irish retailers could now sell alcohol at below-cost price; and supermarkets in particular, were quick to seize the advantage of using very cheap alcohol as a loss leader which would increase ‘footfall’, thereby increasing their customer bases