Nursing
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Item Healthcare graduates for the 21st century; Knowledge and attitudes relating to alcohol and brief interventions.(2009-11-27) Gill, Jan; Nicol, Maggie; Gibson, Caroline; O'May, FionaFinal year students studying a variety of healthcare courses (involving inter-professional education), at six Scottish universities completed a questionnaire (spring 2009). While changes in current health policy endorse graduate attributes promoting shared responsibility, an overlapping of roles, analysis of findings revealed differences between the professions in terms of level of understanding of health guidelines, acceptance of role and perceived confidence in personal knowledge relating to alcohol misuse. Two professions were predominantly viewed as key to this area of practice only by their own students (OT and pharmacy) while three (speech and language, radiography, dietetics) doubted the importance of their role.Item White Cider Consumption and Heavy Drinkers: A Low-Cost Option but an Unknown Price(Oxford Journals, 2014) Black, Heather; Michalova, L.; Gill, Jan; Rees, C.; Chick, Jonathan; O'May, Fiona; Rush, Robert; McPake, BarbaraAims: To compare characteristics of heavy drinkers who do, or do not, drink white cider during their typical drinking week and to contrast white cider drinkers' behaviour with a similar group recruited in comparable settings 4 years previously. To consider if excessive white cider consumption poses a specific health risk. Methods: Cross-sectional survey of alcohol purchasing and consumption by heavy drinkers consuming white cider in Edinburgh and Glasgow during 2012; comparison of purchasing patterns within Edinburgh in 2008-2009 and 2012. Participants were 639 patients (in- and out-patient settings) with serious health problems linked to alcohol, 345 in Glasgow, 294 in Edinburgh in 2012, and 377 in Edinburgh in 2008-2009. Results: In 2012 white cider consumption was reported by 25% of participants (median consumption (all alcohol) was 249 UK units per week-1 UK unit being 8 g of ethanol). They were more likely to be male and younger. They drank more units of alcohol than non-white cider drinkers and reported more alcohol-related problems. The median price paid for white cider in 2012 was 17 ppu. The period 2008-2012 was associated with decreasing affordability of alcohol, but consumption levels amongst the heaviest drinkers were maintained, associated with an increased proportion of units purchased as white cider. Conclusion: White cider makes an important contribution to the weekly intake of heavy drinkers in Scotland, likely facilitated by low price per unit of alcohol. We suggest these characteristics permit this drink to act as a buffer, supporting the continuation of a heavy drinking pattern when affordability of alcohol falls.Item Alcohol purchasing by ill heavy drinkers; cheap alcohol is no single commodity(2015-09-26) Gill, Jan; Chick, J.; Black, H.; Rees, C.; O'May, Fiona; Rush, Robert; McPake, BarbaraObjectives: Potential strategies to address alcohol misuse remain contentious. We aim to characterise the drink purchases of one population group: heavy drinkers in contact with Scottish health services. We contrast our findings with national sales data and explore the impact of socio-economic status on purchasing behaviour. Study design: Cross-sectional study comparing alcohol purchasing and consumption by heavy drinkers in Edinburgh and Glasgow during 2012. Methods: 639 patients with serious health problems linked to alcohol (recruited within NHS hospital clinics (in- and out-patient settings) 345 in Glasgow, 294 in Edinburgh) responded to a questionnaire documenting demographic data and last week's or a 'typical' weekly consumption (type, brand, volume, price, place of purchase). Scottish Index of Multiple Deprivation quintile was derived as proxy of sociodemographic status. Results: Median consumption was 184.8 (IQR = 162.2) UK units/week paying a mean of 39.7 pence per alcohol unit (0.397). Off-sales accounted for 95% of purchases with 85% of those <50 pence (0.5 UK) per alcohol unit. Corresponding figures for the Scottish population are 69% and 60%. The most popular low-priced drinks were white cider, beer and vodka with the most common off-sales outlet being the corner shop, despite supermarkets offering cheaper options. Consumption levels of the cheapest drink (white cider) were similar across all quintiles apart from the least deprived. Conclusions: Heavy drinkers from all quintiles purchase the majority of their drinks from off-sale settings seeking the cheapest drinks, often favouring local suppliers. While beer was popular, recent legislation impacting on the sale of multibuys may prevent the heaviest drinkers benefiting from the lower beer prices available in supermarkets. Non-etheless, drinkers were able to offset higher unit prices with cheaper drink types and maintain high levels of consumption. Whilst price is key, heavy drinkers are influenced by other factors and adapt their purchasing as necessary. 2015 The Authors.Item The price of a drink: levels of consumption and price paid per unit of alcohol by Edinburgh's ill drinkers with a comparison to wider alcohol sales in Scotland(Wiley Online Library, 2011-12) Black, Heather; Gill, Jan; Chick, Jonathan; The study was funded by the NHS LothianAim To compare alcohol purchasing and consumption by ill drinkers in Edinburgh with wider alcohol sales in Scotland. Design Cross-sectional. Setting Two hospitals in Edinburgh in 2008/09. Participants A total of 377 patients with serious alcohol problems; two-thirds were in-patients with medical, surgical or psychiatric problems due to alcohol; one-third were out-patients. Measurements Last week's or typical weekly consumption of alcohol: type, brand, units (1 UK unit 8 g ethanol), purchase place and price. Findings Patients consumed mean 197.7 UK units/week. The mean price paid per unit was £0.43 (lowest £0.09/unit) (£1 = 1.6 US$ or 1.2€), which is below the mean unit price, £0.71 paid in Scotland in 2008. Of units consumed, 70.3% were sold at or below £0.40/unit (mid-range of price models proposed for minimum pricing legislation by the Scottish Government), and 83% at or below £0.50/unit proposed by the Chief Medical Officer of England. The lower the price paid per unit, the more units a patient consumed. A continuous increase in unit price from lower to higher social status, ranked according to the Scottish Index of Multiple Deprivation (based on postcode), was not seen; patients residing in postcodes in the mid-quintile paid the highest price per unit. Cheapness was quoted commonly as a reason for beverage choice; ciders, especially ‘white’ cider, and vodka were, at off-sales, cheapest per unit. Stealing alcohol or drinking alcohol substitutes was only very rarely reported. Conclusions Because patients with serious alcohol problems tend to purchase very cheap alcohol, elimination of the cheapest sales by minimum price or other legislation might reduce their consumption. It is unknown whether proposed price legislation in Scotland will encourage patients with serious alcohol problems to start stealing alcohol or drinking substitutes or will reduce the recruitment of new drinkers with serious alcohol problems and produce predicted longer-term gains in health and social wellbeing.Item Can Part of the Health Damage Linked to Alcohol Misuse in Scotland be Attributable to the Type of Drink and its Low Price (by Permitting a Rapid Rate of Consumption)? A Point of View(Oxford Journals, 2010) Gill, Jan; Tsang, Catherine; Black, Heather; Chick, JonathanThis article considers two sets of data describing the extent of consumption of white spirit drinks by a sample of patients who abuse alcohol and the analysis of drink antioxidant content. We present a proposal for discussion that the rapid consumption of alcoholic drinks, low in protective antioxidant compounds, may potentially be more damaging to the body.Item Using electronic surveying to assess psychological distress within the UK student population: a multi-site pilot investigation(2008) Bewick, B. M.; Gill, Jan; Mulhearn, B.; Barkham, M.; Hill, A. J.This paper describes the level of psychological distress within university students participating in an evaluation of a web-based intervention for alcohol misuse. Data was collected from 1129 student from four UK universities. Psychological distress was assessed using an online version of the CORE-10. Results showed that 29% of students reported clinical levels of psychological distress. Eight percent of students had moderate-to-severe or severe levels of distress. The items tapping depression and anxiety suggest that, when compared to depression scores, levels of anxiety are heightened. These findings are discussed in light of the evidence which suggests that traditional modes of support delivery may not be sufficient for all students. The possibility that web-based therapeutic interventions could be utilized within this highly computer literate population is explored.Item Strong cider sold in Scotland appears to be almost exclusively for dependent drinkers(Royal College of Physicians, 2016-08-01) Chick, Jonathan; Gill, Jan; Black, Heather; O'May, FionaLetterItem Biomedical links between cognitions and behaviour(Elsevier, 2008) Gill, JanItem Healthcare and Medical Graduates of 2009: Their Reactions to Four Key Proposals in the Scottish Government's Strategy for Tackling Alcohol Misuse(2010) Gill, Jan; Gibson, Caroline; Nicol, MaggieAims: This study compares the views of final year medical, and nursing and allied health professional (NAHP) students in relation to four governmental proposals impacting on the sale and purchase of alcohol. Methods: Against a background of political will to address alcohol abuse in Scotland and moves within the National Health Service promoting a shifting of professional roles, self-completed questionnaires were administered in spring 2009 through course websites and lectures to final year medical and NAHP students. Results: Questionnaires were returned by 406 NAHPs and 121 medical students. Over three quarters of all students agreed with the proposed change to reduce the drink driving limit to 50 mg/100 ml blood. Less support was evident for the raising of the minimum legal purchase age for off-sales (37%), the banning of below cost price promotions of alcohol (47%) and minimum retail pricing (37%). However, there were differences between the NAHP and medical students in the case of the final two proposals; over 60% of the medical students agreed they would have a positive impact. For NAHPs, figures were 41% and 31%, respectively. Conclusions: Support for four key proposals outlined by the Scottish Government to address alcohol misuse varied. Only the suggestion to lower the drink driving limit received backing overall and within students in these professions. Effectiveness of proposed restrictions on the price of alcohol was less well regarded except by medical students. Evident gaps in knowledge around health guidelines, and the finding that almost half of NAHPs disagreed that they had the appropriate knowledge to advise patients about responsible drinking advice and alcohol misuse problems, suggest a need for improved undergraduate education and continued professional development with respect to public health aspects of alcohol use.Item Variation in the alcohol content of a 'drink' of wine and spirit poured by a sample of the Scottish population(Oxford University Press, 2004-05-20) Gill, Jan; Donaghy, MarieThe standard UK alcohol unit is used to record alcohol consumption and, in health promotion, as a useful yardstick by which the public may be encouraged to monitor their own drinking levels. To investigate the correspondence between this standard unit and the actual amount contained in the 'usual' drink poured by a sample of the Scottish public, participants (n=251) were recruited from three employers in a major city-a manufacturer, an academic and a financial institution. Following a brief questionnaire, participants were asked to pour their usual drink of wine, and then spirit, into a glass. Among drinkers (n=238), the mean amount of alcohol in a drink of wine corresponded to not 1, but 1.92 UK units. For spirit, the corresponding figure was 2.3 UK units. For wine, 43% of the sample poured more than 2 units, for spirit, 55%. (Males poured significantly more spirit than females.) These findings may have important implications for individuals who wish to promote and to adopt sensible drinking practices when consuming wine and spirit at home. Also, the reliability of many consumption surveys, where there is often the implicit assumption that a 'drink' is equivalent to a 'standard unit', must be questioned.