Journal articles: 'Harm minimisation'

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Shaw, Clare, and Louise Pembroke. "Harm minimisation." Mental Health Practice 14, no. 8 (May 2011): 8. http://dx.doi.org/10.7748/mhp2011.05.14.8.8.p5195.

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Sullivan, Patrick J. "Allowing harm because we care: Self-injury and harm minimisation." Clinical Ethics 13, no. 2 (January 10, 2018): 88–97. http://dx.doi.org/10.1177/1477750917749953.

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Harm minimisation has been proposed as a means of supporting people who self-injure. When adopting this approach, rather than trying to stop self-injury immediately the person is allowed to injure safely whilst developing more appropriate ways of dealing with distress. The approach is controversial as the health care professional actively allows harm to occur. This paper will consider a specific objection to harm minimisation. That is, it is a misguided collaboration between the health care professional and the person who self-injures that is morally and clinically questionable. The objection has two components. The first component is moral in nature and asserts that the health care professional is complicit in any harm that occurs and as a result they can be held morally responsible and subject to moral blame. The second component is clinical in nature and suggests that harm minimisation involves the health care professional in colluding in the perpetuation of self-injury. This element of the objection is based on a psychodynamic understanding of why self-injury occurs and it is argued that harm minimisation is merely a mechanism for avoiding thinking about the psychotherapeutic issues that need to be addressed. Thus, the health care professional merely reinforces a dysfunctional pattern of behaviour and supports the perpetuation of self-injury. I will consider this objection and argue that it fails on both counts. I conclude that the use of harm minimisation techniques is an appropriate form of intervention that is helpful to certain individuals in some situations.

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McMillan, Sara S., Hidy Chan, and Laetitia H. Hattingh. "Australian Community Pharmacy Harm-Minimisation Services: Scope for Service Expansion to Improve Healthcare Access." Pharmacy 9, no. 2 (April 26, 2021): 95. http://dx.doi.org/10.3390/pharmacy9020095.

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Community pharmacies are well positioned to participate in harm-minimisation services to reduce harms caused by both licit and illicit substances. Considering developments in pharmacist practices and the introduction of new professional pharmacy services, we identified a need to explore the contemporary role of community pharmacy in harm minimisation. Semi-structured interviews were undertaken to explore the opinions of stakeholders, pharmacy staff, and clients about the role of community pharmacy in harm minimisation, including provision of current services, experiences, and expectations. Participants (n = 28) included 5 stakeholders, 9 consumers, and 14 staff members from seven community pharmacies. Three over-arching themes were identified across the three participants groups: (i) scope and provision, (ii) complexity, and (iii) importance of person-centred advice and support in relation to community pharmacy harm minimisation services. Community pharmacies are valuable healthcare destinations for delivery of harm minimisation services, with scope for service expansion. Further education, support, and remuneration are needed, as well as linkage to other sector providers, in order to ensure that pharmacists and pharmacy staff are well equipped to provide a range of harm minimisation services.

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Rooney, Siobhan, Aideen Freyne, Gabrielle Kelly, and John O'Connor. "Differences in the quality of life of two groups of drug users." Irish Journal of Psychological Medicine 19, no. 2 (June 2002): 55–59. http://dx.doi.org/10.1017/s0790966700006960.

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AbstractObjectives: The aim of this study was to compare aspects of the quality of life of drug users on a methadone maintenance programme to drug users on a harm minimisation programme.Method: Thirty-six clients attending the harm minimisation programme in the National Drug Treatment Centre, Dublin, were matched for age and sex to 36 clients on the methadone maintenance programme. All were interviewed with the SF-36 Health Survey Questionnaire to measure health related quality of life and with the Hospital Anxiety and Depression Scale (HADs) to measure psychological morbidity.Results: More clients from the harm minimisation programme had previous psychiatric problems than clients on the methadone maintenance programme, with an odds ratio of 4.3 CI(1.2,15.2). On the HADs, clients on the methadone maintenance programme had significantly lower depression scores than clients on the harm minimisation programme. In addition more clients on the harm minimisation programme were severely depressed than clients on the methadone maintenance programme. On the UK SF-36 Scale, clients on the harm minimisation programme perceived a significantly greater deterioration in ‘change in health’ over the previous year than clients on the methadone maintenance programme.Conclusions: Although clients on a methadone maintenance programme had an improved perception of their quality of life in relation to psychological and overall health function from the previous year, compared to clients on a harm minimisation programme, there still existed varying degrees of psychopathology in both groups which need to be considered when providing future services for drug users.

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McKee, I. "Harm minimisation for drug misusers." BMJ 305, no. 6845 (July 11, 1992): 118. http://dx.doi.org/10.1136/bmj.305.6845.118-b.

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Strang, J., and M. Farrell. "Harm minimisation for drug misusers." BMJ 304, no. 6835 (May 2, 1992): 1127–28. http://dx.doi.org/10.1136/bmj.304.6835.1127.

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Payne, N., and P. Amoroso. "Harm minimisation for drug misusers." BMJ 304, no. 6839 (May 30, 1992): 1441. http://dx.doi.org/10.1136/bmj.304.6839.1441-b.

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Brewer, C., J. Marks, and J. Marks. "Harm minimisation for drug misusers." BMJ 304, no. 6839 (May 30, 1992): 1441–42. http://dx.doi.org/10.1136/bmj.304.6839.1441-c.

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Levy, Michael H., Carla Treloar, Rodney M. McDonald, and Norman Booker. "Prisons, hepatitis C and harm minimisation." Medical Journal of Australia 186, no. 12 (June 2007): 647–49. http://dx.doi.org/10.5694/j.1326-5377.2007.tb01085.x.

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Hewitt, David. "Self-harm minimisation and the law." Primary Health Care 20, no. 1 (February 5, 2010): 24–25. http://dx.doi.org/10.7748/phc.20.1.24.s27.

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VAN DER STERREN, ANKE E., IAN P. ANDERSON, and LISA G. THORPE. "‘Individual’ harms, Community ‘harms’: reconciling Indigenous values with drug harm minimisation policy." Drug and Alcohol Review 25, no. 3 (May 2006): 219–25. http://dx.doi.org/10.1080/09595230600644681.

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Etches, Marc W., and Jane Rigbye. "INTRODUCTION." Journal of Gambling Business and Economics 8, no. 3 (April 28, 2015): 1–5. http://dx.doi.org/10.5750/jgbe.v8i3.1033.

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In this special issue, critical consideration is given to existing knowledge and understanding regarding harm minimisation in gambling. While the reviews have been written with the British context in mind, we consider that most matters will have some relevance at an international level also. Papers in this issue also consider operational and regulatory matters through identifying priority areas for research and offering initial guidance on how existing research findings could be applied in operator-based approaches to harm minimisation. It should be noted that concurrent work is being done in Great Britain by both the regulator and industry in response to concerns about the impacts of gambling individually and in local communities. The regulator has recently reviewed social responsibility provisions found within its License Conditions and Codes of Practice (LCCP), and this has established where greater degrees of player protection or player monitoring need to be mandated. In classifying approaches according to their source of implementation and management, the papers in this special issue examine the evidence by considering a specific category of harm minimisation that has been referred to here as ‘operator-based’ harm minimisation. The four papers consider the issues in relation to facilitating awareness and control among consumers engaging in gambling; to restricting access to gambling products; and to ensuring that marketing functions operate in a transparent and responsible way.

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Pengelly, Nicky, Barry Ford, Paul Blenkiron, and Steve Reilly. "Harm minimisation after repeated self-harm: development of a trust handbook." Psychiatric Bulletin 32, no. 2 (February 2008): 60–63. http://dx.doi.org/10.1192/pb.bp.106.012070.

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Repeated self-harm without suicidal intent occurs in approximately 2% of adults (Meltzer et al, 2002). Service users report that professionals can respond to self-harm with unhelpful attitudes and ineffective care. Although evidence for effective treatments is poor (Hawton et al, 1999), this therapeutic pessimism is not found in the self-help approaches promoted by voluntary organisations such as Mind: ‘If you feel the need to self-harm, focus on staying within safe limits' (Harrison & Sharman, 2005). User websites frequently offer advice on harm minimisation: ‘Support the person in beginning to take steps to keep herself safe and to reduce her self-injury – if she wishes to. Examples of very valuable steps might be: taking fewer risks (e.g. washing implements used to cut, avoiding drinking if she thinks she is likely to self-injure)’ (Bristol Crisis Service for Women, 1997).

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Sullivan, Patrick Joseph. "Risk and responding to self injury: is harm minimisation a step too far?" Journal of Mental Health Training, Education and Practice 14, no. 1 (January 14, 2019): 1–11. http://dx.doi.org/10.1108/jmhtep-05-2018-0031.

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Purpose The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient mental health units. It is argued that a focus on risk and the increasing influence of the law and legal styles of thinking often associated with the allocation of blame have produced a more risk adverse clinical environment. As a result health professionals are more likely to err on the side of caution rather than engage in practices that although potentially therapeutic are not without their risks. Design/methodology/approach The analysis draws on the clinical, philosophical and legal literature to help understand how harm minimisation may support people who self-injure. It considers some of the complex medico-legal issues that arise in a clinical environment dominated by risk. Findings A focus on risk and accountability has produced an environment where the law and legal styles of thinking have come to influence practice. This is often associated with blame in the minds of the health professional. Given the legal obligation to prevent suicide, health professionals may take a conservative approach when working with people who self-injure. This makes the adoption of harm minimisation difficult. Originality/value This paper provides a legally informed analysis of some of the challenges associated with using harm minimisation techniques with people who self-injure. It adds to the literature regarding this area of clinical practice.

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Chris Holley, Rachel Horton, Lisa Cartmail, and Eleanor Bradley. "Self-injury and harm minimisation on acute wards." Nursing Standard 26, no. 38 (May 23, 2012): 51–56. http://dx.doi.org/10.7748/ns.26.38.51.s51.

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Holley, Chris, Rachel Horton, Lisa Cartmail, and Eleanor Bradley. "Self-injury and harm minimisation on acute wards." Nursing Standard 26, no. 38 (May 23, 2012): 51–56. http://dx.doi.org/10.7748/ns2012.05.26.38.51.c9113.

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Omar, Yusuf Sheikh, Anna Jenkins, Marieke van Regteren Altena, Harvey Tuck, Chris Hynan, Ahmed Tohow, Prem Chopra, and David Castle. "Khat Use: What Is the Problem and What Can Be Done?" BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/472302.

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The chewing of khat leaves is an established tradition in East Africa but is much less prevalent in other areas of the world and is mostly limited to Somali communities. However, our understanding of what constitutes problematic khat use in the Somali community in Victoria, Australia, is limited. The objectives of this study were to better understand the views of Somali community representatives and primary care practitioners regarding problematic khat use, to consider relevant harm minimisation strategies, and to develop resources to assist individuals with problematic khat use and their families. Qualitative research methods were used to investigate the experiences and perceptions of khat use among Somalis and mainstream primary care practitioners. Six focus groups were conducted with 37 members of the Somali community and 11 primary care practitioners. Thematic analysis was used to analyse transcripts. Various indicators of the problematic use of khat were identified, including adverse physical and mental health effects, social isolation, family breakdown, and neglect of social responsibilities. Potential harm minimisation strategies were identified including the adoption of health promotion through education, outreach to the community, and the use of universal harm minimisation strategies specifically tailored to khat use.

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Ashworth, Owain. "Methadone maintenance treatment as an effective harm minimisation intervention." Mental Health Practice 8, no. 8 (May 2005): 24–27. http://dx.doi.org/10.7748/mhp2005.05.8.8.24.c1861.

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Midford, Richard, Leanne Lester, Tahlia Williams, and Victoria White. "The relationship between Australian harm minimisation alcohol education and student uptake, consumption and harm." International Journal of Drug Policy 52 (February 2018): 25–31. http://dx.doi.org/10.1016/j.drugpo.2017.11.023.

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Evans, Melissa, Leanne Lester, Richard Midford, Helen Walker Cahill, David Foxcroft, Robyn Waghorne, and Lynne Venning. "The impact of gender, socioeconomic status and locality on the development of student patterns of alcohol consumption and harm." Health Education 119, no. 4 (June 3, 2019): 309–18. http://dx.doi.org/10.1108/he-08-2018-0037.

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Purpose The consequences of problematic alcohol consumption fall heavily on Australian adolescents, with this population at increased risk of death, serious injury and other harm. Research regarding whether gender, socioeconomic status (SES) or locality play a role in young people’s alcohol consumption and related harm is limited in Australia. The purpose of this paper is to determine whether Victorian students’ patterns of alcohol uptake, consumption and related harm differed between gender, SES and locality. Design/methodology/approach The study involved secondary analysis of student data from the Drug Education in Victorian Schools harm minimisation drug education programme, undertaken in 21 Victorian government schools over three years The initial cohort of 1,752 students was followed during Years 8, 9 and 10, when their average age would have, respectively, been 13, 14 and 15 years. Findings There were no gender differences in drinking uptake, consumption or harm. Students with low SES were more likely to have consumed a full drink of alcohol and also experienced more alcohol-related harm. Students living in a regional/rural area were more likely to have engaged in high alcohol consumption. Originality/value The findings of this study highlighted that different student demographics have an impact on patterns of alcohol consumption, vulnerability and harm. Students with low SES, living in a regional/rural area, are more at risk than students with higher SES living in a fringe metro/major regional or metro area. Future school harm minimisation drug education programmes should consider the needs of students with demographics that make them more susceptible to higher consumption and harm.

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Sandover, Rosie, Stephen Houghton, and Thomas O'donoghue. "Harm Minimisation Strategies Utilised by Incarcerated Aboriginal Volatile Substance Users'." Addiction Research 5, no. 2 (January 1997): 113–36. http://dx.doi.org/10.3109/16066359709005254.

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Kozor, R., S. Buchholz, R. Bhindi, and G. Figtree. "Harm Minimisation: Should Regular Cocaine Users have a Thrombophilic Screen?" Heart, Lung and Circulation 20 (January 2011): S176. http://dx.doi.org/10.1016/j.hlc.2011.05.436.

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McCaffrey, Hugh. "A Bitter Pill to Swallow: Portugal's Lessons For Drug Law Reform in New Zealand." Victoria University of Wellington Law Review 40, no. 4 (May 4, 2009): 771. http://dx.doi.org/10.26686/vuwlr.v40i4.5252.

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On 1 July 2001, Portugal decriminalised all drugs, replacing criminal sanctions with administrative ones. Portugal's decriminalisation policy focused on individual possession and use of drugs. It was thought that possession and use would be best dealt with outside of the criminal process. In New Zealand, the Law Commission is revisiting the Misuse of Drugs Act 1975. The author seeks to analyse the first two terms of reference: whether the legislative regime should reflect the principle of harm minimisation underpinning the National Drug Policy; and the most suitable model or models for the control of drugs. This paper examines the principles around the criminalisation of possession and use of drugs. In particular, it examines the experience of Portugal, some eight years after decriminalisation. It is argued that New Zealand should adopt a policy of harm minimisation and that the model Portugal presents ought to be seriously considered as a possibility for New Zealand reform.

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Jackson, Alun C., Darren R. Christensen, Kate L. Francis, and Nicki A. Dowling. "Consumer Perspectives on Gambling Harm Minimisation Measures in an Australian Jurisdiction." Journal of Gambling Studies 32, no. 2 (October 6, 2015): 801–22. http://dx.doi.org/10.1007/s10899-015-9568-4.

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Wright, Carly, Greg R. McAnulty, and Paul J. Secombe. "The effect of alcohol policy on intensive care unit admission patterns in Central Australia: A before–after cross-sectional study." Anaesthesia and Intensive Care 49, no. 1 (January 2021): 35–43. http://dx.doi.org/10.1177/0310057x20977503.

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Alcohol misuse is a disproportionately large contributor to morbidity and mortality in the Northern Territory. A number of alcohol harm minimisation policies have been implemented in recent years. The effect of these on intensive care unit (ICU) admissions has not been fully explored. A retrospective before–after cross-sectional study was conducted at the Alice Springs Hospital ICU between 1 October 2017 and 30 September 2019. The primary outcome was the proportion of admissions in which alcohol misuse was a contributing factor in the 12 months before (pre-reforms phase) versus the 12 months following (post-reforms phase) implementation of alcohol legislation reforms. Secondary outcomes were measures of critical care resource use (length of stay, need for and duration of mechanical ventilation). After exclusions, 1323 ICU admissions were analysed. There was a reduction in the proportion of admissions associated with alcohol misuse between the pre-reforms and post-reforms phases (18.8% versus 11.7%, P < 0.01). This was true for both acute (10.6% versus 3.6%, P < 0.01) and chronic misuse (13.3% versus 9.6%, P = 0.03). Rates of mechanical ventilation were unchanged during the post-reforms phase (18.3% versus 14.7%). Admissions with a primary diagnosis of trauma were lower (10.5% versus 4.7%, P < 0.01). This study demonstrated a reduction in ICU admissions associated with alcohol misuse following the implementation of new alcohol harm minimisation policies. This apparent reduction in alcohol-related harm is suggestive of the effectiveness of the Northern Territory’s integrated alcohol harm reduction framework.

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Sullivan, Patrick J. "Sometimes, not always, not never: a response to Pickard and Pearce." Journal of Medical Ethics 44, no. 3 (September 14, 2017): 209–10. http://dx.doi.org/10.1136/medethics-2017-104343.

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This paper provides a response to Hanna Pickard and Stephen Pearce’s paper ‘Balancing costs and benefits: a clinical perspective does not support a harm minimisation approach for self-injury outside of community settings.’ This paper responded to my article ‘Should healthcare professionals sometimes allow harm? The case of self-injury.’ There is much in the paper that I would agree with, but I feel it is important to respond to a number of the criticisms of my paper in order to clarify my position and to facilitate ongoing debate in relation to this important issue.

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Gannon, Jenelle, and Kim E. Kewming. "The Misuse of Insulin by Body Builders: Raising Awareness of the Dangers of this Practice and the Need for Education Resources." Australian Journal of Primary Health 6, no. 1 (2000): 105. http://dx.doi.org/10.1071/py00011.

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Harm minimisation strategies aim to reduce the deleterious health and social consequences to the individual in drug use and abuse and the potential financial burden to the community. Harm minimisation is the guiding principle of the Steroid Peer Education Program (SPEP). This is an outreach program funded by the Department of Human Services (DHS) which provides counselling, education and needle exchange facilities for body-builders who inject with anabolic steroids. In 1998, SPEP became aware that a substantial number of clients were misusing insulin in an attempt to enhance muscle growth. It appears that these athletes were unaware of the dangers of insulin use, such as hypoglycaemia, and the potentially fatal consequences of this practice. Research was carried out which highlighted the need for education material as a harm reduction strategy. Such education material could be used to raise awareness of the dangers of non-medical insulin use and outline how to prevent and treat a hypoglycaemic episode. It appears pertinent to raise awareness of the non-medical use of insulin especially preceding the Sydney 2000 Olympic Games. In addition to the dangers inherent in insulin use as an anabolic enhancement agent, its use cannot be detected by existing control measures. Finally, the long term health consequences of this practice are largely unknown and represent, therefore, an area for future investigation.

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Searle, Geoffrey. "Optimising neuroleptic treatment for psychotic illness." Psychiatric Bulletin 22, no. 9 (September 1998): 548–51. http://dx.doi.org/10.1192/pb.22.9.548.

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The release of the antipsychotic agents risperidone, sertindole and olanzepine forces difficult choices upon clinicians. The new compounds are better tolerated than neuroleptics, expensive and their long-term side-effects unknown. These choices can be made easier by the dose and side-effect minimisation procedure set out below, which aims to produce the greatest benefit and least harm from conventional neuroleptics.

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Rocha, Vitor Moraes. "Analysis of harm minimisation as a public health policy: a Brazil and Australia case study." MOJ Public Health 9, no. 1 (February 4, 2020): 9–12. http://dx.doi.org/10.15406/mojph.2020.09.00316.

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Background: Harm is not only a physical damage. Harm is a set of multifactor problems that encompasses individual, community and society levels. This study aims in identifying drivers and barriers involved during the development of public policies on Harm Minimisation for injected drug users in two distinctive countries and cities (Sydney, Australia and Santos, Brazil). It also draws lessons and policy historical experiences with both successful and failure outcomes. Methods: Based on the historical analysis of open-ended review of published data. Results: Findings strongly suggested that political support and the judiciary cannot be detached from health policy and its successful outcomes demands also further community support and ownership. Conclusion: the paper was able to shed light on the role of political engagement and the community in the development of sustainable public health policy.

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d’Abbs, Peter. "Silence of the sociologists: Indigenous alcohol use, harm minimisation and social control." Health Sociology Review 10, no. 2 (January 2001): 33–52. http://dx.doi.org/10.5172/hesr.2001.10.2.33.

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George, Johnson, and Dennis Thomas. "E-cigarettes for harm minimisation: absence of evidence or evidence of absence?" International Journal of Pharmacy Practice 26, no. 5 (September 25, 2018): 377–79. http://dx.doi.org/10.1111/ijpp.12487.

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Harris, Andrew, and Mark D. Griffiths. "A Critical Review of the Harm-Minimisation Tools Available for Electronic Gambling." Journal of Gambling Studies 33, no. 1 (June 11, 2016): 187–221. http://dx.doi.org/10.1007/s10899-016-9624-8.

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Robertson, J. R. "Harm minimisation is a way of lessening effects of more harmful drugs." BMJ 312, no. 7031 (March 9, 1996): 636. http://dx.doi.org/10.1136/bmj.312.7031.636a.

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Blaszczynski, Alex, Adrian Parke, Andrew Harris, Jonathan Parkes, and Jane Rigbye. "FACILITATING PLAYER CONTROL IN GAMBLING." Journal of Gambling Business and Economics 8, no. 3 (April 28, 2015): 36–51. http://dx.doi.org/10.5750/jgbe.v8i3.973.

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Research indicates that gamblers frequently set self-imposed limits on how much time and money they wish to gamble in a given gambling session, yet consistently gamble more than initially intended. The emotional and arousing impact of gambling, as well as dissociative states gamblers experience whilst gambling, may contribute to this behavioural shift which reflects a failure in self-control. Essential then, is the need for harm minimisation strategies aimed at allowing a gambler to stay in control of their decisions and behaviour during gambling, whilst concurrently limiting the negative impact this may have on the gambling experience for those who frequently stay in control. The following article evaluates the use of limit setting and pre-commitment, the use of ‘cooling off’ periods, and restricting access to additional funds as harm minimisation strategies, in terms of their efficacy in facilitating self-control in problem and non-problem gambling populations. As with any potential mass intervention, such as the use of mandatory limit setting, the need for robust empirical evidence to prove its efficacy is essential. Existing research, while providing promise, falls short of this criterion, indicating a requirement for more stringent empirical research to best guide responsible gambling practices aimed at facilitating player control during gambling.

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Parke, Jonathan, and Adrian Parke. "DOES SIZE REALLY MATTER? A REVIEW OF THE ROLE OF STAKE AND PRIZE LEVELS IN RELATION TO GAMBLING-RELATED HARM." Journal of Gambling Business and Economics 7, no. 3 (December 9, 2013): 77–110. http://dx.doi.org/10.5750/jgbe.v7i3.819.

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Regulatory and industry decisions influencing commercial gambling activities require clear understanding of the role that stakes and prizes play in the development and facilitation of gambling-related harm. Although industry proponents argue for increases in stakes and prizes to meet market demands, regulators remain cautious about the potential implication for gambling-related harm, while industry opponents generally condemn relaxing aspects of gambling policies. To inform this debate, this paper provides a critical examination of the relevant literature. From the review, it is concluded that limitations of the existing literature restrict our ability to draw definitive conclusions regarding the effects of stake and prize variables. Most studies contain multiple, methodological limitations, the most significant of which are diluted risk and reward scenarios used in analogue research settings not reflective of real gambling situations. In addition, there is a lack of conceptual clarity regarding many constructs, particularly the parameters defining jackpots, and the interactive nature and effect of the differing configurations of game parameters and environments are often not taken into consideration when investigating changes to one or more variables. Notwithstanding these limitations, there is sufficient evidence to suggest that stake and prize levels merit consideration in relation to harm minimisation efforts. However, substantial knowledge gaps currently exist, particularly in relation to understanding staking and prize thresholds for risky behaviour, how the impact of stakes and prizes change depending on the configuration and interaction of other game characteristics, and the role of individual and situational determinants. Based on the potential risk factors and the implications for commercial appeal, a player-focussed harm minimisation response may hold the most promise for future research and evaluation in jurisdictions where gambling is a legal and legitimate leisure activity.

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Parke, Jonathan, Adrian Parke, Andrew Harris, Jane Rigbye, and Alex Blaszczynski. "RESTRICTING ACCESS: SELF-EXCLUSION AS A GAMBLING HARM MINIMISATION MEASURE IN GREAT BRITAIN." Journal of Gambling Business and Economics 8, no. 3 (April 28, 2015): 52–94. http://dx.doi.org/10.5750/jgbe.v8i3.1032.

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The purpose of this review was to examine the academic literature regarding self-exclusion as a form of harm minimisation in gambling and consider views from gambling operators and treatment providers. The extant literature was limited in that most studies were completed more than five ago; related specifically to a particular product or jurisdiction; relied on weak research designs and drew from self-selected samples. There were however some consistent findings indicating that in order to improve effectiveness, self-exclusion protocols should be: actively yet strategically promoted; quick and simple to implement; administered by attentive, well-trained staff; attracting sufficient investment in resources and technology to improve enforcement; and comprehensive rather than isolated in coverage (where feasible). Programmes should also be subject to robust evaluation and regulatory expectations should be detailed and specific rather than open to interpretation and general. Further scoping of the feasibility of multi-operator self-exclusion schemes (MOSES) was identified as a priority for future work.

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Gainsbury, Sally M., Matthijs Blankers, Claire Wilkinson, Karen Schelleman-Offermans, and Janna Cousijn. "Recommendations for International Gambling Harm-Minimisation Guidelines: Comparison with Effective Public Health Policy." Journal of Gambling Studies 30, no. 4 (June 8, 2013): 771–88. http://dx.doi.org/10.1007/s10899-013-9389-2.

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Measham, Fiona. "The new policy mix: Alcohol, harm minimisation, and determined drunkenness in contemporary society." International Journal of Drug Policy 17, no. 4 (July 2006): 258–68. http://dx.doi.org/10.1016/j.drugpo.2006.02.013.

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HAMILTON, GREG, DONNA CROSS, KEN RESNICOW, and THERESE SHAW. "Does harm minimisation lead to greater experimentation? Results from a school smoking intervention trial." Drug and Alcohol Review 26, no. 6 (November 2007): 605–13. http://dx.doi.org/10.1080/09595230701613585.

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Hall, Wayne. "Variations in Prohibition: Harm Minimisation and Drug Wars in Australia and the United States." Australian & New Zealand Journal of Criminology 28, no. 1_suppl (December 1995): 74–77. http://dx.doi.org/10.1177/00048658950280s110.

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Lindorff, Margaret, Elizabeth Prior Jonson, and Linda McGuire. "Strategic Corporate Social Responsibility in Controversial Industry Sectors: The Social Value of Harm Minimisation." Journal of Business Ethics 110, no. 4 (September 25, 2012): 457–67. http://dx.doi.org/10.1007/s10551-012-1493-1.

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Midford, Richard, Johanna Mitchell, Leanne Lester, Helen Cahill, David Foxcroft, Robyn Ramsden, Lynne Venning, and Michelle Pose. "Preventing alcohol harm: Early results from a cluster randomised, controlled trial in Victoria, Australia of comprehensive harm minimisation school drug education." International Journal of Drug Policy 25, no. 1 (January 2014): 142–50. http://dx.doi.org/10.1016/j.drugpo.2013.05.012.

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Morrissey, Jean, Louise Doyle, and Agnes Higgins. "Self-harm: from risk management to relational and recovery-oriented care." Journal of Mental Health Training, Education and Practice 13, no. 1 (January 8, 2018): 34–43. http://dx.doi.org/10.1108/jmhtep-03-2017-0017.

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Purpose The purpose of this paper is to examine the discourses that shape nurses’ understanding of self-harm and explore strategies for working with people who self-harm in a relational and a recovery-oriented manner. Design/methodology/approach Self-harm is a relatively common experience for a cohort of people who present to the mental health services and is, therefore, a phenomenon that mental health nurses will be familiar with. Traditionally, however, mental health nurses’ responses to people who self-harm have been largely framed by a risk adverse and biomedical discourse which positions self-harm as a “symptom” of a diagnosed mental illness, most often borderline personality disorder. Findings This has led to the development of largely unhelpful strategies to eliminate self-harm, often in the absence of real therapeutic engagement, which can have negative outcomes for the person. Attitudes towards those who self-harm amongst mental health nurses can also be problematic, particularly when those who hurt themselves are perceived to be attention seeking and beyond help. This, in turn, has a negative impact on treatment outcomes and future help-seeking intentions. Research limitations/implications Despite some deficiencies in how mental health nurses respond to people who self-harm, it is widely recognised that they have an important role to play in self-harm prevention reduction and harm minimisation. Practical implications By moving the focus of practice away from the traditional concept of “risk” towards co-constructed collaborative safety planning, mental health nurses can respond in a more embodied individualised and sensitive manner to those who self-harm. Originality/value This paper adds further knowledge and understanding to assist nurses’ understanding and working with people who self-harm in a relational and a recovery-oriented manner.

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Levy, Michael H., and Carla Treloar. "Harm minimisation in Australian prisons — health protection still depends on where you serve your time." Medical Journal of Australia 197, no. 7 (October 2012): 382. http://dx.doi.org/10.5694/mja12.10228.

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Oster, Candice. "Harm minimisation as technologies of the self: some experiences of interviewing people with genital herpes." Nursing Inquiry 10, no. 3 (September 2003): 201–3. http://dx.doi.org/10.1046/j.1440-1800.2003.00173.x.

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Hübner, Dietmar, and Lucie White. "Crash Algorithms for Autonomous Cars: How the Trolley Problem Can Move Us Beyond Harm Minimisation." Ethical Theory and Moral Practice 21, no. 3 (June 2018): 685–98. http://dx.doi.org/10.1007/s10677-018-9910-x.

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Maker, Yvette, and Bernadette McSherry. "Regulating restraint use in mental health and aged care settings: Lessons from the Oakden scandal." Alternative Law Journal 44, no. 1 (December 20, 2018): 29–36. http://dx.doi.org/10.1177/1037969x18817592.

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This article argues that there exist unnecessary gaps in the regulation of the use of physical, mechanical and chemical restraints in mental health and aged care settings. While the use of these forms of restraint may be rationalised on the basis of preventing harm to self or others, there are adverse consequences that necessitate the minimisation, if not elimination, of their use. The overuse of mechanical and chemical restraints at the Oakden Older Persons Mental Health Service in South Australia led to several scathing inquiries. This article looks at the lessons learned and suggests a multidimensional, consistent approach is overdue.

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Allan, Julaine. "Engaging primary health care workers in drug and alcohol and mental health interventions: challenges for service delivery in rural and remote Australia." Australian Journal of Primary Health 16, no. 4 (2010): 311. http://dx.doi.org/10.1071/py10015.

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Access to drug and alcohol treatment services is a particularly salient issue for Australia. The nation is paying considerable attention to risky drug and alcohol use. Indigenous Australians are particularly concerned about drug and alcohol related harms in their communities. Access to treatment is the most effective way of reducing drug related harm for disadvantaged populations. Primary health care is the optimal site for delivering drug and alcohol treatment. Semi-structured in-depth interviews with 47 primary health care, drug and alcohol and other health and welfare workers in rural and remote locations were conducted. Thematic analysis of interview data identified divergent perspectives according to a participant’s work role about drug and alcohol treatment, client needs and problems and service delivery approaches. Primary health care workers were conceptualised as locals. They tended to perceive that drug and alcohol interventions should quickly prevent individuals from on-going problematic use. Drug and alcohol workers were conceptualised as insiders. Most did not have knowledge or experience of the primary health care setting. Therefore they could not assist primary health care workers to integrate drug and alcohol interventions into their interactions with clients. Professional and organisational barriers constrain the primary health care worker role and limit the application of specialist interventions. Drug and alcohol work is only one of many competing demands in the primary health setting. The lack of understanding of the primary health care worker role and responsibilities is the most significant barrier to implementing specialist interventions in this role. Primary health care workers’ perceptions of substance misuse are more consistent with the individual moral or personal deficit philosophy of drug and alcohol treatment than harm minimisation approaches. This is a challenge for a specialist agency that is promoting harm minimisation and an adaptive approach to treatment within the primary care setting. Building the capacity of primary health care workers to do more varied tasks requires a good understanding of the pragmatic and practical realities of their day to day practice and the philosophies that underpin these.

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Mules, Thomas, Jennifer Taylor, Rachel Price, Logan Walker, Baneet Singh, Patrick Newsam, Thenmoli Palaniyappan, et al. "Addressing patient alcohol use: a view from general practice." Journal of Primary Health Care 4, no. 3 (2012): 217. http://dx.doi.org/10.1071/hc12217.

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INTRODUCTION: General practitioners (GPs) have the potential to promote alcohol harm minimisation via discussion of alcohol use with patients, but knowledge of GPs current practice and attitudes on this matter is limited. Our aim was to assess GPs current practice and attitudes towards discussing alcohol use with their patients. METHODS: This qualitative study involved semi-structured, face-to-face interviews with 19 GPs by a group of medical students in primary care practices in Wellington, New Zealand. FINDINGS: Despite agreement amongst GPs about the importance of their role in alcohol harm minimisation, alcohol was not often raised in patient consultations. GPs usual practice included referral to drug and alcohol services and advice. GPs were also aware of national drinking guidelines and alcohol screening tools, but in practice these were rarely utilised. Key barriers to discussing alcohol use included its societal taboo nature, time constraints, and perceptions of patient dishonesty. CONCLUSION: In this study there is a fundamental mismatch between the health communitys expectations of GPs to discuss alcohol with patients and the reality. Potential solutions to the most commonly identified barriers include screening outside the GP consultation, incorporating screening tools into existing software used by GPs, exploring with GPs the social stigma associated with alcohol misuse, and framing alcohol misuse as a health issue. As it is unclear if these approaches will change GP practice, there remains scope for the development and pilot testing of potential solutions identified in this research, together with an assessment of their efficacy in reducing hazardous alcohol consumption. KEYWORDS: Primary health care; general practice; alcohol drinking; alcohol-related disorders, attitude of health personnel

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Sendziuk, Paul. "Diving under the 'Second Wave': Harm Minimisation Approaches to Drug Use and HIV Infection in Australia." Health and History 3, no. 2 (2001): 55. http://dx.doi.org/10.2307/40111405.

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Journal articles on the topic 'Harm minimisation'

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