Suchergebnisse

Gambling has been a popular pastime in ancient and colonial India, and continues to be in modern India. Problem gambling is an important public health issue because of its prevalence, increased risk to certain vulnerable groups and its numerous adverse consequences to the gambler, his/her family and the wider society. In this paper, we present an overview of gambling in ancient and modern India, and also suggest a public health approach aimed at reducing gambling-related harm and associated problems.

INTRODUCTION AND AIMS: Of the Indian population, 2.7% have alcohol dependence, the most severe of alcohol use disorders. Alcohol use disorders have previously been found to be correlated with a range of negative economic outcomes, but dependent drinking has yet to be causally identified as a poverty trap. We use qualitative data as the first step towards identifying the mechanisms that may underlie a dependent drinking driven poverty trap in India. DESIGN AND METHODS: Thirty-six in-depth interviews were conducted and analysed using inductive thematic analysis. Participants were men having probable alcohol dependence (n = 11), doctors (n = 13) who come into contact with patients presenting with alcohol dependence at government hospitals and clinics, and family members of men with probable alcohol dependence (n = 12) in Goa, India. RESULTS: Our key findings showed that families of those who have alcohol dependence have less opportunity for saving, more job instability and poor treatment opportunity to aid recovery and allow escaping from the trap. DISCUSSION AND CONCLUSIONS: Households in Goa, India with a member with alcohol dependence display patterns consistent with a poverty trap, though the mechanisms derived from these qualitative data need to be further demonstrated by longitudinal quantitative data to corroborate a causal relationship between alcohol use disorders and poverty.

INTRODUCTION: The aim of this review is to provide the first consolidation of the policy environment surrounding alcohol-related societal harm in India giving researchers and policy-makers a clearer base for future reforms. This review is also an important adaptation on the scoping review method for policy reviews in low-resource settings that may serve as an example for other policy reviews in similar settings. METHODS AND ANALYSIS: We will undertake a scoping review with policy relevant adaptations in order to map the alcohol-related policy environment in India. Following the six-step approach put forward by ArskeyandO'Malley and refined by Levac, we will first undertake an academic scoping search to identify relevant knowledge already existing in the literature about the policy environment in India. We will then use the knowledge that appears in this search iteratively, as is true to the scoping method, to develop a more targeted search of grey literature and Indian government websites for Indian policy documents. These documents will be analysed using qualitative methods to synthesise the current alcohol policy environment in India. ETHICS AND DISSEMINATION: This study will only use already published information and therefore does not require an ethics review. We will circulate this protocol and the final report to policy researchers in similar settings who could make use of our adaptation of the scoping review method for a low-resource setting. We will also publish our findings in a peer-review journal.

Abstract
Background
Armed conflict has significant impacts on individuals and families living in conflict-affected settings globally. Scholars working to prevent violence within families have hypothesised that experiencing armed conflict leads to an increase in family violence and mental health problems. In this review, we assessed the prevalence of family violence in conflict settings, its association with the mental health of survivors, moderating factors, and the importance of gender relations.

Methods
Following PRISMA guidelines, we systematically reviewed quantitative and qualitative studies that assessed the prevalence of family violence and the association between family violence and mental health problems, within conflict settings (PROSPERO reference CRD42018114443).

Results
We identified 2605 records, from which 174 full text articles were screened. Twenty-nine studies that reported family violence during or up to 10 years after conflict were eligible for inclusion. Twenty one studies were quantitative, measuring prevalence and association between family violence and mental health problems. The studies were generally of high quality and all reported high prevalence of violence. The prevalence of violence against women was mostly in the range of 30–40%, the highest reported prevalence of physical abuse being 78.9% in Bosnia and Herzegovina. For violence against children, over three-quarters had ever experienced violence, the highest prevalence being 95.6% in Sri Lanka. Associations were found with a number of mental health problems, particularly post-traumatic stress disorder. The risk varied in different locations. Eight qualitative studies showed how men's experience of conflict, including financial stresses, contributes to their perpetration of family violence.

Conclusions
Family violence was common in conflict settings and was associated with mental health outcomes, but the studies were too heterogenous to determine whether prevalence or risk was greater than in non-conflict settings. The review highlights an urgent need for more robust data on perpetrators, forms of family violence, and mental health outcomes in conflict-affected settings in order to help understand the magnitude of the problem and identify potential solutions to address it.