O Transtorno Afetivo Bipolar (TAB) é uma condição crônica, caracterizada pela existência de episódios agudos e recorrentes de alteração patológica do humor, que ocasiona grande impacto na vida do paciente, reduzindo seu funcionamento e sua qualidade de vida. O uso de medicamentos consiste em uma realidade necessária ao cotidiano da pessoa com TAB. Este estudo teve como objetivo compreender o significado da terapêutica medicamentosa para a pessoa com TAB, em sua perspectiva e na de seu familiar. Dada a natureza do problema, esta investigação utilizou uma abordagem qualitativa, tendo como referencial metodológico a Teoria Fundamentada nos Dados, à luz do Interacionismo Simbólico. Participaram do estudo 14 pessoas com TAB que estavam em acompanhamento em uma Unidade Ambulatorial de Transtornos do Humor de um hospital universitário e 14 familiares indicados pelas mesmas. A entrevista e observação foram utilizadas como principais estratégias de obtenção de dados. As entrevistas gravadas, após serem transcritas, foram codificadas em três etapas: codificação aberta, codificação axial e codificação seletiva. A análise comparativa dos dados resultou no fenômeno central: ?ESTANDO ENTRE A CRUZ E A ESPADA? em relação à terapêutica medicamentosa. Tal processo foi constituído pela integração entre categorias no modelo de paradigma de Strauss e Corbin, envolvendo a causa desencadeadora do fenômeno, o contexto em que o mesmo está inserido, as condições intervenientes, a estratégia de ação sobre o fenômeno e suas conseqüências. O fenômeno ESTANDO ENTRE A CRUZ E A ESPADA permitiu compreender que, para pessoas com TAB, existe uma situação de ambivalência em relação à terapêutica medicamentosa: no início, não reconhecendo o transtorno e, paralelamente, tomando muitos medicamentos. Como não se percebem doentes, geralmente não identificam motivos para utilizar medicamentos que lhes impõem como realidade conviver com o preconceito e com as perdas e limitações impostas tanto pelos seus efeitos colaterais quanto pelos sintomas do transtorno, sendo freqüente o abandono da terapia medicamentosa. Ao identificar a real necessidade do medicamento, evidenciada pela vivência de crises na ausência do mesmo, as pessoas com TAB percebem-se frente a um dilema entre as duas alternativas de vida em que se constituem a saúde e a doença. Nesse sentido, ao mesmo tempo em que depositam no medicamento o símbolo de sanidade, esse passa a ser a prova concreta e cotidiana de que possuem um transtorno mental e crônico. Este estudo permitiu, assim, compreender os fatores associados e determinantes da realidade vivenciada pelas pessoas com TAB em relação à terapêutica medicamentosa, possibilitando um salto na implementação de estratégias de intervenção nos serviços de saúde direcionadas à qualidade da assistência a esses pacientes / Bipolar Affective Disorder (BAD) is a chronic condition, characterized by the existence of acute and recurring episodes of pathological mood change, which causes a great impact on patients? lives, reduces their functioning and quality of life. Taking medication is a necessary reality in the daily lives of BAD patients. This study aimed to understand the meaning of medication therapy for these patients, according to their perspectives and those of family members. Given the nature of the problem, this research used a qualitative approach, based on Grounded Theory, in the light of Symbolic Interactionism. Study participants were 14 BAD patients who were followed at a Clinical Unit for Mood Disorders of a university hospital and 14 relatives they indicated. Interviews and observation were the main strategies for data collection. The recorded interviews were first transcribed and then coded in three phases: open coding, axial coding and selective coding. Comparative data analysis resulted in the central phenomenon: BEING BETWEEN THE DEVIL AND THE DEEP BLUE SEA with respect to medication therapy. This process was constituted by integrating categories in Strauss and Corbin?s paradigm model, involving the cause that triggered the phenomenon, the context in which it is inserted, intervening conditions, the strategy to act on the phenomenon and its consequences. The phenomenon of BEING BETWEEN THE DEVIL AND THE DEEP BLUE SEA allowed us to understand that, for patients with BAD, there is an ambivalent situation related to medication therapy. This is perceived, at first, by not acknowledging the disorder and, in parallel, by taking many drugs. As patients do not perceive themselves as ill, they generally do not identify, at this moment in the history of the disorder, motives to take drugs that impose the reality of living with prejudice and with the losses and limitations imposed by their collateral effects as well as by the symptoms of the disorders, with frequent abandonment of medication therapy. By identifying the real need for the drug, evidenced by the experience of crises when it is absent, patients with BAD find themselves faced with a dilemma between the two alternatives of life, which are health and disease. In this sense, patients place the symbol of sanity in the medication but, at the same time, it becomes the concrete and daily proof that they have a mental and chronic disorder. This study allowed us to understand associated and determinant factors of the reality BAD patients experience in relation to medication therapy, permitting a leap in the implementation of intervention strategies in health service directed at the quality of care for these patients

Peer influence is a well-studied and established phenomenon in the social sciences with much research focusing on peers influencing one another in negative ways. However, peers have also been shown to provide a positive influence. Research on substance treatment programs indicates that one's social network can influence one to enter treatment as well as help maintain abstinence following the completion of the program. However, little is known about the influence that peer's drug treatment can have on the substance levels of an individual. I use the peer nomination data and Waves 1 and 2 of the National Longitudinal Study of Adolescent to Adult Health to study this instance of peer influence. Results indicate that having a higher proportion of peers who attend drug treatment is not associated with lower levels of respondent illicit drug, alcohol use, and binge drinking behaviors. Consistent with past findings, having a higher proportion of one's peers who reported drug use is associated with higher levels of respondent substance use. Implications for clinicians and other treatment providers are discussed with an emphasis on the role that strong parental attachment can play in offsetting negative peer influence.

Background: In East Tennessee and Middle Appalachia, the epicenter of the opioid epidemic, approximately 15% of women give birth taking buprenorphine or methadone for opioid addiction (medical assisted therapy--MAT) or using other drugs illicitly and 5% of births are diagnosed with neonatal abstinence syndrome (NAS). A better understanding is needed of factors contributing to the severity of NAS. Objective: To identify maternal and infant characteristics associated with length of stay among newborns with neonatal abstinence syndrome. Design/Methods: Participants were 150 newborns systematically sampled from births diagnosed with NAS during the past 5 years at a single medical center. Data were obtained through abstraction of maternal prenatal records, infant delivery and infant medical charts. The abstraction included maternal and child demographic and clinical characteristics. Drug and other substance use/exposure histories were based on maternal history, and urine and cord tissue drug screening. Results: The infants’ average length of stay was 18.6 (s.d. = 11.9), 15% were low birthweight, and had an average gestational age of 38.8 (s.d. = 1.8); 62% were male; 49% were breast-fed. The mothers mean age was 27.5 (s.d. = 5.0); mean parity was 1.6 (s.d. = 1.4); 77% were unmarried; 75% had < HS education; and 89% had exposure at some time during pregnancy to other prescription (in addition to buprenorphine or methadone) or illicit opioids. In the least squares regression, which included important potential covariates such as infant sex, birth weight and gestational age, significant predictors of infant length of stay include: maternal benzodiazepine use (8.3 day longer LOS on average; p = 0.019), and infants whose mothers had a history of mental illness (3.9 day longer LOS on average, p = 0.040 ). While infants born to mothers smoking in the final 30 days of pregnancy had a 2.7 day longer LOS on average after adjustment for other significant predictors, this association was no longer significant in regression analysis (p = 0.293). Conclusion(s): Maternal use of prescription or illicit opioids leading to NAS is rooted in women’s’ life histories characterized by disadvantage, relationship instability, polysubstance use and mental illness. Efforts to reduce the incidence and severity of NAS among those on MAT during pregnancy should focus on preventing poly-substance misuse and providing supports for other maternal health needs including treating mental illness.

The relationship between alcohol or drug use and subjective well‑being among master of social work students and practitioners was examined. Subjective well‑being measures included core, life satisfaction, affect, eudaimonia and domain evaluation. Frequency of alcohol, tobacco, cannabinoids and psychotropic drug use was collected. There were modest to moderate negative correlations between alcohol and life satisfaction and eudaimonia. There were moderate negative correlations between psychotropic medication and life satisfaction, eudaimonia and domain. There was a modest negative correlation between tobacco and life satisfaction and a strong negative correlation between tobacco and eudaimonia. There were no significant correlations with cannabinoids in any subjective well‑being measure. Together, these findings suggest that alcohol or drug use has little effect on subjective well‑being.

Research suggests evidence of an association between sociodemographic determinants and illicit drug use. However, these data do not take into consideration the effect an economic obstacle, such as a recession, could have on an individual's urge to cope with this stressful period with illicit drugs. Furthermore, there is no research to suggest how clinicians and/or treatment institutions can forecast whether the use of monetary resources will be sustainable due to private and/or governmental fund reductions during an economic recession. Based on theories of social learning and social disorganization within an ecological framework, this study employed a quantitative trend analysis to explore the impact the 2007-2009 economic recession had on illicit drug use throughout the United States. A sample of respondents from the Substance Abuse and Mental Health Data Archive from 2006 to 2010 surveys was used to run the statistical analysis. Based on the analyses, age and gender (covariates) and all variables (social disorganization and Gross Domestic Product) were found to be significant predictors of illicit drug use. Although methamphetamine was not significant for prevalence over time, total drug use, cocaine, and heroin were prevalent over time based on predictors. These findings suggest local, state, and federal policies regarding the prosecution and imprisonment of nonviolent and minor drug offenders should be reprioritized towards the rehabilitation of addicts while enforcing firmer laws upon the most disruptive and severe aspects of the drug trade in order to promote a genuine positive change towards social organization.

According to the CDC, young people, aged 15-24 years, share the greatest risk of new sexually transmitted diseases (STD) and the negative impact of alcohol and drug use. The purpose of this quantitative study, based on the theory of social-psychological problem-behavior, was to analyze the 2013 YRBSS secondary data and document if a relationship existed between race/ethnicity and youth sexual behavior, alcohol consumption, and drug use for the 13,583 survey participants. A Kolmogorov-Smirnov test and Chi-Square were conducted to answer the research questions. Results indicated that American Indian/Alaskan Natives were most likely to report first sexual activity before 11 years old (7.5%), while Asians were most likely to report never having sex (76.6%). Race/ethnicity also impacted all other variables, such as drugs, with a mixture of results. Hispanic/Latinos were most likely to report higher alcohol consumption (15.12%) compared to Multiple Hispanic (5.12%), while, Multiple Non-Hispanic were more likely to report use of drugs before sexual activity (9.7%) compared to Hispanic Latinos (7.99%). Social change implication of the study called for developed and effective sustainable interventions to help youth with behavior, and it required full integration of race/ethnicity as prerequisites in alleviation strategy. Dissemination plans involved use of public health campaigns, school workshops, and churches to fight the negative impact on youth.

Paralleling recent increased public awareness of transgender issues, gender nonconforming youth are coming out at increasingly earlier ages. It is important to understand the impact that family acceptance or family rejection has on the health outcomes of transgender young people, who are at increased risk of discrimination, prejudice, harassment, victimization, violence, and possible mental health issues and who are understudied. This understanding can be framed within the minority stress model and Carl Rogers' theory of self, which provide insight into how minority groups experience negative reactions from both society and an internalized sense of congruence. The purpose of this descriptive, cross-sectional, quantitative study was to measure the levels of negative health behaviors between transgender young adults who felt they had the support of their parents for their gender identity and those who did not. Data from 96 young transgender adults, between 18 and 25 years of age recruited through LGBT and transgender community organizations, were analyzed using correlation and logistic regression. Results showed significant relationships between the perception of parental support and suicidal ideation, number of suicide attempts, and illicit drug use. Findings from this study could contribute to positive social change by informing families, schools, health care providers, mental health practitioners, and policy makers about the significance of affirmative support for transgender youth. Quantifiable data regarding the impact of parental responses to a young person's gender identity could lead to the development of programs and policies leading to improved health outcomes for transgender youth.

Thesis (MPH.) -- University of Limpopo, 2012 / Tuberculosis (TB) is the cause of 1, 8 million deaths annually, 99% of the deaths occurs in the developing countries and among the poorest people of these countries. Studies between high and low income countries demonstrate that rates of TB are significantly higher in poorer populations. World Health Organization introduced DOTS as global strategy for providing TB services which was expected to be delivered primarily by government run public health services (Malmborg, Mann, Thomson, & Squire, 2006). AIM Investigate factors that influence compliance and non-compliance to treatment among patients on tuberculosis drug treatment. STUDY SITE This study was conducted in Shiluvane local area in Greater Tzaneen Municipality under Mopani District in Limpopo Province, South Africa. One district hospital, one health centre and five clinics were selected for this study: Dr CN Phatudi hospital, Shiluvane Health Centre, Moime, Lenyenye, Mogoboya, Maake and Lephepane Clinics. (v) STUDY DESIGN This is a quantitative and qualitative study as mixed methods were used to get a comprehensive research report. SAMPLING The sample size used 150 of a given population using Morgan and Krejcie table (1994). The case register was used to select respondents. The respondents were selected according to particular interval; each second name on the list was selected. Questionnaire and structured interview was selected for data collection. Questionnaires were distributed among clients who are able to read and write for them to complete, the researcher and the assistant helped to fill questionnaires for those who cannot read or write. The study was conducted at identified hospital, health center and clinics. RESULTS Education Level, the findings of this study displays that only 3,7% of participants hold tertiary qualifications, and 50% secondary education and 37,3% of primary education. Occupation, 76.4% of participants are unemployed. Income, 52,6% of participants earn between R1000-R2999 and 17,5% does not have income. (vi) CONCLUSION In conclusion based on the results and objectives of this study compliance with drug treatment among patients with tuberculosis in Shiluvane local Area, Mopani District, Limpopo province is 90.9%.

General strain theory has received a fair amount of empirical support and theoretical elaboration over the past several years. Since the introduction of general strain theory, Agnew and others have attempted to increase the comprehensiveness of the processes involved in strain theory. Until recently, the general strain theory literature has ignored what Agnew and associates (Agnew, Brezina, Wright, & Cullen, 2002) argue may be one of the most important conditioning effects of the strain-crime relationship, namely the dispositions or personality traits of the individual experiencing strain. Recently, Agnew and associates (2002) published results from a study examining the conditioning effects of personality traits (i.e., negative emotionality and low constraint) on the strain-delinquency relationship. Their findings indicated that certain personality traits significantly condition the effect of strain on delinquency. Research has suggested that more severe personality and behavioral traits, such as psychopathy, also influence criminality. The present study examined moderating effects of both personality dispositions and psychopathic behavioral features among a sample of 137 youths referred to juvenile diversion by the court system. The results suggest that personality dispositions and psychopathic behavioral features do not significantly moderate the strain-delinquency relationship. In addition, this study conducted ad hoc analyses examining whether or not delinquency significantly increases the likelihood that subsequent strain and delinquency will result (i.e., a state dependence explanation (see Nagin & Farrington, 1992; Nagin & Paternoster, 1991)). Moderating effects of personality and psychopathy were also included in this model. Further, the role of strain as a mediator for the personality and psychopathy link to delinquency was tested. The findings suggest that delinquency exacerbated subsequent strain and delinquency levels among these youths. Personality and psychopathic features did not moderate the strain-delinquency relationship. Strain did not significantly moderate the personality-delinquency relationship. Limitations and implications for future research and policy are discussed.

Substance use during adolescence is of particular concern because it is known to be associated with many undesirable outcomes. When an adolescent discovers that a peer is using substances, he or she is faced with a decision regarding the response to be taken (e.g., use substances with the peer, report it to authorities, tell the peer to stop). Available literature has given little consideration to this issue; therefore, the current study sought to examine the response of adolescents to discovering that a peer is using substances, within an ethnically diverse sample of 139 students from a public high school located in Florida. Since responses taken likely vary based on adolescents' own personal traits and characteristics, this study investigated how adolescents' gender, ethnicity, socio-economic status, grade level, and own use or non-use of substances were related to their response to discovering that a peer is using substances. Findings revealed that those students that reported personal marijuana use were more likely to report that they would respond to peer substance use in an undesirable way (e.g., use with the peer, do nothing), and less likely to take a positive action of any sort (e.g., discuss the peer's substance use with a trusted adult, tell the peer to stop). A second purpose of this study was to examine whether or not an adolescent's relationship with the peer using drugs or alcohol (specifically, close friend versus classmate) was related to the action the adolescent takes in response to the peer's substance use. Findings revealed that overall students reported a higher likelihood that they would take a positive action of some sort if the peer using substances was a close friend than a classmate. More specifically, more students reported that they would tell a close friend to stop using substances than tell a classmate the same thing. On the other hand, students also reported that they would be more likely to use substances with a close friend than with a classmate. Implications of these findings for future research and practice are discussed.