This thesis is about clients who are in treatment in therapeutic communities for drug addicts and suffer with a mental illness alongside drug addiction. The theoretical part summarizes the definition and description of dual diagnosis, the prevalence of people with dual diagnosis and discusses the possibilities of therapeutic approaches to clients with these specific demands. Finally, attention is paid to the theory of self-medication for symptoms of mental illness through addictive substances which supports the theoretical model of addiction as a result of reactions to psychiatric illness. The research was carried out at the research group, which was formed by all clients currently in treatment in two therapeutic communities for drug addicts in July 2015. The research was conducted as a quantitative design through non-standardized questionnaire. This research shows that from the total number of respondents, 79% had a psychiatric diagnosis in addition to substance abuse. Most often these were methamphetamine users and multiple substance users. From psychiatric disorders were most strongly represented personality disorders, depressive disorders and disorders from psychotic spectrum. With respondents who reported substance abuse to suppress psychopathological symptoms occurred reduction of most of...

Understanding Medication Self-Management Capacity among Older Adults Living in Low-Income Housing Communities ABSTRACT Background: Medication self-management capacity (MMC) is an individual’s cognitive and functional ability to self-administer a medication regimen as prescribed. Poor MMC is an issue in older adults often resulting in negative health outcomes and loss of independence. Therefore, understanding low-income older adults’ capacity to manage their medications may help identify individuals who are at risk for developing medication mismanagement and guide future intervention strategies based on an individual need to promote safe medication use and healthy aging in place in the community. Objectives: 1) To determine the cognitive and physical functional deficiencies in MMC among low-income older adults, 2) To identify variables that predict deficiencies in MMC in this population, 3) To determine the impact of using pharmaceutical aids/services on MMC, and 4) To examine the association between MMC and emergency room (ER) visits. Methods: This was a cross-sectional study of older adult residents living in low-income housing buildings served by the RHWP. At a study interview, information on demographics, medical history, and medication use was collected. MMC was evaluated using the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) tool. Cognitive and functional status, health literacy and depression symptoms were assessed. ER visits were determined retrospectively over the last six months Descriptive analyses were performed to identify cognitive and physical functional deficiencies in MMC. Linear regression analysis was conducted to identify variables that predict MMC and assess the relationship between MMC and using pharmaceutical aid/service. Logistic regression analysis was used to examine the association between ER visits and MMC. Results: A total of 107 participants were included, and 89% were African-American with an average age of 68.54 years (±7.23). They had an average of 4.92 (±2.85) comorbidities and used approximately 8 (±4.12) medications on a regular basis. The mean total deficiency in medication management was 3 (±2.00) as assessed by MedMaIDE. Lacking medication knowledge was common among the participants: 69.16% could not name and 46% state the indication of all of their medications, and 38.32% did not how and when all of their medications should be taken. When controlling for ADLs and falls, the mean total deficiency score in MedMaIDE increased among those with an educational level equal to high school or less compared with participants who had a higher educational level than high school [β=1.32, 1.24, p= 0.0195, 0.0415, respectively], and participants who reported difficulty reading prescription medication labels or opening medication bottles compared with those who did not report any difficulties [β=1.18, 1.43, p= 0.0036, 0.0047, respectively]. About 20.56% of participants were receiving assistance with medications from someone, and 79.44% used at least one pharmaceutical aid/service. However, receiving assistance with medications and using pharmaceutical aid/service were not significantly associated with MMC [p= 0.5334, 0.0853, respectively]. The participants reported a total of 23 (21.5%) ER visits within six months. The adjusted model for age, educational level, number of comorbidities, and ADLs suggested that for every one-unit increase in the total deficiency score, the odds of ER visits increased by 1.23 (p=0.1809) times. Conclusion: Many older adults who lived in low-income housing had impaired capacity to manage their medications independently. They appeared to have inadequate medication knowledge, which affects their cognitive ability to manage medications. Low educational level and health literacy and reporting trouble reading labels or opening medication bottles were predictors to deficient MMC. Future studies are needed to confirm whether or not MMC predicts those who may not able to remain living independently safely or who may need additional support with medications to remain independent.

Introduction: The thesis deals with the relationship between substance use and eating disorder. In particular, it focuses on the phenomenon of self-medication substance abuse among women who have experienced an eating disorders. The theoretical part provides a comprehensive picture of the studied issue, supported by Czech and international research in the area. The empirical part is based on qualitative data collection and consists of a combination of short case studies and thematic analysis. Objectives: The main aim of the thesis is to map out and find out whether women who suffer from eating disorders use addictive substances, including alcohol, for the purpose of self-medication. The thesis also aims to find out whether there is a difference between the different forms of eating disorders and the pattern of substance use. Sample: The research sample consisted of 10 women aged 19 - 38 years who have had experiences with eating disorders. Methods: The method of semi-structured interview was chosen for the purpose of the research. The data obtained were presented using short case reports. The case studies were supplemented by a timeline and a test battery, which consisted of AUDIT, DAST and FTND questionnaires for better orientation of the researcher. The data were subsequently analyzed through...

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Acompanha: Ensino de química na EJA na perspectiva CTS: a partir da automedicação / O ensino de Química para a Educação de Jovens e Adultos (EJA) deve ser trabalhado de forma diferenciada em relação ao ensino regular, devido à especificidade da modalidade. A partir disso, essa pesquisa, que apresenta como proposta metodológica a temática automedicação, na abordagem Ciência Tecnologia e Sociedade (CTS), pode contribuir para ensinar Química na EJA, considerando o público dessa modalidade. Para isso, tem como objetivo identificar, propostas voltadas à EJA, desenvolver uma sequência de aulas a partir da temática "automedicação para o ensino de Química na EJA, na perspectiva CTS", avaliar o desenvolvimento da sequência de aulas e apresentar um Caderno de Orientações Pedagógicas. A temática propõe discutir as principais situações e/ou problemas de saúde enfrentados pelas pessoas, em especial os estudantes da EJA, trabalhando o conteúdo de forma contextualizada e, ainda, identificar a contribuição, colaborando na discussão e reflexão, valorizando a construção do conhecimento científico e o cotidiano do sujeito para tomadas de decisões e preparando o estudante para questionar, participar e construir coletivamente respostas para problemas sociais. Fundamentada na abordagem qualitativa, a pesquisa é caracterizada como pesquisa-ação. Os interlocutores envolvidos para esta pesquisa foram a professora pesquisadora da disciplina de Química e 18 estudantes, com idade entre 19 e 34 anos, de uma turma de Química da EJA, que estudam no período noturno, do CEEBJA Professora Laís Miqueloto, localizado na cidade de Curitiba–PR. O estudo no colégio foi desenvolvido no primeiro semestre de 2016. Para o levantamento de dados foram utilizados triangulação múltipla a partir dos instrumentos com roda de conversa, questionário, filmagem, registros da professora pesquisadora, registros dos estudantes e a produção de um jogo de papéis gerado durante a aplicação da metodologia, com o propósito de analisar as respostas dos estudantes sobre o assunto, sendo que esses se constituíram o corpus da pesquisa, na qual utilizou-se a Análise Textual Discursiva (ATD). A partir da ATD podem ser geradas categorias a priori, e após analisar os dados coletados de cada instrumento, as possíveis categorias emergentes. De acordo com a análise, considera-se que por meio da sequência de aulas, abordando a temática automedicação, é possível contribuir com as propostas metodológicas voltadas a esta modalidade de ensino, uma vez que permitiu a apropriação e a contextualização do conhecimento por meio da abordagem CTS, colaborando significativamente para a compreensão do conhecimento científico e das suas inter-relações com a sociedade e a tecnologia. Os resultados obtidos podem ser um ponto de partida para pesquisas futuras, com o intuito de melhorar a formação dos estudantes e contribuir na tomada de decisão e para que sejam capazes de opinar sobre aspectos do cotidiano. Após a análise dos dados gerados com o uso dos instrumentos, foi desenvolvido um Caderno de Orientações Pedagógicas como produto final da pesquisa, sendo este um item obrigatório no mestrado profissional. / The teaching of Chemistry for the Education of Young and Adults (EJA), must be worked in a differentiated way in relation to the regular education, due to the specificity of the modality. From this, the research presents as a methodological proposal on the subject of self-medication, in the approach Science Technology and Society (STS) can contribute to teach Chemistry in the EJA, considering the specificity of the public of this modality. To do so, it aims to identify, analyze proposals aimed at this modality, develop a sequence of classes from the subject of self-medication for the teaching of Chemistry in the EJA in the STS perspective, evaluate the development of the sequence of classes and present a Notebook of Pedagogical Guidelines. The theme proposes to discuss the main health situations and / or problems faced by people, especially those students of the EJA from this subject, working the content in a contextualized way, also to identify the contribution of this subject in the teaching of Chemistry. As well as collaborating in the discussion and reflection, valuing the construction of scientific knowledge and the daily life of the subject for decision making, and also preparing the student to question, participate and collectively build responses to social problems. Based on the qualitative approach, research is characterized as action research. The interlocutors involved in this research were the research professor of the chemistry discipline and 18 students, aged between 19 and 34 years, from a chemistry class of the EJA, at night, of the CEEBJA Professor Laís Miqueloto, in the city of Curitiba – PR. The study in the college was developed in the first half of 2016. For the data collection, multiple triangulation was used from the conversation wheel, questionnaire, filming, researcher's records, student records and the production of a set of papers generated during the application Of the methodology, with the purpose of analyzing the students' answers on the subject. Being that these constituted the corpus of the research, in which the Discursive Textual Analysis (DTA) was used. From DTA, a priori categories can be generated, and after analyzing the data collected from each instrument the possible emergent categories. From the analysis, it is considered that through the sequence of classes addressing the subject of self-medication can contribute with the methodological proposals focused on this modality of teaching, since it allowed the appropriation and contextualization of knowledge through the STS approach, Contribute significantly to the understanding of scientific knowledge and its interrelationships with society and technology. The results obtained can be a starting point for future research, in order to improve student training and contribute to decision making and to be able to comment on aspects of daily life. After analyzing the data generated with the use of the instruments, a Pedagogical Guidelines Book was developed as the final product of the research, which is a mandatory item in the professional master's degree.

Objetivo: desenvolver sistema de suporte à decisão clínica dos farmacêuticos no manejo de sintomas menores (SM) com medicamentos isentos de prescrição (MIPs). Métodos: Inicialmente, foi realizada uma revisão sistemática, entre janeiro 1980 a agosto de 2010, nas bases de dados Medline/Pubmed, Scopus, Lilacs e Embase. Posteriormente, uma amostra de conveniência de farmacêuticos comunitários (FC) participou de uma entrevista semiestruturada realizada nas farmácias comunitárias de duas grandes redes em Aracaju, no período de Junho a Agosto de 2012. Em seguida, a metodologia do paciente simulado (PS) foi aplicada a mesma amostra de FC com dois casos de SM (1 - mulher adulta com sinusite; 2 - mulher grávida com tosse seca e dor nas costelas). As simulações foram avaliadas de acordo com o instrumento desenvolvido pela Farmacopéia dos Estados Unidos (USP) chamado "Medication Counseling Behavior Guidelines" e validado para o português. No período de fevereiro de 2012 a janeiro de 2014, foi desenvolvido um software para auxiliar o farmacêutico no processo de manejo de SM do trato respiratório com MIPs. Para tanto, 7 farmacêuticos clínicos, juntamente com engenheiros de produção, determinaram o conteúdo dos algoritmos. Resultados: Apenas nove artigos preencheram todos os critérios de inclusão estabelecidos na revisão sistemática. Foi observado que quatro estudos relataram adesão do paciente a orientação do farmacêutico. Participaram da entrevista 40 FC e destes, 62,9% não cursaram na graduação disciplina sobre o manejo de SM. As respostas dos FC sobre sua atitude frente a automedicação, revelou que a depender do tempo da queixa eles indicam um tratamento ou encaminham o paciente ao médico. Foram realizadas 80 simulações que apresentaram um tempo total de atendimento farmacêutico de 91,31 segundos (DP ±68,63). A análise das simulações revelou que 83,3% e 72,5% dos FC recomendaram a visita ao médico para o PS1 e para o PS2, respectivamente. Foi observado que 45% e 17% dos FC revisaram a solicitação do paciente antes da orientação. No processo de desenvolvimento do software, os farmacêuticos especialistas apontaram que os algoritmos deveriam explorar as características dos SM (início, frequência, duração), os tratamentos farmacológicos e não- farmacológicos apropriados e os parâmetros de encaminhamento do paciente ao médico. A versão final do software proporciona a determinação de diagnóstico condizente com o conjunto de sinais e sintomas do paciente, retornando ao farmacêutico uma pequena lista das possíveis enfermidades. Conclusão: O software poderá melhorar as condições de trabalho dos farmacêuticos comunitários, adicionando-lhes maior evidência cientifica no manejo de SM com MIPs.

The purpose of this research is to empirically investigate consumers' health care decision choices in a dynamic market setting. The unprecedented demands on the U.S. health care system coupled with the mounting controversies surrounding health care reform suggest that consumers' health care decisions warrant empirical research attention. Toward this end, this dissertation empirically explored (1) the characteristics of consumers who possess a willingness to use non-conventional treatments over conventional treatments, (2) the characteristics of consumers who elect self-medication in lieu of health care practitioner-directed medication, and (3) the salient dimensions of consumers' channel choice for the procurement of health care products. Each of these decision choice factors were tested across two U.S. generational segments to assess whether differences existed across Baby Boomers' and Gen Yers' health care decision choices. The conceptual framework for empirical assessment is Bandura's (1986) social cognitive theory. From Bandura's social cognitive theory, a general model of healthcare decision choice is proposed to assess consumers' states of mind, states of being and states of action (decision choice). Results indicate that social cognitive factors (e.g., self-efficacy, objectivism) play an important role in each of the decision domains explored in this dissertation. Moreover, health value was found to be an important moderator between the social cognitive factors and health care decision choices. The predictors of the health care decision choices were found to vary across the Baby Boomers and Generation Yers on several dimensions, confirming the notion that generational differences may be a salient dimension of consumers' health care decision choice. The research offers several implications for practitioners, academicians and policy makers. Both descriptive and normative implications are gleaned from the research findings. Most notably, the results indicate that consumers' social cognitive factors and health value may be mechanisms for managing health care decisions.

La presente investigación tiene como objetivo conocer cuál es la relación que existe entre las estrategias de promoción y el posicionamiento de los medicamentos de libre prescripción o también denominados Over the Counter (OTC). Desde el punto de vista del marketing, esta investigación suele ser bastante atractiva ya que la industria farmacéutica, una de las más poderosas del mundo, tiende a tener bastantes restricciones por parte del estado, por lo que la manera de promocionar sus productos suele ser bastante limitada, la creatividad, es un concepto clave para que ellos puedan desarrollar estrategias de promoción que les permitan tener un crecimiento en ventas y un posicionamiento de marca definido. Dichas estrategias vienen acompañadas de acciones tácticas como líderes de opinión, recortes en prensa, promoción en redes sociales y publicidad masiva, permitiendo que los medicamentos sean consumidos y recordados por el público objetivo. Sin embargo, existe una línea bastante fina si es que realmente los medicamentos se deben de seguir promocionando, ya que esto puede incurrir a que las personas se automediquen, tomando decisiones por su propia cuenta sin consultar a un médico especialista. / This research aims to understand the relationship between promotion strategies and the positioning of free prescription drugs or also called Over the Counter (OTC). From a marketing point of view this research is usually quite attractive since the pharmaceutical industry, one of the most powerful in the world tends to have quite a few restrictions on the part of the state, so the way to promote its products is usually quite limited, creativity, is a key concept for them to develop promotion strategies that allow it to have a growth in sales and a defined brand positioning. These strategies are accompanied by tactical actions such as opinion leaders, press cuts, social media promotion and mass advertising, allowing drugs to be consumed and remembered by the target audience. However, there is a fairly fine line if drugs really should be further promoted, as this may result in people self-medicating, making decisions on their own without consulting a specialist doctor. / Trabajo de investigación