Utilizing a well-established manualized alcohol-focused intervention, the Brief Alcohol Screening for College Students (BASICS), this study explored the efficacy of implementing BASICS in a small group setting for mandated college students. The study assessed pretest and posttest data over a two month period to explore whether participation in the small group implementation of BASICS was associated with changes in substance use and related risk factors (i.e., alcohol use, marijuana use, typical blood alcohol concentration, peak blood alcohol concentration, hazardous drinking, alcohol consequences, risky sexual behavior, and depression and anxiety), pro-social change factors (i.e., harm reduction, readiness for change, and student engagement), and coping behaviors. Repeated measures multivariate analyses of variance and covariance were conducted with a final sample of 52 participants. Multivariate analyses were examined with and without the use of covariates (baseline alcohol use and alcohol consequences scores) for substance use and related risk factors and pro-social change factors. Further exploration of substance use and related risk factors were conducted with the addition of marijuana condition. A final set of analyses explored fourteen subscales of coping behaviors. Given limitations surrounding small and homogenous sampling, results should be interpreted with caution. The main analyses revealed no significant differences between the intervention and waitlist control group for substance use and related risk factors outcomes. This study is unable to make a definitive judgment on the effectiveness of BASICS implemented in small group setting for mandated students; however, findings suggest that in a small group setting BASICS may facilitate a reduction in engagement with substance use behaviors and associated consequences but does not promote lower risk practices. The examination of the marijuana condition revealed that participants who endorsed marijuana use demonstrated higher baseline scores for alcohol use, hazardous drinking, alcohol consequences, and risky sexual behavior. Overall, further analyses need to be conducted to determine the effectiveness of BASICS implemented in a small group setting for mandated students. These future research endeavors may benefit from collaborative efforts to increase sample size and implement the intervention with more diverse student populations.

A pesquisa que deu vida a esta tese teve como objetivo seguir rastros da construção de corpos inseridos num Centro de Atenção Psicossocial para Álcool e outras Drogas (CAPS ad) de Aracaju, Sergipe, particularmente, em seus arranjos de masculinidades. A tentativa foi a de forjar um corpo de pesquisa e de escrita bem ali entre o mandato de produzir corpos normalizados, identificados, generificados e a teimosia em resistir desses mesmos corpos submetidos a tal mandato, inclusive do próprio corpo do cuidado. As perguntas que nortearam esta pesquisa foram: que insistências, que (re)existências experimentam corpos num cenário de cuidado em álcool e outras drogas? Que (re)existências experimentam corpos num contexto biopolítico de face neoliberal, em que o exercício de poder pretende encerrar a produção da vida e dos corpos humanos numa dimensão empresarial, fabricando corpos e sujeitos empreendedores de si? Os campos teóricos que fundamentaram a pesquisa foram os estudos foucaultianos, alinhavados por algumas questões e conceitos de Nietzsche, Deleuze e Guattari operados no campo da saúde pública, em particular, o da saúde mental, bem como no dos estudos de gênero e sexualidade. Para a montagem metodológica, inspirou-se em questões propostas pelo método etnográfico, em discussões da escola francesa de análise institucional e em pistas apontadas pela cartografia. Os dados foram produzidos por meio de: 1) cadernos de formação desenhados durante o trabalho na rede de saúde mental aracajuana e no CAPS ad em particular, bem ali onde um processo de trabalho se constituiu como uma paisagem de formação e pesquisa; 2) diários de campo; 3) entrevistas individuais com usuários/as e profissionais; 4) grupos focais com usuários/as e profissionais; 5) roda de conversa com usuários de álcool e outras drogas numa praça da cidade; e 6) realização de uma oficina de “contação de histórias”. Foi pactuado um modo coletivo de acompanhamento da pesquisa e produção de análises por meio da formação de um grupo pesquisador composto por duas profissionais do CAPS ad, duas profissionais e um profissional do Projeto de Redução de Danos e um usuário. Os seguintes eixos funcionaram como focos para a produção de análises: corpo, gênero, sexualidade, cuidado em ad; arranjos corporais, arranjos de gênero e sexualidade; arranjos terapêuticos em articulação com arranjos pedagógicos; CAPS como um território de ensino e formatação corporal; CAPS como território de (des)aprendizagens corporais, abertura dos corpos para a variância, para composição de novas formas, inclusive do corpo do cuidado; projetos terapêuticos como projetos pedagógicos; projetos terapêuticos-pedagógicos de gênero. A partir desse itinerário de pesquisa, se o que se quer é resistir ao biopoder por meio de um acompanhar a potência dos corpos, sinaliza-se a importância da composição de uma clínica da experimentação, clínica artesanal, menor; clínica das passagens, da (des)aprendizagem, da abertura dos corpos para outras rotas, outras formas. / The research which has brought the present thesis to life was aimed at following traces of the construction of bodies involved in a public alcohol and drug rehab center called ‘Centro de Atenção Psicossocial para Álcool e outras Drogas/CAPS ad’ in the city of Aracaju, Sergipe, mainly in their arrangements of masculinity. The attempt was to form a body of research and writing right in between the mandate of producing normalized, identified, generalized bodies and the stubbornness of these bodies – submitted to such mandate, including that of the caring body itself – in resisting. The questions which the research was based upon were: what insistences, what re-existences do these bodies experience in a care scenario of alcohol and drugs? What re-existences do these bodies face in a neoliberal biopolitical context, in which the exercising of power is intended extinguish the production of life and human bodies in a corporate context, manufacturing bodies and subjects that are entrepreneurs of themselves? The theoretical fields which served as fundaments for this research were the foucaultian studies, complemented by some issues and concepts of Nietzsche, Deleuze and Guattari operated in the field of public healthcare, particularly in mental health, as well as gender and sexuality studies. The methodological foundation was inspired by questions and issues posed by the ethnographic method, in discussions of the French school of Institutional Analysis and also clues and leads pointed out by cartography. Data were obtained by means of: 1) study notebooks used during the work at the City of Aracaju’s mental healthcare network, especially at CAPS ad, right in the place where the work began to build the grounds for further studies and research; 2) field diaries; 3)one on one interviews with patients and professionals; 4) focus groups with patients and professionals; 5) informal conversation circle with alcohol and drug users at a city square; and 6) “story telling” workshop. A collective research monitoring and analysis system was agreed on, one which was formed by two CAPS ad professionals, three Damage Mitigation Project professionals and one patient. The following guidelines served as analytical directions in the process: body, gender, sexuality, alcohol and drug care; bodily arrangements, gender and sexuality arrangements; therapeutic arrangements in articulation with pedagogical arrangements; CAPS as a teaching and body formation territory, CAPS as a bodily (un)learning territory; the opening of bodies to variance, to the composition of new forms, including the caring body; therapeutic projects as pedagogical projects, therapeutic-pedagogical projects of gender. Based on that research direction, if the intention is to resist biopower by means of keeping up with the potency of bodies, the importance of the composition of an experimentation clinic, a smaller handcrafted clinic; the clinic of passages, of (un)learning, of the opening of bodies to other routes, other forms, becomes noticeable.

Abstract Background People with alcohol and other drug (AOD) problems are offered treatment by a variety of organisations in the non-government sector, many of which have religious affiliations. Little is known about the actual treatment offered, and whether the ideology of the organisation has an impact on the choice of treatment provided. Christian churches were amongst the first service-delivery organisations in the Australian AOD sector, and those remaining in the sector appear to have evolved from providing overt Christian-care to providing some evidence-based care in line with the move to best practice under Australia’s National Drug Strategy. It remains to be determined, however, whether the approach to treatment and service provision by religiously-affiliated agencies is influenced by their religious background and orientation. To resolve this gap in knowledge a national survey of non-government AOD agencies was conducted in late 2005–early 2006. Methods Survey participants consisted of all identified non-government AOD agencies in Australia. The operational definition of AOD agencies was in keeping with definitions used in other investigations in the sector. The sample frame was compiled using the most recent directories and databases available. Two questionnaires were posted to 331 agencies throughout Australia. Responses were sought from both the director/coordinator and a staff member working directly with clients. Completed questionnaires were received from 169 (51 per cent) of agencies. A completed questionnaire from both the director/coordinator and an AOD worker was received from 90 of these 169 agencies. Where this was the case, the response from the director/coordinator was taken to be the ‘agency response’. Questions were about the agency’s profile, goals, activities, the respondent’s own view of substance dependence and the respondent’s demographic characteristics. Qualitative methods were also used to gain further information and clarification from key informants, both prior to and after the quantitative survey. Findings There was surprising homogeneity amongst all agencies in their use of the eight treatment orientations studied (12-step, therapeutic community, cognitive behaviour, psychodynamic, rehabilitation, dual diagnosis, medical, and family). Cognitive behaviour therapy was the most popular treatment across all types of agencies in contrast to the 12-step approach which was only a major focus for a small number of agencies. Psychodynamic and therapeutic community orientations were also widely used but family and rehabilitation orientations were amongst the least popular orientations. With the family orientation there was a wide discrepancy between agencies that had family goals but not family activities. In regard to accessing treatment, mothers accompanied by their children and couples were the two groups least likely to be accepted into treatment (44 per cent and 40 per cent respectively did not accept couples). Directors interviewed in this study indicated that not accepting mothers accompanied by their children was due to the cost of providing relevant services. Of the agencies surveyed, 42 per cent were affiliated with a church organisation. Although 85 per cent of church-affiliated agencies indicated that they received some contribution towards policy from a religious organisation, results suggested that there was very little difference between church-affiliated and non-church-affiliated agencies in service delivery. One area of significant difference between church-affiliated and non-church-affiliated agencies was access. Church-affiliated agencies were significantly more likely than non-church-affiliated agencies to not accept couples, Indigenous people, and people referred from the criminal justice system. Church-affiliated agencies were also significantly more likely to take into consideration a prospective client’s motivation to succeed. Across all agencies activities of a spiritual nature (e.g. meditation/prayer, talking with clients about spirituality/religion) were only a major feature for a small number of agencies; although 70 per cent of agencies included developing a client’s spiritual self in their goals. The majority of directors/coordinators indicated that they have a broad set of beliefs about substance use that allows for various social and psychological understandings and treatment responses. Conclusion Overall, there was uniformity in the type of treatment goals and activities offered by the non-government AOD agencies. The findings suggest that churches are becoming indistinguishable from secular organisations in their delivery of AOD services. Where once there may have been faith in religion as a basis of service provision there now appears to be faith in science. This is in the context that the ‘best evidence’ of effective treatments suggests that most treatments are relatively weak predictors of a positive outcome, and that the choice of treatment may not impact on treatment outcomes. The evidence-based medicine movement may have become a form of religion and, in association with a population health approach, is dominating the AOD service delivery sector. Although successful drug treatment programs may well require that the client/patient undergo moral and value changes, these may occur without connection to organised religion. Ideology in the form of religious belief has historically played a central role in treatment choices and it continues to do so in the form of an ideology giving priority to best practice, despite the likelihood that best practice may nevertheless continue to produce poor outcomes.

A pesquisa que deu vida a esta tese teve como objetivo seguir rastros da construção de corpos inseridos num Centro de Atenção Psicossocial para Álcool e outras Drogas (CAPS ad) de Aracaju, Sergipe, particularmente, em seus arranjos de masculinidades. A tentativa foi a de forjar um corpo de pesquisa e de escrita bem ali entre o mandato de produzir corpos normalizados, identificados, generificados e a teimosia em resistir desses mesmos corpos submetidos a tal mandato, inclusive do próprio corpo do cuidado. As perguntas que nortearam esta pesquisa foram: que insistências, que (re)existências experimentam corpos num cenário de cuidado em álcool e outras drogas? Que (re)existências experimentam corpos num contexto biopolítico de face neoliberal, em que o exercício de poder pretende encerrar a produção da vida e dos corpos humanos numa dimensão empresarial, fabricando corpos e sujeitos empreendedores de si? Os campos teóricos que fundamentaram a pesquisa foram os estudos foucaultianos, alinhavados por algumas questões e conceitos de Nietzsche, Deleuze e Guattari operados no campo da saúde pública, em particular, o da saúde mental, bem como no dos estudos de gênero e sexualidade. Para a montagem metodológica, inspirou-se em questões propostas pelo método etnográfico, em discussões da escola francesa de análise institucional e em pistas apontadas pela cartografia. Os dados foram produzidos por meio de: 1) cadernos de formação desenhados durante o trabalho na rede de saúde mental aracajuana e no CAPS ad em particular, bem ali onde um processo de trabalho se constituiu como uma paisagem de formação e pesquisa; 2) diários de campo; 3) entrevistas individuais com usuários/as e profissionais; 4) grupos focais com usuários/as e profissionais; 5) roda de conversa com usuários de álcool e outras drogas numa praça da cidade; e 6) realização de uma oficina de “contação de histórias”. Foi pactuado um modo coletivo de acompanhamento da pesquisa e produção de análises por meio da formação de um grupo pesquisador composto por duas profissionais do CAPS ad, duas profissionais e um profissional do Projeto de Redução de Danos e um usuário. Os seguintes eixos funcionaram como focos para a produção de análises: corpo, gênero, sexualidade, cuidado em ad; arranjos corporais, arranjos de gênero e sexualidade; arranjos terapêuticos em articulação com arranjos pedagógicos; CAPS como um território de ensino e formatação corporal; CAPS como território de (des)aprendizagens corporais, abertura dos corpos para a variância, para composição de novas formas, inclusive do corpo do cuidado; projetos terapêuticos como projetos pedagógicos; projetos terapêuticos-pedagógicos de gênero. A partir desse itinerário de pesquisa, se o que se quer é resistir ao biopoder por meio de um acompanhar a potência dos corpos, sinaliza-se a importância da composição de uma clínica da experimentação, clínica artesanal, menor; clínica das passagens, da (des)aprendizagem, da abertura dos corpos para outras rotas, outras formas. / The research which has brought the present thesis to life was aimed at following traces of the construction of bodies involved in a public alcohol and drug rehab center called ‘Centro de Atenção Psicossocial para Álcool e outras Drogas/CAPS ad’ in the city of Aracaju, Sergipe, mainly in their arrangements of masculinity. The attempt was to form a body of research and writing right in between the mandate of producing normalized, identified, generalized bodies and the stubbornness of these bodies – submitted to such mandate, including that of the caring body itself – in resisting. The questions which the research was based upon were: what insistences, what re-existences do these bodies experience in a care scenario of alcohol and drugs? What re-existences do these bodies face in a neoliberal biopolitical context, in which the exercising of power is intended extinguish the production of life and human bodies in a corporate context, manufacturing bodies and subjects that are entrepreneurs of themselves? The theoretical fields which served as fundaments for this research were the foucaultian studies, complemented by some issues and concepts of Nietzsche, Deleuze and Guattari operated in the field of public healthcare, particularly in mental health, as well as gender and sexuality studies. The methodological foundation was inspired by questions and issues posed by the ethnographic method, in discussions of the French school of Institutional Analysis and also clues and leads pointed out by cartography. Data were obtained by means of: 1) study notebooks used during the work at the City of Aracaju’s mental healthcare network, especially at CAPS ad, right in the place where the work began to build the grounds for further studies and research; 2) field diaries; 3)one on one interviews with patients and professionals; 4) focus groups with patients and professionals; 5) informal conversation circle with alcohol and drug users at a city square; and 6) “story telling” workshop. A collective research monitoring and analysis system was agreed on, one which was formed by two CAPS ad professionals, three Damage Mitigation Project professionals and one patient. The following guidelines served as analytical directions in the process: body, gender, sexuality, alcohol and drug care; bodily arrangements, gender and sexuality arrangements; therapeutic arrangements in articulation with pedagogical arrangements; CAPS as a teaching and body formation territory, CAPS as a bodily (un)learning territory; the opening of bodies to variance, to the composition of new forms, including the caring body; therapeutic projects as pedagogical projects, therapeutic-pedagogical projects of gender. Based on that research direction, if the intention is to resist biopower by means of keeping up with the potency of bodies, the importance of the composition of an experimentation clinic, a smaller handcrafted clinic; the clinic of passages, of (un)learning, of the opening of bodies to other routes, other forms, becomes noticeable.

Made available in DSpace on 2014-06-11T19:29:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2005Bitstream added on 2014-06-13T18:38:41Z : No. of bitstreams: 1 souza_n_me_assis.pdf: 417166 bytes, checksum: d2ad00721b573b416fe5fae4a59a4819 (MD5) / O presente estudo tem por objetivo cartografar as práticas de atenção e cuidado para aqueles que sofrem com transtornos decorrentes do uso de álcool e de outras drogas nas ações do serviço público em territórios de risco social. Na primeira cartografia, descrevemos o trabalho desenvolvido através da ONG Vir a Ser no projeto Conquistando a cidadania, que vem a ser um subprojeto do Programa Estadual Adolescer é preciso. Este trabalho foi desenvolvido na cidade de Londrina (PR), no período compreendido entre março e novembro de 2003, nos territórios Jardim Santa Fé e Jardim Monte Cristo, situados na região Leste da cidade e considerados de risco. Esta condição é decorrente de um cenário de pobreza e violência, zona de intenso tráfico de drogas ilícitas e de alto consumo de álcool e outras drogas. Nossa proposta foi desenvolver estratégias com os adolescentes, suas famílias e a comunidade em que vivem para buscar as ofertas que existem para além das drogas, bem como promover a comunicação para a melhoria da qualidade da relação adolescente/família/escola/comunidade. Na segunda cartografia, estão os diferentes circuitos que compõem as estratégias de intervenção que foram sendo delineadas durante nossa permanência no território, criando vias de acesso para outros circuitos que atravessavam nosso trabalho, nos encontros na comunidade, nas conversas com os adolescentes e nas demandas que foram surgindo na rede estabelecida entre nós. Na terceira cartografia, analisamos como estão sendo concebidas as políticas públicas para a questão do álcool e outras drogas e como as ações delas decorrentes estão sendo conduzidas naquele território. Como o Estado não tem aparatos adequados, ele terceiriza os serviços com o repasse financeiro para ONGs... / The objective of this study was to map out the attention and care practices adopted by public services with people suffering from disorders caused by alcohol and other drugs, in grounds considered socially dangerous. The first mapping describes the work developed by the NGO Vir a Ser as part of the project Conquistando a Cidadania , a by-project of the State Program Adolescer é preciso. This study was carried out in the city of Londrina, Paraná, Brazil, between March and November 2003 , at Jardim Santa Fé and Jardim Monte Cristo neighborhoods, in the West Side of the city, known as socially dangerous grounds due to poverty ,violence, intense alcohol and drug use and dealing. Our proposal was to develop strategies together with the adolescents , their families , the schools , and the community they live in , to find opportunities to help them overcome their drug-related problems , and to improve the communication among them. The second mapping shows the different circuits that made out the intervention strategies developed during our stay in the area, which gave access to other circuits that permeate our work in community meetings, talks with the adolescents, and in other situations imposed by the network established among us. The third mapping analyses how the public policies for alcohol and drug issues are being formulated and how their actions are being implemented. As the State lacks adequate infrastructure , it has outsourced these services to NGOs. In the last part of this work we analyze the work of charity and religious institutions, which usually emphasizes abstinence, creating a tension that goes against all national and local damage reduction guidelines.

Orientador : Sônia Aparecida Moreira França / Banca: Leila Sollberger Jeolás / Banca: Cristina Amélia Luzio / Resumo: O presente estudo tem por objetivo cartografar as práticas de atenção e cuidado para aqueles que sofrem com transtornos decorrentes do uso de álcool e de outras drogas nas ações do serviço público em territórios de risco social. Na primeira cartografia, descrevemos o trabalho desenvolvido através da ONG "Vir a Ser" no projeto "Conquistando a cidadania", que vem a ser um subprojeto do Programa Estadual "Adolescer é preciso". Este trabalho foi desenvolvido na cidade de Londrina (PR), no período compreendido entre março e novembro de 2003, nos territórios Jardim Santa Fé e Jardim Monte Cristo, situados na região Leste da cidade e considerados de risco. Esta condição é decorrente de um cenário de pobreza e violência, zona de intenso tráfico de drogas ilícitas e de alto consumo de álcool e outras drogas. Nossa proposta foi desenvolver estratégias com os adolescentes, suas famílias e a comunidade em que vivem para buscar as ofertas que existem para além das drogas, bem como promover a comunicação para a melhoria da qualidade da relação adolescente/família/escola/comunidade. Na segunda cartografia, estão os diferentes circuitos que compõem as estratégias de intervenção que foram sendo delineadas durante nossa permanência no território, criando vias de acesso para outros circuitos que atravessavam nosso trabalho, nos encontros na comunidade, nas conversas com os adolescentes e nas demandas que foram surgindo na rede estabelecida entre nós. Na terceira cartografia, analisamos como estão sendo concebidas as políticas públicas para a questão do álcool e outras drogas e como as ações delas decorrentes estão sendo conduzidas naquele território. Como o Estado não tem aparatos adequados, ele terceiriza os serviços com o repasse financeiro para ONGs... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The objective of this study was to map out the attention and care practices adopted by public services with people suffering from disorders caused by alcohol and other drugs, in grounds considered socially dangerous. The first mapping describes the work developed by the NGO "Vir a Ser" as part of the project "Conquistando a Cidadania" , a by-project of the State Program "Adolescer é preciso". This study was carried out in the city of Londrina, Paraná, Brazil, between March and November 2003 , at Jardim Santa Fé and Jardim Monte Cristo neighborhoods, in the West Side of the city, known as socially dangerous grounds due to poverty ,violence, intense alcohol and drug use and dealing. Our proposal was to develop strategies together with the adolescents , their families , the schools , and the community they live in , to find opportunities to help them overcome their drug-related problems , and to improve the communication among them. The second mapping shows the different circuits that made out the intervention strategies developed during our stay in the area, which gave access to other circuits that permeate our work in community meetings, talks with the adolescents, and in other situations imposed by the network established among us. The third mapping analyses how the public policies for alcohol and drug issues are being formulated and how their actions are being implemented. As the State lacks adequate infrastructure , it has outsourced these services to NGOs. In the last part of this work we analyze the work of charity and religious institutions, which usually emphasizes abstinence, creating a tension that goes against all national and local damage reduction guidelines. / Mestre

A pesquisa que deu vida a esta tese teve como objetivo seguir rastros da construção de corpos inseridos num Centro de Atenção Psicossocial para Álcool e outras Drogas (CAPS ad) de Aracaju, Sergipe, particularmente, em seus arranjos de masculinidades. A tentativa foi a de forjar um corpo de pesquisa e de escrita bem ali entre o mandato de produzir corpos normalizados, identificados, generificados e a teimosia em resistir desses mesmos corpos submetidos a tal mandato, inclusive do próprio corpo do cuidado. As perguntas que nortearam esta pesquisa foram: que insistências, que (re)existências experimentam corpos num cenário de cuidado em álcool e outras drogas? Que (re)existências experimentam corpos num contexto biopolítico de face neoliberal, em que o exercício de poder pretende encerrar a produção da vida e dos corpos humanos numa dimensão empresarial, fabricando corpos e sujeitos empreendedores de si? Os campos teóricos que fundamentaram a pesquisa foram os estudos foucaultianos, alinhavados por algumas questões e conceitos de Nietzsche, Deleuze e Guattari operados no campo da saúde pública, em particular, o da saúde mental, bem como no dos estudos de gênero e sexualidade. Para a montagem metodológica, inspirou-se em questões propostas pelo método etnográfico, em discussões da escola francesa de análise institucional e em pistas apontadas pela cartografia. Os dados foram produzidos por meio de: 1) cadernos de formação desenhados durante o trabalho na rede de saúde mental aracajuana e no CAPS ad em particular, bem ali onde um processo de trabalho se constituiu como uma paisagem de formação e pesquisa; 2) diários de campo; 3) entrevistas individuais com usuários/as e profissionais; 4) grupos focais com usuários/as e profissionais; 5) roda de conversa com usuários de álcool e outras drogas numa praça da cidade; e 6) realização de uma oficina de “contação de histórias”. Foi pactuado um modo coletivo de acompanhamento da pesquisa e produção de análises por meio da formação de um grupo pesquisador composto por duas profissionais do CAPS ad, duas profissionais e um profissional do Projeto de Redução de Danos e um usuário. Os seguintes eixos funcionaram como focos para a produção de análises: corpo, gênero, sexualidade, cuidado em ad; arranjos corporais, arranjos de gênero e sexualidade; arranjos terapêuticos em articulação com arranjos pedagógicos; CAPS como um território de ensino e formatação corporal; CAPS como território de (des)aprendizagens corporais, abertura dos corpos para a variância, para composição de novas formas, inclusive do corpo do cuidado; projetos terapêuticos como projetos pedagógicos; projetos terapêuticos-pedagógicos de gênero. A partir desse itinerário de pesquisa, se o que se quer é resistir ao biopoder por meio de um acompanhar a potência dos corpos, sinaliza-se a importância da composição de uma clínica da experimentação, clínica artesanal, menor; clínica das passagens, da (des)aprendizagem, da abertura dos corpos para outras rotas, outras formas. / The research which has brought the present thesis to life was aimed at following traces of the construction of bodies involved in a public alcohol and drug rehab center called ‘Centro de Atenção Psicossocial para Álcool e outras Drogas/CAPS ad’ in the city of Aracaju, Sergipe, mainly in their arrangements of masculinity. The attempt was to form a body of research and writing right in between the mandate of producing normalized, identified, generalized bodies and the stubbornness of these bodies – submitted to such mandate, including that of the caring body itself – in resisting. The questions which the research was based upon were: what insistences, what re-existences do these bodies experience in a care scenario of alcohol and drugs? What re-existences do these bodies face in a neoliberal biopolitical context, in which the exercising of power is intended extinguish the production of life and human bodies in a corporate context, manufacturing bodies and subjects that are entrepreneurs of themselves? The theoretical fields which served as fundaments for this research were the foucaultian studies, complemented by some issues and concepts of Nietzsche, Deleuze and Guattari operated in the field of public healthcare, particularly in mental health, as well as gender and sexuality studies. The methodological foundation was inspired by questions and issues posed by the ethnographic method, in discussions of the French school of Institutional Analysis and also clues and leads pointed out by cartography. Data were obtained by means of: 1) study notebooks used during the work at the City of Aracaju’s mental healthcare network, especially at CAPS ad, right in the place where the work began to build the grounds for further studies and research; 2) field diaries; 3)one on one interviews with patients and professionals; 4) focus groups with patients and professionals; 5) informal conversation circle with alcohol and drug users at a city square; and 6) “story telling” workshop. A collective research monitoring and analysis system was agreed on, one which was formed by two CAPS ad professionals, three Damage Mitigation Project professionals and one patient. The following guidelines served as analytical directions in the process: body, gender, sexuality, alcohol and drug care; bodily arrangements, gender and sexuality arrangements; therapeutic arrangements in articulation with pedagogical arrangements; CAPS as a teaching and body formation territory, CAPS as a bodily (un)learning territory; the opening of bodies to variance, to the composition of new forms, including the caring body; therapeutic projects as pedagogical projects, therapeutic-pedagogical projects of gender. Based on that research direction, if the intention is to resist biopower by means of keeping up with the potency of bodies, the importance of the composition of an experimentation clinic, a smaller handcrafted clinic; the clinic of passages, of (un)learning, of the opening of bodies to other routes, other forms, becomes noticeable.

Made available in DSpace on 2016-06-02T20:45:42Z (GMT). No. of bitstreams: 1 6639.pdf: 1822615 bytes, checksum: 173f92b21699ea3c0b7305de829736f1 (MD5) Previous issue date: 2014-12-02 / This research aimed at investigating the device called " overnight-stay " in moment of crisis the user of alcohol and other drugs , in the context of a Psychosocial Care Center Alcohol and Drugs 24 ( CAPS ad III ) , in Campinas SP . It was intended to characterize the users who occupied overnight-stay according to demographic data, data on the use of psychoactive substances, data relating to the commencement CAPSad III as well as characterize the bed occupancy rates and indications of the team for their use. This is a descriptive cross-sectional study (April / 2012 to March / 2013), using research roadmap and documentary record data from four sources: medical records, insertion records in overnight-stay, books and bank shift changes data team. As a complementary source of information we used interview with service managers. Data were organized and analyzed from a computerized database using the Excel program. The research pointed out that the bed night shelter was occupied by 167 users 315 times, most males (77,25%), single (46,11%), aged between 31 and 40 (36,53%), incomplete elementary education (40,12%), unemployed (51,50%) and living with a family member (50,30%) . The demand for treatment was mainly due to the use of multiple drugs (53, 89%), especially if alcohol linked to another substance, followed by the exclusive use of alcohol (39,52%). Most cases (81,43%) had a comorbidity, particularly psychiatric (51,23 %). The length of enrollment in CAPSadII patients for 6 months (36,53%) and equipment for emergency care were the services most have referred users (30,43%). Among the indications for insertion into overnight-stay, include the promotion of abstinence (34, 85%), psychiatric stabilization (21,08%) and the need for protected environment (20,64%). Changes in mental examination were significant (66, 67%), especially mood changes (29, 97%) and insomnia (22, 67%). Significant portions of users were on the streets (34,13%) which requires other joints and need of supporting this vulnerable population. The logic of overnight-stay occupancy rates and indications of the team for their use were characterized. The overnightstay in CAPSad III , is seen as an opportunity to expand attention to the crisis the user of alcohol and other drugs in the anti-asylum logic , as they allow the regulation and care of the team. His newly deployment within the network of care to the user of alcohol and other drugs brings relevance to this investigation given the fact that it can contribute to a better understanding and characterization as well as for actiong planning. / Esta pesquisa teve como objeto de investigação o dispositivo denominado leito de acolhimento noturno" na atenção à crise ao usuário de álcool e outras drogas, no contexto de um Centro de Atenção Psicossocial álcool e drogas 24h (CAPS ad III), no município de Campinas-SP. Pretendeu-se caracterizar os usuários que ocuparam o leito de acolhimento noturno segundo dados sociodemográficos, dados referentes ao uso de substâncias psicoativas, dados relativos à vinculação ao CAPSad III assim como caracterizar a ocupação dos leitos e as indicações da equipe para a sua utilização. Trata-se de um estudo descritivo de corte transversal (abril/2012 a março/2013), que em sua investigação utilizou dados de quatro fontes: prontuários, fichas de inserção no leito, livros de passagem de plantão e banco de dados da equipe. Os dados foram organizados e analisados a partir de um banco de dados informatizado utilizando o programa Excel. A análise indicou que o leito de acolhimento noturno foi ocupado 315 vezes por 167 usuários, sendo a maioria do gênero masculino (77,25%), solteiros (46,11%), faixa etária entre 31 e 40 anos (36,53%), ensino fundamental incompleto (40,12%), desempregados (51,50%) e moravam com algum familiar (50,30%). A procura pelo tratamento aconteceu principalmente devido ao uso de múltiplas drogas (53,89%), destacando-se o álcool associado à outra substância, seguido do uso exclusivo do álcool (39,52%). A maior parte dos casos (81,43%) apresentou alguma comorbidade, principalmente psiquiátrica (51,23%). O tempo de cadastro no CAPSadII foi de até 6 meses (36,53%) e os equipamentos de urgência e emergência foram os serviços que mais referenciaram os usuários (30,43%). Dentre as indicações para inserção no leito de acolhimento noturno destacam-se a promoção de abstinência (34,85%), estabilização psiquiátrica (21,08%) e a necessidade de ambiente protegido (20,64%). As alterações no exame psíquico foram significativas (66,67%), em especial as alterações de humor (29,97%) e insônia (22,67%). Destaca-se que 34,13% dos usuários estava em situação de rua, o que demanda outras articulações e necessidade de apoio a essa população vulnerável. A lógica de ocupação dos leitos e as indicações da equipe para a sua utilização foram caracterizadas. Os leitos de acolhimento noturno em CAPSad III são vistos enquanto possibilidades de ampliar a atenção à crise ao usuário de álcool e outras drogas na direção da integralidade do cuidado e autonomia da equipe. Sua recém implantação dentro da rede de cuidados ao usuário de álcool e outras drogas traz relevância para esta investigação tendo em vista que pode contribuir para um maior conhecimento e caracterização do serviço assim como no planejamento de ações.

Masters in Public Administration - MPA / The City of Cape Town Municipality is the implementing agent of service delivery and developmental programmes. The importance and impact of the services and programmes are imperative to the citizens it serves; thus, the standard of work and efficiency provided by public officials is instrumental in achieving set priorities. Workplace substance abuse hampers service delivery and can cause damage to the employee, the public as well as the Municipality. Accidents, injuries or inability to perform functions by employees may have tremendous legal, financial and social repercussions for the City of Cape Town. This study seeks to evaluate efficacy of processes that seek to curb the existence of workplace substance abuse in the City of Cape Town, specifically within the Safety and Security Directorate. A qualitative and quantitative research methodology was applied. A combination of quantitative questionnaires, qualitative semi-structured interviews and focus group discussions were employed with employees in the Safety and Security Directorate. A purposeful sample was selected. The study results indicate that there is a prevalence of employees reporting for duty with a ‘hangover’. This is accepted as the norm, and staff are protected by their colleagues. The participating departments, Fire and Rescue Service and Metro Police, have highly stressful and traumatic working environments for staff to work in. There is a lack of debriefing and regular counselling after call-outs. Staff feel that management does not care and are tardy in providing support to them. A lack of trust between management and staff and among staff exists. The paper concludes with recommendations for each of the research findings.

INTRODUÇÃO: O abuso no consumo de drogas constitui um problema social e de saúde pública na maioria dos países, pelas consequências negativas que esse consumo provoca sobre o desenvolvimento emocional e físico das pessoas. O início do uso de substâncias tem-se apresentado na população de adolescentes cada vez mais cedo e, como consequência, uma avaliação para identificar comportamentos de risco é imprescindível para triagem e encaminhamentos adequados. Assim, o objetivo deste estudo foi revisar estudos e descrever três importantes instrumentos validados para o Brasil e utilizados para avaliação do abuso de álcool e outras drogas em adolescentes. MÉTODO: Estudo de revisão de literatura, realizado no período de janeiro de 1998 a agosto de 2010, em publicações nas bases de dados: Adolec, MedLine, Lilacs, PubMed e SciELO. Na seleção dos estudos, foram avaliados: artigos com aplicação dos instrumentos DUSI-R, Teen ASI e CBCL; o detalhamento do instrumento utilizado para diagnóstico; utilização de algum indicador de desempenho do instrumento; qualidade do estudo que permita avaliação do desempenho do instrumento, assim como a sua coerência com a literatura. RESULTADOS: Foram encontrados 767 artigos e, de acordo com os critérios de inclusão, foram avaliados 54, após as exclusões daqueles que não atenderam aos critérios. Os artigos com aplicação do instrumento DUSI-R foram 30, sendo 25 referentes a intervenções, prevalência e outros. Os estudos sobre validação do instrumento foram 5, com taxas de sensibilidade variando de 80 a 85% e especificidade variando de 70 a 90%. Outra medida foi a consistência interna com Alfa de Cronbach de 0,91 a 0,9451, apresentada em dois estudos. Já os artigos com aplicação do Teen ASI foram 12, sendo 8 estudos sobre intervenção, prevalência e outros. Para a validação do instrumento, foram encontrados 4 estudos, com taxa de confiabilidade em 2 estudos com r variando entre 0,69 e 0,90, um estudo com consistência interna com Alfa de Cronbach de 0,54 a 0,88 e outro estudo que avaliou a área sobre a curva de ROC = 0,88. Finalmente, os artigos com aplicação do CBCL foram 12, dos quais 8 foram sobre prevalência e fatores de risco. As medidas de desempenho do instrumento foram apresentadas em 4 estudos, sendo que dois mediram a taxa de sensibilidade do instrumento, variando de 80,4 a 87%. Ainda, um estudo apresentou consistência interna com Alfa de Cronbach entre 0,85 e 0,94 e outro estudou as propriedades psicométricas conforme dados da versão alemã do CBCL. CONCLUSÃO: Os resultados dos estudos apontam que os instrumentos pesquisados avaliam o abuso de álcool e outras drogas em adolescentes, possuindo boas propriedades psicométricas, porém de formas diferentes. O Teen ASI e o DUSI-R identificam e avaliam o uso de substâncias e outras áreas da vida. Por sua vez, o CBCL é voltado para avaliar a saúde mental do adolescente, não sendo específico para avaliar o abuso de álcool e outras drogas. Portanto, na escolha de instrumentos de avaliação, é importante considerar: organização do tempo, investimento na formação de profissionais e consolidação dos resultados que contribua efetivamente na melhora do tratamento / INTRODUCTION: The substance abuse is a major social problem in public health in most countries, due to the negative consequences of this behavior on the physical and emotional development of the people involved. The initiation phase of the substance abuse is beginning at earlier ages, and, as a consequence of that, an assessment to identify risk behaviors is very important for an acurate triage and subsequent steps. The objective of this study was to review studies and to describe 3 important instruments validated for Brazil and applied for the assessment of substance abuse in adolescents. METHOD: A literature review study, in the period from January of 1998 to August of 2010, in the databases of: Adolec, MedLine, Lilacs, PubMed and SciELO. In the selection of the studies the following criteria were evaluated: articles with application of the instruments DUSI-R, Teen ASI, and CBCL; the detailing of the instrument utilized for diagnostics; utilization of a performance indicator; quality of the study that enables the performance assessment of the instrument, and its coherence with the literature. RESULTS: 767 articles were found according to the inclusion criteria, and 54 of them were analysed, after the exclusions of the ones that did not meet the detailed criteria. 30 articles for the DUSI-R instrument were found, 25 of them related to interventions, prevalence and others. 5 studies were related to the validation of the instrument, with sensitivity rates varying from 80 to 85% and specificity variying from 70 to 90%. Another measure was the internal consistency with Cronbachs Alpha varying from 0.91 to 0.9451, presented in two studies. For the Teen ASI, 12 articles were found, and 8 of them were related to intervention, prevalence and others. For the validation of the instrument, 4 studies were found, with the reliability in 2 studies varying from r = 0.69 to 0.90, one study with internal consistency with Cronbachs Alpha varying from 0.54 to 0.88 and another study with the area under the ROC curve = 0.88. For the CBCL, 12 studies were found, and 8 of them were related to the prevalence and risk factors. The performance measures were presented in 4 studies, where 2 instruments measured the sensitivity rate varying from 80.4 to 87%. One study report the Cronbachs Alpha between 0.85 and 0.94, and another study studied the psicometric properties for the German version. CONCLUSION: The results of the studies suggest that the instruments included on the research evaluate the substance abuse in adolescents, with good psychometric properties, although in different ways. The Teen ASI and DUSI-R evaluate the substance abuse and other areas of life. The CBCL is useful to evaluate the mental health, and its not specific to conduct an assessment for substance abuse. So, when choosing assessment instruments, its important to consider: time management, investment in the education of the professionals; and consolidation of the results that contribute effectively to the improvement of the treatment