Orientadores: Ellen Hardy, Maria Jose Duarte Osis / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-11-09T13:16:09Z (GMT). No. of bitstreams: 1 Bassi_FabianaGuariglia_D.pdf: 1703561 bytes, checksum: 492a5b1b282e8a5db7051f9283374f80 (MD5) Previous issue date: 2009 / Resumo: As crianças estão sujeitas a muitas das doenças de que sofrem os adultos e, muitas vezes, são tratadas com os mesmos medicamentos. Nos últimos 30 anos foram realizadas poucas pesquisas para se desenvolver medicamentos pediátricos. A medicina baseada em evidências tem sido ponto de referência de uma boa prática clínica. Entretanto, as crianças são excluídas dessa prática, uma vez que os tratamentos não foram cientificamente avaliados nesse grupo etário. A ausência de estudos pediátricos representa um dilema ético para o profissional responsável pela saúde dos menores, os medicamentos acabam sendo ministrados sem a garantia de serem adequados às necessidades de cada grupo etário. Estes profissionais não têm orientação oficial a respeito do melhor para as crianças: expô-las ao risco de tomar medicamentos não adequados ou ao risco de participar de um ensaio clínico. Objetivo: Conhecer a experiência e a opinião de docentes de Departamentos de Pediatria e de Neonatologia de Faculdades de Medicina brasileiras a respeito do desenvolvimento de ensaios clínicos, para avaliar fármacos e formas de administração em crianças. Sujeitos e métodos: Este estudo foi realizado em duas etapas: a primeira foi quantitativa de corte transversal, descritiva utilizando um questionário autorrespondido A segunda foi qualitativa, utilizando entrevistas semi-estruturadas. Essa segunda etapa foi realizada para obter informações que permitissem a melhor compreensão do significado das informações obtidas inicialmente. Quantitativa: Os sujeitos do estudo foram docentes-pediatras das Faculdades de Medicina do Brasil. Foi enviada, por correio eletrônico, uma carta-convite personalizada explicando o objetivo do estudo e em anexo o questionário a ser autorrespondido. Realizouse análise descritiva univariada que consistiu de tabelas de distribuição de frequências de todas as variáveis consideradas. Qualitativa: Para esta etapa foram convidados os docentes-pesquisadores que responderam ao questionário na Etapa Quantitativa e relataram que foram pesquisadores principais, nos últimos 24 meses, de um de ensaio clínico que incluiu voluntários que o pesquisador considerou crianças. Todos os pesquisadores que aceitaram o convite foram entrevistados pessoalmente através de uma entrevista semi-estruturada de questões abertas. Realizou-se a análise de conteúdo. Resultados: Dos 89 docentes-pediatras que responderam ao questionário, 31 relataram que nos últimos 24 meses tinham sido pesquisador principal de um ensaio clínico pediátrico. Entretanto, apenas 58% das pesquisas referidas correspondiam a um ensaio clínico segundo definido para esta pesquisa. Foi detectado que as opiniões dos docentes-pediatras estavam em harmonia com as orientações internacionais existentes atualmente, apesar de ter sido identificado que dentre os docentes-pesquisadores não havia um conhecimento apurado das normas existentes no Brasil e das normas internacionais para a realização de ensaios clínicos na população pediátrica. Houve um consenso quanto à necessidade cada vez maior de se realizar ensaios clínicos para essa população e, consequentemente, da necessidade de se regulamentar esse tipo de pesquisa no Brasil. Conclusões: Com uma regulamentação nacional que as crianças e adolescentes do Brasil poderão ter uma possibilidade de garantir seus direitos, como a proteção de sua integridade física, emocional e social. Como também o acesso a novas tecnologias que atendam às suas reais necessidades. / Abstract: Children are subjected to many of the diseases adults suffer from, and most of the times they are treated with the same medication. In the past 30 years there have been conducted few researches to develop pediatric medication. The medicine based on evidence has been a reference point of a good clinical practice. However, children are excluded of this practice once the treatments haven't been scientifically tested in this age group. The lack of pediatric studies represent an ethical dilemma for the professional responsible for the children's health, because the medication ends up being administered without the guarantee that they are appropriate for the needs of each group. These professionals don't have professional official orientation in respect of the best for the children's: expose them to the risk of taking medicine that are not appropriate or to the risk of participating in a clinical study. Objective: To find out about the experience and opinion of professors from Neonatology and Pediatric Departments of Brazilian Medical Schools in respect of clinical trials developments to evaluate medicine and administration methods in children. Subjects and methods: this study was conducted in 2 stages: the first was quantitative and in a transversal cut and descriptive, using a self responded questionnaire. The second was qualitative, using semi-structured interviews. This second stage was developed to obtain information that permitted the best understanding of the information's meaning obtained initially. QUANTITATIVE: The study's subjects were pediatrics professors of Brazil's Medical School. A personalized invitation letter was sent, via -mail, explaining the objective of the study and the questionnaire was attached. The unvaried descriptive analysis consisted of frequency distribution tables of all the considered variants. QUALITATIVE: For this stage, the research professors were invited to respond to the questionnaire in the Quantitative Stage and they reported they had been the main researchers, over the past 24 months, of a clinical trial that included volunteers that the researcher took children into account. All the researchers who accepted the invitation were interviewed in person, through a semi-structured interview of open questions. The content analysis was performed. Results: From the 89 pediatrics professors who responded to the questionnaire, 31 reported that over the past 24 months they had been the main researchers of a pediatric clinical trial. However, only 58% of the reported surveys corresponded to a clinical trial according to the one defined for this survey. It has been detected that the pediatric professors opinions were in harmony with the international orientation that exists nowadays, even though it had been discovered that among the pediatric professors there was no accurate knowledge of the existing norms in Brazil and the international norms for the conduction of clinical trials in the pediatric population. There was an agreement concerning the increasing need of carrying out clinical trials for this population and consequently the need of regulating this kind of research in Brazil. Conclusions: With a national regulation that children and adolescents from Brazil will have a possibility of guaranteeing their rights, as well as their social, emotional and physical integrity protection. And also the access to new technologies that suit their real needs. / Doutorado / Ciencias Biomedicas / Doutor em Tocoginecologia

The use and abuse of drugs among adolescents and adults has prompted a renewed national concern about drug abuse. Educational programs have attempted to provided factual information and create negative attitudes about drug use so that students will decide not to use drugs. Studies have revealed, however, that the drug programs have not been effective in reducing drug use. The present research addresses two primary questions: 1) Are there developmental differences in young persons' perceptions of social and moral dilemmas associated with drug use? and 2) Are gender and race associated with social and moral reasoning about drug use? Semi-structured interviewers were conducted with 32 fourth and 32 eleventh grade students. The interview posed two vignettes about drug-related behavior, including helping behavior. In addition, the interview probed respondents' conceptions of the problems associated with drug use and of the treatment that users and dealers should receive. Content analysis produced 40 codes which reached the reliability criterion of 60 percent agreement. The Kappas ranged from .57 to .91 (m = .66). Chi square tests were conducted, using the variables of race, sex and the thematic categories associated with each question. Of the 26 tests of significance conducted on the variables, two were significant for grade, two were significant for gender and one was significant for race. Eleventh grade students were more likely to specifically reject some category of help than the fourth grade students (x2 = 4.48,p < .05, df = 1). Fourth grade students were more likely to consider teachers as a source of help (x2 = 3.48,p < .06, df= 1). Female students were more likely to acknowledge risk to themselves due to helping (x2 = 4.27,p < .04, df= I). Caucasian students were more likely to acknowledge that there may be risks to the helpee due to helping (x2 = 3.52,p < .06, df= 1). Male students were more likely to want punishment and control of drug dealers (x2 = 5.32,p < .05, df= 1). In general, the :findings indicate that there are fewer developmental, gender and race differences in children's perception of drug use and associated dilemmas than might be expected. Students' descriptions did reveal that they are thinking and reasoning about the information given to them.

This study explores youth's perceptions and understanding of the social phenomenon of drugs in our society. Sixty-four students (32 fourth graders and 32 eleventh graders), selected from schools in the Portland Public School District participated individually in a one hour interview where they responded to open ended questions that probed for their perceptions of drug use. Participants were also asked to describe their feelings regarding anti-drug messages they view in the media and their comments regarding the "Just Say NO" program. The tape-recorded interviews were transcribed and half were used to develop a code that captured recurring themes in the data. Using the code book, five trained individuals coded the 64 transcripts. Reliability, assessed by computing Cohen's Kappa on half the interviews, ranged from .62 to .75, with an average reliability of .69. Seventeen themes derived from the content analysis were discussed which confirm the dramatic impact the peer group has on drug use as well as demonstrate age differences associated with perceptions of anti-drug messages. One hundred percent of the participants noted that there are peer influences promoting drug use. Eleventh graders were more likely than fourth graders to note that drugs are used as a means to escape, overcome constraints or for pleasurable stimulation. Fourth graders were more positive in their responses to the anti-drug commercials and the "Just Say NO" campaign. This research provides information regarding the perceptions of young people that can potentially broaden the dialogue of program planners as well as increase the effectiveness of anti-drug programs and messages.

Thesis (M.A. (Social Work)) --University of Limpopo, 2015 / Please refer to the document / University of Limpopo

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The effectiveness of a shor-term prevention program to increase drug refusal behavior in elementary school children was assessed. Fifty-seven third grade children were randomly assigned to one of three groups: rehearsal-plus, traditional, and control. Children in the rehearsal-plus group were taught drug knowledge, assertiveness skills, decision making skills, and specific drug refusal techniques in the context of a skills-based strategy. This procedure included behavioral training and elaborative rehearsal. The traditional group targeted the same components, drug knowledge, assertiveness skills, decision making skills, and drug refusal skills, and employed a general educational-based approach to enhance children's functioning. Training occurred in three socially validated situations corresponding to settings where children are likely to be offered drugs. Assessment was carried out at pre- and post-test phases. It was hypothesized that children in the rehearsal-plus group would outperform those in the traditional and control groups on targeted responses. The results suggest that the rehearsal-plus procedure was most effective in enhancing desired behavior. / Master of Science

This study employs interviews to measure the perceptions of sixteen teachers, nine school principals, and seven School Resource Officers on the Drug Abuse Resistance Education (DARE) program, offered to grade six students in one small (population approximately 70,000) city in western Canada. Perceptions in three areas are examined: curricular content, program delivery, and efficacy. Subjects overwhelming viewed the curricular content favourably. Similarly, there was strong agreement that the program was well delivered. The efficacy of the program was judged less positively; however, this did not mitigate the subjects' strong desire to continue implementation of the program. These results are consistent with the research literature on DARE which documents the popularity of the program, but acknowledges that it appears to have limited effects upon reducing student drug use. The results of this study are used to examine five options for delivering an in-school program for preventing or reducing drug abuse and violence among students. The options explored range from retaining the DARE program in its current form, to eliminating it, reforming it, implementing an alternative program, or designing an entirely new drug and violence prevention program. The conclusion drawn is that the DARE program should be withdrawn and replaced with an entirely new drug and violence prevention program and curriculum specific to community realities and needs. / vii, 109 leaves ; 28 cm.

The proposed research aims to explore and describe the experiences, challenges and coping strategies of fathers, parenting children, abusing illegal substances. The use and abuse of illegal substances became national and global dilemmas. The impact and damage caused when drugs are widely used over time is irreversible, as it influences the lives of users and those of their families, their communities, and the country. This research provides an opportunity for fathers, parenting children, abusing illegal substances to share their experiences and challenges. Data are collected by conducting in-depth and face-toface interviews with the participants. The collected data are analysed by following the eight steps of Tesch in Creswell (2009:186). Data are analysed using Lincoln and Guba’s model of trustworthiness of qualitative research for validation. The study endeavours to obtain an understanding of the experiences and challenges encountered by fathers, parenting children, abusing illegal substances and how social workers could assist in addressing this dilemma. / Social Work / M.A. (Social Work)