p. 1-207 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-29T18:45:50Z No. of bitstreams: 1 6666666.pdf: 3394609 bytes, checksum: 92c8f0423ce24e1d1259b243a8d3d219 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:37:25Z (GMT) No. of bitstreams: 1 6666666.pdf: 3394609 bytes, checksum: 92c8f0423ce24e1d1259b243a8d3d219 (MD5) / Made available in DSpace on 2013-05-04T17:37:25Z (GMT). No. of bitstreams: 1 6666666.pdf: 3394609 bytes, checksum: 92c8f0423ce24e1d1259b243a8d3d219 (MD5) Previous issue date: 2008 / Esta tese busca investigar as formas como profissionais que atuam numa unidade básica da rede pública de saúde, em Salvador – Bahia representam e abordam o uso e o abuso de drogas e a influência dessa representação na assistência. Considerando que o consumo de drogas é uma conduta em expansão com repercussões sociais e de saúde diversas que, inevitavelmente, todo profissional de saúde enfrenta no cotidiano de suas atividades, nos distintos setores dos serviços de saúde, as representações sociais e práticas adotadas por profissionais em torno do consumo de drogas podem se constituir num elemento importante para implantação de estratégias de enfrentamento. Procurou-se conhecer a imagem construída por profissionais em atuação num contexto assistencial de saúde acerca das drogas e da pessoa usuária de drogas; analisar as representações sociais apreendidas numa perspectiva de gênero e identificar se e como as representações sociais apreendidas influenciam a visibilidade do consumo de drogas como problema de saúde. A Teoria das Representações Sociais foi adotada como eixo teórico e gênero como categoria de análise. Foi utilizada uma metodologia qualitativa mista, de cunho etnográfico, buscando contextualizar a realidade vivenciada pelos sujeitos investigados em seus distintos contextos de atuação. Foram utilizadas diversas técnicas e instrumentos possibilitando o envolvimento de todas as categorias profissionais em atuação na unidade: associação livre de palavras com 102 profissionais os quais foram organizados em três grupos, segundo nível de escolaridade e local de atuação; entrevista semi-estruturada com 21 desses profissionais; e observação participante das atividades assistenciais do serviço de saúde. Revelou-se que embora os profissionais reconheçam de formas distintas, dependendo do seu local de atuação e formação, que o consumo de drogas é um problema que atinge a comunidade e que causa repercussões para saúde, nas práticas profissionais nenhuma ação é direcionada para tal problema. As drogas e seu consumo são representados, pelos profissionais que atuam dentro da unidade como uma doença caracterizada por dependência, mostrando a hegemonia do modelo biomédico. A imagem da pessoa usuária de drogas é estereotipada de forma que aquelas que não conformam a tal imagem (a maioria da clientela que faz algum uso de drogas) não são reconhecidas como usuárias. A(O)s ACS produzem representações ancoradas na realidade vivenciada na comunidade de que as drogas e seu consumo causa sofrimento, tristeza e depressão. A hegemonia do modelo biomédico, a fragmentação das ações, a desarticulação entre os profissionais, a falta de capacitação específica e, ainda, as representações sociais estereotipadas sobre as drogas e seu consumo e sobre a pessoa usuária de drogas foram apontadas como elementos que influenciam na visibilidade do consumo de drogas como problema de saúde no contexto assistencial investigado. / Salvador

INTRODUCTION: Drug consumption rooms (DCR) are places for the hygienic consumption of preobtained drugs in a non-judgemental environment and under the supervision of trained staff. Since 1986, the DCR have been established in 10 countries around the world. Despite the fact that Czech Republic offers wide range of services aimed to minimize the risks connected to problematic drug users, intravenous aplication still prevails. While, effectivity of DCR has already been proven, there are none in the Czech Republic. AIMS: The work aims to provide systematic and comprehensive summary of current state of knowledge regarding establishment and runing of DCR from international experiences. Additionally, the target of this work is to describe what conditions, necessary for legal establishment of DCR, were set in these countries and whether these conditions can be set in Czech Republic. Finally, the thesis analyzes whether the DCR are visited and used by clients and describes what the profile of a typical client is. METHODS: For the first part which deals with establishment of DCR, method of written text analysis based on international scientific databases was used. Second part considering the running of DCR was prepared by analyzing the webpages of individual institutions in order to find out organizational...

Dual Antidepressant Consumption in the Czech Republic Author: Kristýna Čiháková Supervisor: PharmDr. Pavel Horký, Ph.D. Consultant: PharmDr. Kateřina Malá, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction: Antidepressants are widely used in many indications. Dual antidepressants are prescribed in treatment of depressive disorder, anxiety disorder, in pain therapy and insomnia. Besides that, there are trials to prove the efficacy of dual antidepressants in different indications. Generally, antidepressant consumption in the Czech Republic is increasing. The question is, what the real proportion of dual antidepressant consumption is. Objective: As the objective, dual antidepressant consumption was analysed. Methods: The consumption of antidepressants venlafaxine, duloxetine, mirtazapine and mianserin was performed in the period from 1 January 2008 to 31 December 2018. The State Institute for Drug Control (SÚKL) database was used. The data were described by descriptive statistics. The drug consumption in Defined Daily Doses (DDD) was converted into Defined Daily Dose/1,000 inhabitants/day (DID). In addition, comparison of use of particular dual antidepressant doses was made. Results: Overall, the relative consumption of dual...

SSRI antidepressant consumption in Czech republic Author: Júlia Behrová Supervisor: PharmDr. Pavel Horký, PhD. Consultant: PharmDr. Eva Zimčíková, Ph.D Introduction: Selective serotonin reuptake inhibitors increase the available amount of neurotransmitter serotonin in synapses, resulting in their antidepressant and anxiolytic effect. Objective: The objective of this diploma thesis was to evaluate the consumption of SSRI antidepressants in the Czech Republic in the period from 01. 01. 2008 - 31. 12. 2018, based on the data on consumption from the State Institute of Drug Control (SIDC). Methods: The research consisted of a retrospective analysis of the SIDC database. The study included all approved SSRI in the Czech Republic. Drug Utilization Review was used in the thesis as a methodology. Drug consumption is calculated as the number of defined daily doses per thousand inhabitants per day (DID). The data on the number of residents was acquired from the Czech Statistical Office. Descriptive statistics and ATC/DDD methodology were applied. Results: The consumption of sertraline and escitalopram increased significantly during the period under review. For sertraline, the DID increased from an initial 8.623 to 15.513, increasing consumption by 1.8 fold. The greatest increase in consumption was observed...

Supervised Injection Facilities (SIFs) for the medical supervision of illicit drug use exist in Europe, Canada, and Australia to reduce infectious disease transmission, overdose deaths, and other harms of drug use. They have been shown to reduce rates of needle sharing by 69% and local overdose mortality by 35% without increasing rates of drug use or related crime. In light of increasing rates of illicit opioid use and overdose death in Massachusetts, the Massachusetts Medical Society recently endorsed opening a SIF in Boston. This thesis proposes a study of the Boston SIF with the hypothesis that higher SIF utilization will be associated with decreased incidence of fatal overdose, HIV seroconversion, and HCV seroconversion during the study period. I propose evaluating this hypothesis prospectively by following clients of the SIF at 6 month intervals and comparing the rates of overdose death and HIV or HCV seroconversion among frequent and infrequent clients of the SIF. Based on data reported from previous SIFs and projections of the population of people who inject drugs (PWID) in Boston, a study with this design should detect a significant difference in these three primary endpoints between people using the SIF frequently and those using it infrequently within five years. A positive finding would confirm the efficacy of SIFs in harm reduction and secondary prevention for Opioid Use Disorder (OUD), potentially leading to broader adoption in other hotspots of opioid use in the United States.

O objeto deste estudo é a prevenção relacionada ao uso de drogas e dirigida aos adolescentes. Seu objetivo é avaliar políticas públicas na área. Particularmente, analisa-se um projeto de prevenção realizado nas escolas públicas do Estado de São Paulo de 91 a 94 - o Projeto Escola é Vida. Essa análise foi desenvolvida a partir de considerações sobre: a diversidade e complexidade das relações dos indivíduos com as drogas no mundo contemporâneo; e os processos de socialização dos adolescentes, sempre historicamente determinados. As considerações teóricas propõem que, para que a prevenção seja adequada, ela deve considerar a complementaridade entre duas abordagens sociológicas. Uma que se aproxima do problema da relação dos indivíduos com as drogas a partir das interações sociais que acontecem no âmbito microssocial. E outra, que coloca em evidência o peso dos fatores econômicos ou macrossociais na determinação de uma relação prejudicial dos indivíduos com as drogas. As categorias analisadas por referência à prevenção são: objetivos da prevenção; concepções sobre drogas e adolescentes; AIDS como um possível prejuízo ao nível do processo saúde?doença. A análise dessas categorias foi feita a partir dos depoimentos de: supervisores do projeto, professores treinados pelo projeto; escolares que participaram de atividades do projeto e escolares de escolas que não participaram do projeto. No sentido de trazer para o campo da prevenção, alguns elementos da realidade concreta, levantou-se as características dos adolescentes que adquiriram AIDS pelo uso de drogas injetáveis com objetivo de apreender: elementos sócio-culturais referentes à prática do uso de drogas; situações de transmissão do HIV; e suas propostas em relação à prevenção. Por fim, apresenta-se conclusões que têm implicações para as políticas públicas de prevenção na área de drogas e AIDS junto ao grupo de adolescentes. / The object of this study is the prevention related to drug use and focused on adolescents. Its objective is to evaluate the public policy in this field. Particularly, a public school prevention project is analyzed. The Escola é Vida project took place between 1991 and 1994 in the public schools of the São Paulo state. The analysis was developed from considerations: about the diversity and complexity related o contemporary drug use; and about the socialization processes of adolescents, always historically determined. The theoretical considerations propose that, for prevention to be adequate, it has to consider the complementarity of two sociological approaches. One that approaches the relation between individuals and drugs from social interactions which happen in a microssocial domain. And another one that puts in evidence the weight of economic and macrossocial factors determining a harming relation between individuals and drugs. The categories analyzed related to prevention are: prevention objectives; conceptions about drugs; conceptions about adolescents; Aids as a possible consequence to the health-illness process. The analysis was based on the statements of: program supervisors; teachers trained by the program; students who participated in program activities and finally students from schools which had not participated in the state program. A case study was developed to bring to the prevention field a few elements from the concrete reality. The objective was to perceive, through the statements of adolescents who had aids mainly due to injected drug use: socio-cultural factors related to drug use; HIV transmission situations; and their propositions to prevention. Finally, conclusions are presented that have implications for public policies related to drugs and aids prevention focused on adolescents.

Thesis (PhD. (Social Work)) --University of the North, 2004. / Refer to the document / The Department of Arts, Culture , Science and Technology (DACST)

The theoretical part of this diploma thesis defines basic terms related to the marketing and gives a general overview of marketing strategies. It also evaluates the importance of marketing in public health services and describes possibilities of internet health technologies that patients use for the contact with health professionals and getting information about health. The practical part analyzes patients' opinion on pharmacy marketing practice and importance of internet communication. Data were collected via the questionnaire survey among the users of internet and Facebook and customers in one independent community pharmacy in Beroun. Practical part also refers about the experimental marketing campaign that was performed in the pharmacy in Beroun and that focused on the creating promotion materials and technologies of internet communication. According to results, many patients appreciate marketing activities of community pharmacies. There is also noticeable a positive trend of using the web sites and social media to connect with the community pharmacy. Key words: marketing, healthcare, community pharmacy, internet, social media, the Czech Republic

O objeto deste estudo é a prevenção relacionada ao uso de drogas e dirigida aos adolescentes. Seu objetivo é avaliar políticas públicas na área. Particularmente, analisa-se um projeto de prevenção realizado nas escolas públicas do Estado de São Paulo de 91 a 94 - o Projeto Escola é Vida. Essa análise foi desenvolvida a partir de considerações sobre: a diversidade e complexidade das relações dos indivíduos com as drogas no mundo contemporâneo; e os processos de socialização dos adolescentes, sempre historicamente determinados. As considerações teóricas propõem que, para que a prevenção seja adequada, ela deve considerar a complementaridade entre duas abordagens sociológicas. Uma que se aproxima do problema da relação dos indivíduos com as drogas a partir das interações sociais que acontecem no âmbito microssocial. E outra, que coloca em evidência o peso dos fatores econômicos ou macrossociais na determinação de uma relação prejudicial dos indivíduos com as drogas. As categorias analisadas por referência à prevenção são: objetivos da prevenção; concepções sobre drogas e adolescentes; AIDS como um possível prejuízo ao nível do processo saúde?doença. A análise dessas categorias foi feita a partir dos depoimentos de: supervisores do projeto, professores treinados pelo projeto; escolares que participaram de atividades do projeto e escolares de escolas que não participaram do projeto. No sentido de trazer para o campo da prevenção, alguns elementos da realidade concreta, levantou-se as características dos adolescentes que adquiriram AIDS pelo uso de drogas injetáveis com objetivo de apreender: elementos sócio-culturais referentes à prática do uso de drogas; situações de transmissão do HIV; e suas propostas em relação à prevenção. Por fim, apresenta-se conclusões que têm implicações para as políticas públicas de prevenção na área de drogas e AIDS junto ao grupo de adolescentes. / The object of this study is the prevention related to drug use and focused on adolescents. Its objective is to evaluate the public policy in this field. Particularly, a public school prevention project is analyzed. The Escola é Vida project took place between 1991 and 1994 in the public schools of the São Paulo state. The analysis was developed from considerations: about the diversity and complexity related o contemporary drug use; and about the socialization processes of adolescents, always historically determined. The theoretical considerations propose that, for prevention to be adequate, it has to consider the complementarity of two sociological approaches. One that approaches the relation between individuals and drugs from social interactions which happen in a microssocial domain. And another one that puts in evidence the weight of economic and macrossocial factors determining a harming relation between individuals and drugs. The categories analyzed related to prevention are: prevention objectives; conceptions about drugs; conceptions about adolescents; Aids as a possible consequence to the health-illness process. The analysis was based on the statements of: program supervisors; teachers trained by the program; students who participated in program activities and finally students from schools which had not participated in the state program. A case study was developed to bring to the prevention field a few elements from the concrete reality. The objective was to perceive, through the statements of adolescents who had aids mainly due to injected drug use: socio-cultural factors related to drug use; HIV transmission situations; and their propositions to prevention. Finally, conclusions are presented that have implications for public policies related to drugs and aids prevention focused on adolescents.

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