Introduction and background Opioid use disorder (OUD) is an epidemic in the U.S. OUD affects both the mother’s and infant’s health. Substance-exposed infants suffer from decreased health outcomes relative to non-exposed infants. Purpose The aim is to identify infant health outcomes when pregnant women are prescribed medication-assisted treatment (MAT) for OUD. Among pregnant women with OUD in the U.S., is medication-assisted therapy as compared to no therapy associated with decreased negative infant health outcomes? Literature review Five studies on OUD and infant outcomes in the U.S. were reviewed. CINAHL and PubMed were searched using terms opioid use disorder, pregnancy, and neonatal abstinence syndrome (NAS). The search was limited to the last five years and full text only. Of the 815 results, five articles were selected that focused on infant outcomes and prevention of NAS. Articles were excluded if the focus was solely on the maternal outcomes, cost, or unoriginal research. One meta-analysis was included that compared two types of MAT for pregnant women with OUD. Findings MAT is correlated with a shorter hospital stay and less severe NAS symptoms in infants. Conclusion and implications Rates of NAS and OUD have increased significantly in the US. Some of the increase may be attributed to the transition to ICD-10 codes. MAT for pregnant women with OUD is associated with better health outcomes for infants. Patient-centered care could help decrease negative health outcomes for both infants and women with OUD. Future study should focus on degrees of opioid exposure and related outcomes.

The word addiction is almost immediately associated with notions of drug dependency and alcoholism, and drug addiction is often referred to as a pandemic that affects individuals, families, communities and society at large. Aetiological approaches to understanding and treating addiction have changed dramatically throughout history, and currently the most contemporary approach is that of the disease model which views addiction as an illness rather than as a ‘badness’. While the underpinnings of Narcotics Anonymous’ 12 step philosophy employs non-specific drug language as it views all drugs as having the capacity to become addictive, and while it does not distinguish between the capacity for substances and certain behaviours to become addictive, activities such as overeating, having sex and gambling are yet to be classified as legitimate addictions by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). As a result, it appears as if some confusion exists as to whether these behaviours should be classified as impulse control disorders or as genuine addictions due to the various similarities they share in common with substance based disorders. The research conducted explored how people recovering from addiction, as well as how people working with addiction understand addiction and multiple dependency, together with the factors that contribute to relapse and the ability to abstain. Various 12 Step meetings from a variety of 12 Step Fellowships were attended and members were invited to participate in the study. Ultimately seventy eight participants completed a self developed questionnaire which was utilised to assess how people recovering from addiction understood addiction and multiple dependency and the factors that contribute to relapse and the ability to abstain. Quantitative data were analysed via descriptive and inferential statistics. Furthermore twenty participants working with addiction were interviewed with the use of a semi structured interview schedule in order to explore their perceptions around addiction and the factors that contribute to relapse and sobriety. Qualitative data were analysed using thematic content analysis. Results indicated that the majority of recovering addicts and professionals working with addiction understand addiction as a disease. However, discrepancy was apparent with regards to whether or not all recovering addicts have the same disease and subsequently whether all addictions can be treated in the same manner. The above result suggested that there was no standardised, uniform way in which the disease model is understood and interpreted. Factors such as cross addiction, resistance to change and issues relating to the maintenance of change were identified as issues that contribute to relapse, while factors such as aftercare, following the 12 step programme and support were identified as the main aspects that contribute to sobriety. No statistical significance was noted between participants who had relapsed as opposed to those who had not for variables of sensation seeking, impulsivity and perceived stress (which may have been as a result of small sample size). Deeper understanding of the disease model together with broader application of it, and a focus on appropriate training and more comprehensive assessment could perhaps see a reduction in high rates of relapse and recidivism more commonly known as the ‘revolving door syndrome’.

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This study explores factors that influence the sexual attitudes and behaviors of adolescents specifically through an examination of social constructs that measure sexual beliefs and attitudes of adolescents and the relationships between race and gender and sexual beliefs and attitudes. As the U.S. has maintained one of the highest rates of unplanned teen pregnancy and births among industrialized nations, schools and community groups have struggled to combat teen pregnancy and worked toward designing effective prevention programs. Through an emphasis either on abstinence or safe sex practices, these programs strive to influence adolescents' sexual behavior. However, studies and reports reveal a paucity of research that examines adolescents' attitudes and beliefs of sexual behavior, especially for cultural- and gender- specific groups of adolescents. Drawing from social constructionist theory and multiracial and radical feminist theoretical frameworks, this study utilizes Virginia Abstinence Education Initiative (VAEI) data from surveys administered to adolescents measuring sexual attitudes, beliefs, and behaviors. This study examines race and gender differences among the participants with regard to beliefs and attitudes about sexual behavior. The goal is to both better understand race and gender influences on adolescents' sexual beliefs and attitudes and to provide information to those who are in the position to develop more successful and effective teen pregnancy prevention programs. Consistent with existing literature, findings indicate gender-based differences regarding sexual beliefs and attitudes and minimal race-based differences in this analysis. An intersectional analysis further suggests that although female adolescents across race held similar beliefs and attitudes regarding sexuality, there were differences across race among male adolescents.

My final work is about three basic types of prevention, which are used in the field of narcotic's prevention. It's mostly about secondary and tertiary prevention. Besides the basic terminology you can read about the details of differents preventions, who is responsible for it and also about the treatment of addictive behaviours. In my work you can also find the descriptions of legal and illegal narcotics, which excessive using leads to jones. The questions in the questionaire were created with a respect to the respondents - they are the clients of the mental treatment, who decided to help themselves (sometimes not for the first time).

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...

Made available in DSpace on 2016-03-22T17:26:16Z (GMT). No. of bitstreams: 1 Cristine Eliane Gomes Rodrigues.pdf: 248923 bytes, checksum: 0f2e18a14496907b79cd280de11c5c53 (MD5) Previous issue date: 2009-09-02 / Aim: Evaluating the time and problems met at resuming sexual intercourse after childbirth concerning women in Pelotas. Outlinig: Prospective Cohort Study. Sampling: Women who had their children at maternity hospitals in Pelotas, from September of 2002 to November of 2003. Population: From 2,741 parturients at perinatal period one obtained a random sample of 920 women on their 180 days after childbirth. Methods: Uni and multivaried analyses were performed and only those variables with a p<0.05 were considered as associated to the outcome with a significant statistically way. Prime Measures: Prevalence reason with a confidence interval. Results: The difficulty prevalence at resuming sexual intercourse was 25.5%, and 80% of the women resumed sexual intercourse on the first six months after deliverance. The main cause for not having sexual intercourse was for the woman not having a mate (63%); other causes were the lack of desire or time. The primiparas and women with a health problem on the prenatal or postnatal presented a higher prevalence difficulty: pelvic pains, insecurity and lack of desire. Conclusion: One found a high prevalence difficulty upon resuming sexual intercourse after deliverance. This was a study performed in a city at the south of Brazil, and that is why the findings are contextualized to the education and to the habits of these women. It is appropriate to highlight here the relevance 55 towards the need of an orientation at the prenatal, in order to soften or avoid problems which are prone to a resolution. / Objetivo: Avaliar o tempo e os problemas encontrados na retomada da atividade sexual após o parto nas mulheres de Pelotas. Delineamento: Estudo de Coorte prospectivo. Amostragem: Mulheres que tiveram seus filhos nas maternidades de Pelotas de setembro de 2002 a novembro de 2003. População: De 2741 parturientes no período perinatal, obteve-se uma amostra aleatória de 920 mulheres aos 180 dias após o nascimento. Métodos: Realizadas análise uni e multivariada e somente as variáveis com p<0,05 foram consideradas associadas ao desfecho de forma estatisticamente significativa. Principais medidas: Razão de prevalência com intervalo de confiança. Resultados: A prevalência de dificuldade no retorno à atividade sexual foi de 25,5% e 80% das mulheres retomaram a vida sexual nos primeiros dois meses após o parto. O principal motivo para não ter relação sexual foi o fato de a mulher não ter companheiro (63%); as demais causas foram a falta de vontade ou de tempo. As primigestas e as mulheres com problemas de saúde no pré ou no pós-natal, apresentaram uma prevalência mais elevada de dificuldades: dores pélvicas, insegurança ou medo e falta de desejo. Conclusão: Encontrou-se uma alta prevalência de dificuldades em retomar as atividades sexuais após o nascimento. Foi um estudo realizado numa cidade do sul do Brasil e, por isso, os achados estão contextualizados à cultura e aos hábitos destas mulheres. Cabe ressaltar a relevância da necessidade de 38 orientação no pré-natal, para amenizar ou evitar problemas passíveis de resolução

Made available in DSpace on 2016-04-28T20:39:09Z (GMT). No. of bitstreams: 1 Marcia Schivartche.pdf: 631969 bytes, checksum: 88276ca2db94a9756a1f2925fd76eb84 (MD5) Previous issue date: 2015-09-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The goal of this research is to understand the function of the lie during psychoanalysis as well as portraying the analyst's role with regards to handling such a report in light of Freudian psychoanalytic theory. The idea behind this study arose from the analyst's difficulty of working with this type of symptom and a subsequent need to further investigate this everyday phenomenon. Therefore, a study on lies was performed, serving as a starting point for the presentation of a clinical case, which inspired this research. Given the difficulty of the transference management for this type of psychopathology, Freud's work was employed as a support to the psychoanalytic technique. Furthermore, the author also presents other psychoanalysts' reports of patient liars, who in turn, offer a better comprehension of the various aspects that may underlie the lie as told by the patient.Thus, this research intends to consider lies within Psychoanalysis / Esta pesquisa procura compreender a função que tem a mentira contada em análise, bem como retratar qual a função do analista no que diz respeito ao manejo transferencial desse tipo de relato, à luz da teoria psicanalítica freudiana. A ideia para este trabalho surgiu da dificuldade da analista em trabalhar esse tipo de sintomatologia, e uma posterior necessidade em investigar melhor esse fenômeno tão corriqueiro na clínica. Dessa forma efetuou-se um estudo sobre a mentira, servindo como ponto de partida para a apresentação de um caso clínico, que inspirou essa pesquisa. Tendo em vista a dificuldade do manejo transferencial para esse tipo de psicopatologia, a obra de Freud foi empregada para dar sustentabilidade ao que seja a técnica psicanalítica, indo um pouco mais adiante, a autora traz aqui relatos de psicanalistas que tiveram pacientes mentirosos em suas clínicas, que ofereceram, subsídios para a compreensão dos vários aspectos que podem estar subjacentes na mentira relatada pelo paciente. Dessa forma, pretende-se com esta pesquisa considerar a mentira no âmbito da Psicanálise

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