L’addiction ou dépendance aux substances psychoactives est une affection chronique, fréquente et grave, émaillée de rechutes et de périodes d’abstinence. Les études épidémiologiques montrent que l’abstinence aux opiacés est fortement associée à une prévalence accrue de la dépression. Nous résumons ici les principaux aspects cliniques de la dépendance aux opiacés et de la dépression, en détaillant leurs mécanismes physiopathologiques. Puis, nous présentons notre modèle d’abstinence aux opiacés chez la souris. Suite à un traitement morphinique chronique et au cours de l’abstinence apparaissent progressivement des comportements apparentés à la dépression. Ce traitement morphinique modifie profondément le fonctionnement du système sérotoninergique, notamment dans le noyau du raphé dorsal. De plus, les déficits comportementaux observés peuvent être prévenus par un traitement chronique par la fluoxétine, un antidépresseur ciblant ce système. Nous avons généralisé ce modèle à l’héroïne, un autre opiacé illicite. Nous avons révélé par des approches génétiques de délétion constitutive et conditionnelle les rôles distincts des 3 récepteurs opioïdes (mu, delta et kappa) lors de l’abstinence à l’héroïne. Enfin, nous avons initié une étude de caractérisation, à l’échelle de l’ensemble du génome, des adaptations transcriptomiques (ARN messagers et micro-ARN) dans le noyau du raphé dorsal au cours de l’abstinence à l’héroïne et du traitement antidépresseur. Ce travail devrait permettre d’améliorer notre compréhension des mécanismes neurobiologiques à l’œuvre dans la comorbidité entre dépendance aux opiacés et dépression et pourrait suggérer de nouvelles pistes thérapeutiques. / Addiction is a chronic, frequent and serious brain disease, with relapse alternating with abstinence periods. Epidemiological studies show that abstinence, notably from opiates, is strongly associated with depression.Here we present the main clinical aspects of opiate addiction and depression, and most recent advances in molecular pathophysiology of both disorders. Then, we present our mouse model of opiate abstinence. Following chronic morphine exposure, depressive-like behaviours progressively emerge. Morphine treatment profoundly disrupts serotonergic signalling, notably in the dorsal raphe nucleus. In addition, behavioural deficits can be prevented by chronic treatment with fluoxetine, an antidepressant targeting serotonergic neurons. We then generalized our mouse model to heroin, another major illicit opiate. Using constitutive and conditional knockout strategies, we documented distinct roles for all 3 opioid receptors (mu, delta and kappa) in heroin abstinence. Finally, we initiated a large-scale analysis of transcriptomic regulations (mRNA and micro-RNA) occurring in our model as a function of heroin abstinence and fluoxetine treatment.These studies should reveal an unforeseen contribution of the dorsal raphe nucleus to addiction. They should uncover new molecular mechanisms underlying depressive-like behaviors in mice during opiate abstinence and thus put forward new therapeutic targets in humans.

Master of Science / Department of Programs in General Human Ecology / Karen S. Myers-Bowman / The alarming incidence of sex-related health problems among American adolescents has health educators searching for effective curricula-based programs aiming at behavioral changes. Such desire and urgent need to find or create programs and curricula that work have generated different approaches, philosophies, and educational strategies. However, this also may have produced a number of programs that have not benefited from a careful and thorough evaluation: neither evaluation of content, message, and cognitive and/or behavioral effect. The focus of this paper is on the curricula utilized in sexuality health programs in middle and high schools. Questions arise about the impact of these programs. Currently, abstinence-based programs are the only ones funded by the government. Research data does not convincingly show that abstinence-only sexuality education significantly decreases the number of adolescents engaging in sexual intercourse prior to marriage. This paper attempts to review current research about abstinence and comprehensive curricula. I begin by discussing the different approaches and their supporters. The importance of adolescent development and theory will be incorporated into my review. Effectiveness of each approach, as well as evaluation studies will be examined. From this review, I composed my own assessment of one abstinence-based curriculum and one comprehensive based curriculum.

Based on the various changes in sexual education, many schools throughout the United States still teach abstinence-only education. There is a plethora of literature on the effectiveness of sexual education programs as well as adolescent sexual practices. However, there is a deep gap in literature on students' perspectives of their sexual education and the possible effects it has on their experiences while in college. Therefore, this phenomenological study aims to explore and describe the essence of the experience female university students have regarding the abstinence-only education they received during secondary schooling. The informants (n=12) were 19-22 year old female university undergraduate students who received abstinence-only education within their middle and/or high school. Data was collected through semi-structured interviews. Data was analyzed through a phenomenological approach where themes and sub-themes emerged. The results from this study indicate that no matter what the participants’ personal beliefs and values surrounding sex are, their abstinence-only sexual education did not teach them adequate information for their secondary school years nor to prepare them for their time in a university setting.

Subject: How a drogue ex-user see a period of his addiction. Abstract: The work focus on the actual situation of ex-users. These people were fighting with an addiction and now they are a part of the majority society. The qualitative research, inspired by a grounded theory, try to approach their point of view. What they think about their past and how do they see their relations with a family, friends and a vicinage. Not just in that period but nowadays as well. Relationships with home-folks are stigmatized by a degree of drug addiction. The smaller addiction the smaller losses. Once a drug user is falling down into the drug trap, the losses depend on how deep he will fall. On the bottom there are no friends, no family, just nothing. Some of the drug users do not fall to the bottom, they do their decision earlier. We call that decision a break point ( a moment when they decide to abstain). A break point comes individually and it is connected to an "interior border" of each person. Anyway, it is a moment, when an individual concerned decide to live a different way. It is a very intense moment and very fundamental for a abstinence success. We have used an interview to study not just this phenomenon. During the interview we tried to find out how a life looks with and without an addiction. Key words: addiction,...

This project studies the theological legacy of white evangelical purity culture (WEPC) and proposes a constructive Baptist practical theology of baptism in response. It foregrounds the activism and testimonies of Christian women to foment and intervene in white supremacist constructions of womanhood in the Female Moral Reform movement; to perpetuate and prevent racial violence in the lynching era through the deployment of a reimagined vision of sacred white womanhood; and to expand conceptions of the wounding legacies, persisting challenges, and alternative visions proposed by those harmed by WEPC. In the “afterlife” of white evangelical purity culture, baptism, conceived as a practice of solidarity, is a critical intervention to the persistent and problematic deformations of identity, salvation, and ecclesial formation. The project begins with analysis of the theopolitical history of WEPC and its founding frameworks and promises. It then turns to the Female Moral Reform movement, and particularly the activism and theological arguments of Sarah Grimké and a dissenting interlocutor in 1838, to illustrate how questions of womanhood, race, and women’s rights were forged in the context of institutional slavery. Next, this project engages the activism of Rebecca Felton, Ida B. Wells-Barnett, and the Association of Southern Women for the Prevention of Lynching, attends to the character de/formations deployed in women’s activism and rhetoric supportive of and against lynching, and argues that the uninterrogated sacred status of white womanhood prevents a full acknowledgement and dismantling of the regnant theological frameworks of WEPC. It then frames the online writing as testimonies to the wounding experiences in WEPC, offering an emergent tripartite framework of shame, misplaced blame, and silence to capture the impact of WEPC. Finally, drawing from the works of James Wm. McClendon, Jr., Ada María Isasi-Díaz and M. Shawn Copeland, it proposes a Baptist theology of baptism wherein baptism is revelatory rite that initiates solidarity in the service of a world that engenders the possibility of mutual liberation and human flourishing. This project contributes to the growing literature on WEPC by exposing the raced theological scaffolding that necessitate a transformation of core Christian practices. / 2022-12-09T00:00:00Z

Objective: The purpose of this study was to determine the characteristics, assessment, and treatment of infants with Neonatal Abstinence Syndrome (NAS) as perceived by Speech-Language Pathologists (SLP) and whether it differed from those of other Neonatal Intensive Care Unit populations. Methods: A secure web-based questionnaire with 62 questions collected information on NAS, caseloads, treatment environment, and demographics. Twenty-six respondents initiated the survey; 42% completed most or all questions. Response analyses included descriptive and nonparametric inferential statistics. Results: Infants with NAS were on the caseloads of 73% of respondents. The majority (79%) only saw infants with NAS and feeding problems. Primary problems included incomplete or increased time to complete feeds, increased/excessive/irregular sucking rates, and reflux. Working on teams, respondents provided assessment, treatment, and education of infant feeding and state. Conclusion: Growing demand for SLP intervention with infants with NAS is likely to persist if opioid use continues to increase as projected.

Made available in DSpace on 2016-04-28T20:38:51Z (GMT). No. of bitstreams: 1 Carol Godoi Hampariam.pdf: 1038950 bytes, checksum: 76d228a5129c9eeb285ce6cfd157e717 (MD5) Previous issue date: 2014-04-04 / Fundação de Amparo a Pesquisa do Estado de São Paulo / The present work, from the question why it is so hard to get rid of drugs, investigate the circumstances surrounding the period of abstinence and relapse consequently preventing or influencing those patients who definitely want to get rid of drugs. Thus, the phenomenon of addiction were studied in an attempt to understand what happens psychologically when a person becomes dependent on a substance which he chooses as an unstoppable object, subsequently breaking that occurs in the psyche when it is abstemious drug. In this sense, it was possible to elucidate what happens in psychic abstinence process to envision the difficulties and possibilities of intervention with a drug addicted patient said. With that, we addressed the edges and nuances found in treating an addict, this is done in a treatment institution or a private practice, considering the interfaces of the institution of the family in this process. From this study, formulated the proposal of understanding that refrain the drug is not simply distance himself from her, but make a conscious and unconscious to stay away from this deception choice facing it, psychic reality, the pain , the inconveniences, the human incompleteness without holding an anchor in the processes that govern the psychic functioning / O presente trabalho visa, a partir da pergunta por que é tão difícil livrar-se das drogas, investigar as circunstâncias envolvidas no período da abstinência e consequentemente da recaída que impeçam ou influenciam aqueles pacientes que desejam livrar-se definitivamente das drogas. Para tanto, foram estudados o fenômeno da adicção, numa tentativa de entender o que ocorre psiquicamente quando um sujeito torna-se dependente de uma substância a qual ele elege como um objeto irrefreável, para posteriormente, desbravar o que ocorre no psiquismo quando este se encontra abstêmio da droga. Neste sentido, foi possível elucidar o que ocorre no processo de abstinência psíquica a fim de vislumbrar as dificuldades e possibilidades de intervenção com um paciente dito toxicômano. Com isso, foram abordadas as arestas e nuanças presentes no tratamento de um dependente químico, seja este realizado numa instituição tratamento ou num consultório particular, considerando as interfaces da instituição família neste processo. A partir deste estudo, formulou-se a proposta de compreensão de que abster-se da droga não é simplesmente distanciar-se dela, mas fazer uma escolha consciente e inconsciente de permanecer longe deste artifício, enfrentando com isso, a realidade psíquica, os dores, os desprazeres, a incompletude humana sem manter uma ancora nos processos que regem o funcionamento psíquico

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Background: In East Tennessee and Middle Appalachia, the epicenter of the opioid epidemic, approximately 15% of women give birth taking buprenorphine or methadone for opioid addiction (medical assisted therapy--MAT) or using other drugs illicitly and 5% of births are diagnosed with neonatal abstinence syndrome (NAS). A better understanding is needed of factors contributing to the severity of NAS. Objective: To identify maternal and infant characteristics associated with length of stay among newborns with neonatal abstinence syndrome. Design/Methods: Participants were 150 newborns systematically sampled from births diagnosed with NAS during the past 5 years at a single medical center. Data were obtained through abstraction of maternal prenatal records, infant delivery and infant medical charts. The abstraction included maternal and child demographic and clinical characteristics. Drug and other substance use/exposure histories were based on maternal history, and urine and cord tissue drug screening. Results: The infants’ average length of stay was 18.6 (s.d. = 11.9), 15% were low birthweight, and had an average gestational age of 38.8 (s.d. = 1.8); 62% were male; 49% were breast-fed. The mothers mean age was 27.5 (s.d. = 5.0); mean parity was 1.6 (s.d. = 1.4); 77% were unmarried; 75% had < HS education; and 89% had exposure at some time during pregnancy to other prescription (in addition to buprenorphine or methadone) or illicit opioids. In the least squares regression, which included important potential covariates such as infant sex, birth weight and gestational age, significant predictors of infant length of stay include: maternal benzodiazepine use (8.3 day longer LOS on average; p = 0.019), and infants whose mothers had a history of mental illness (3.9 day longer LOS on average, p = 0.040 ). While infants born to mothers smoking in the final 30 days of pregnancy had a 2.7 day longer LOS on average after adjustment for other significant predictors, this association was no longer significant in regression analysis (p = 0.293). Conclusion(s): Maternal use of prescription or illicit opioids leading to NAS is rooted in women’s’ life histories characterized by disadvantage, relationship instability, polysubstance use and mental illness. Efforts to reduce the incidence and severity of NAS among those on MAT during pregnancy should focus on preventing poly-substance misuse and providing supports for other maternal health needs including treating mental illness.