Place is not a static backdrop for social relationships; rather, it is a dynamic product of the interactions among the people, practices, objects, and representations contained within it. Often, street-involved people who use drugs are excluded from interactions that would otherwise allow them to participate in community dynamics. In Vancouver, British Columbia, peer-based outreach groups redress these barriers by providing low-threshold positions to individuals living with active or past addiction. The overall question of this thesis is: what is the role of place in the health of an individual and of a community? Objectives include: (1) applying existing models of social exclusion to outline barriers preventing Peer Members from engaging in placemaking; (2) mapping the ideological positionality of the Peer Members and the rest of the community with regard to citizenship; and (3) exploring how Peer Members utilize their biosocial role as outreach workers to establish social capital and situate themselves as participants in a healthy community. By providing a platform where various social identities can interact with one another, ties of familiarity are established between these groups, thus enabling the transfer of resources, knowledge, and shared norms of respect. The first half of the discussion focuses on how social and geographic displacement legitimizes the process of social abandonment. Consequently, this relegated the Peer Members and their peers into the role of anti-citizen, rationalized their marginalization, and reinforced the wider community’s stigma toward people who use drugs. The latter half of the discussion illustrates how the Peer Members utilize their biosocial role of outreach and support workers to navigate boundaries and establish social connections to circulate knowledge and information within and among different social fields. This enabled the expression of mutual reciprocity, thereby negotiating the place of people who use drugs and harm reduction among the wider community. Place is therefore a concept that shapes, and is shaped by, the social networks that determine social legitimacy or illegitimacy. Although marginality and oppression cannot be transformed immediately, creating a social environment where Peer Members can be supported and support one another helps mitigate the marginalization that characterizes their lives.

This research aims to determine teacher perceptions on alcohol- and drug use among students, as well as how they implement the municipality framework against alcohol and drugs. The research was carried out in a midsized town in the centre of Sweden. It is characterized by an inductive approach and was performed through a qualitative method. Results were analyzed from a hermeneutic approach, and theories used are system theory, salutogenic approach and Mead’s symbolic interaction theory. One outcome from this research was the fact that teachers generally implement their work out of the municipality framework, even though teachers express their lack of knowledge about the content of the framework. Furthermore the research revealed that many teachers thought the relationship towards the students had a big impact on how they could manage to help them, that it was important that students felt that the teachers were trustworthy. The conclusion of this research is that there is a great variety regarding the commitment and knowledge among teachers when it comes to student usage of alcohol and drugs, even though teachers were given a common framework.

The goal of the present study was to examine the relationships between college students with prior therapy and psychotropic drug experience and total number of therapy sessions. This study also investigated specific types of medications students were taking and total number of therapy sessions attended. The first hypothesis under investigation was that students who have received therapy prior to beginning treatment would remain in therapy significantly longer than participants who have received no prior therapy. It was also hypothesized that students who were prescribed psychotropic medications prior to beginning therapy will remain in therapy significantly longer than students who were taking no psychotropic medications. Lastly, it was hypothesized that students who reported taking anti-anxiety or anti-depressant medications would stay in therapy longer than students taking other types of psychotropic medications will. Participants (n = 279) were collected from a pre-existing database and included students who received therapeutic services from a Southern university whose population comprised 18,485 students. The first two hypotheses were evaluated using a 2 (Prior Therapy: Yes vs. No) x 2 (Prior Medication: Yes vs. No) Analysis of Variance (ANOVA). The third hypothesis was analyzed using a 2 (Antidepressant Medication: Yes vs. No) x 2 (Anxiolytic Medication: Yes vs. No) x 2 (Other Psychotropic Medications: Yes vs. No) ANOVA. Results supported hypothesis 1: students who have previously attended therapy will stay in therapy significantly longer than students with no prior therapy experience F (1, 275) = 6.65, p = .01). However, findings did not support either hypotheses 2 or 3: students who were taking psychotropic medications prior to entering therapy did not stay in therapy significantly longer than students who were not taking psychotropic medications prior to therapy, regardless of type of medication. Results of the present study are important, as they provide a basis for future research examining prior college student therapy and psychotropic medication experience and duration of treatment at campus counseling centers. Additionally, results suggest that students with prior exposure to therapy stay in therapy longer than students with no prior exposure to therapy. One explanation for this finding is that students with prior therapy experience are likely more familiar, and more comfortable, with the therapy process than those with no prior experience. In turn, they stay in treatment longer. Universities and campus counseling centers may consider providing students with information about mental health and therapy, as this finding and research suggests that students with personal experience or prior knowledge of mental illness or therapy have more favorable attitudes about therapy than those with no prior knowledge or experience. It is also feasible that students who continue therapy while attending college have more severe mental health problems or disorders and require further treatment. This finding is significant for universities and campus counseling centers, also, as many counseling centers use a brief model of therapy, which may not prove beneficial for students with more severe problems. However, definitive information is not available, as the current data set lacks important information, such as the previous duration of treatment, student diagnoses, time of semester that the students entered therapy, and improvement in symptoms following current therapy. Thus, results should be interpreted with caution. Other limitations and suggestions for further research are also discussed.

Using data from the Drug Use Forecasting (DUF) and the Arrestee Drug Abuse Monitoring (ADAM) programs collected by the National Institute of Justice the question whether the drug estimates of DUF, using a non-probability sample, and the drug use estimates of ADAM, using a probability sample, yield substantially different results will be explored. The following main questions will be addressed using equivalence analysis: Are there substantial differences in the DUF and ADAM samples with regard to the drug use information obtained from arrestees at nine sites across the United States? The analysis suggests that the drug use information contained in DUF and ADAM is not substantially different for marijuana, cocaine, and opiates for all sites analyzed together. Additionally, there are no substantial differences for seven of the nine sites. The implications of these findings are discussed.

Substance use among high school students has become an increased concern for administrators, parents, and community members. Previous research has demonstrated relationships between adolescent substance use and numerous negative outcomes. This study investigated the relationship between athletic participation and substance use using self-report data from a sample of 139 high school students. Specifically, the current study examined the relationship between frequency and setting of participation in athletic activities (e.g., football, baseball, soccer) and multiple types of substance use (e.g., alcohol, tobacco, marijuana, other illicit drugs) in adolescents. The results of this study indicate that nonathletes reported significantly more marijuana use than athletes when gender, ethnicity, SES, and grade were controlled for in the analyses. Additionally, there was a significant relationship between students‟ grade and substance use. Specifically, 12 th grade students reported significantly higher rates of alcohol use than 10th grade students. Implications for school psychologists and directions for future research are presented.

This study used the Andersen Model for Health Services Utilization to examine a pharmacist-provided telephone MTM program among Medicare Part D beneficiaries. Predisposing (age, gender, race) and need factors (number of medications, number of chronic diseases, medication regimen complexity) were assessed. The health behavior, MTM utilization, distinguished the intervention and control groups. The health outcomes were change in number of medication-related problems, change in medication adherence [using the medication possession ratio (MPR)], and change in total drug costs. Medication knowledge, medication adherence (using the Morisky Scale), and patient satisfaction were also measured in the intervention group. The intervention and control groups were not significantly different in age (71.2 ± 7.5 vs. 73.9 ± 8.0 years), number of medications (13.0 ± 3.2 vs. 13.2 ± 3.4), number of chronic diseases (6.5 ± 2.3 vs. 7.0 ± 2.1), and medication regimen complexity [21.5 (range 8 – 43) vs. 22.8 (range 9 – 42.5)], respectively. For the subset of problems that was evaluated in the intervention and control groups, 4.8 (± 2.7) and 9.2 (± 2.9) problems were identified at baseline and 2.7 (± 2.3) and 8.6 (± 2.9) problems remained at the 3-month follow-up, respectively. Cost-related and preventative care needs and drug-drug interactions were the three most common problems identified. Multivariate regression analysis revealed that the intervention group had significantly more problems resolved (p < 0.0001) when compared to the control group, while controlling for predisposing and need factors. Significantly fewer problems were resolved (p = 0.01) as number of diseases increased and significantly more problems were resolved (p = 0.01) as medication regimen complexity increased. There were no significant predictors of change in MPR or total drug costs from baseline to the 3-month follow-up. Medication knowledge and medication adherence measured by the Morisky scale did not change significantly from baseline to the 2-week follow-up. However, patients were very satisfied with the service. A pharmacist-provided telephone MTM program was an effective method for identifying and resolving medication and health-related problems. A longer follow-up period may be necessary to detect the impact of pharmacist provision of MTM on adherence, total drug costs, and knowledge. / text

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

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In 2005, suicide was the third leading cause of death among youth 10-24 years of age in the U.S. —accounting for 4,482 deaths. Youth suicide is an important public health problem in the U.S. and research focusing specifically on gender differences is needed and warranted since recent research shows that rates of suicide attempts have increased specifically among young girls. Analyses of the recently released 2007 YRBS data (n=14,041; girls=7,036; boys=6,992) of high school students in 9-12th grades, show that 6.9% of adolescents attempted suicide (9.3% of girls versus 4.6% of boys) and 14.5% seriously considered a suicide attempt (18.7% of girls versus 10.3% of boys). Girls are 2.89 (95% CI: 2.31-3.61) times more likely than boys to report attempting suicide in the past 12 months. Moreover, girls who reported attempting suicide were significantly more likely to also report other risk factors such as depression (OR= 5.74), weapon carrying (OR= 1.48), experiencing intimate partner violence (OR=1.60), being forced to have sexual intercourse (1.72), huffing glue (OR=2.04), and being a minority (OR 1.65). However, boys who reported attempting suicide were significantly more likely to also report weapon carrying (OR=1.66), being forced to have sexual intercourse (OR=2.60), huffing glue (OR=1.63), participating in sports (OR=1.52), depression (OR=10.96), hard drug use (OR=2.18), and being a minority (OR=1.93). Furthermore, analyses of 1991 – 2007 YRBS data revealed that these gender specific risks have remained fairly constant over time. These findings will help guide prevention and intervention strategies to prevent suicide and suicidal behaviors among both girls and boys.

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