Research on risk and resilience related to behaviour and poor health outcomes among young people consistently indicates the need to take greater cognisance of social and environmental factors. This is particularly true of research in developing countries. In South Africa, there is a paucity of research on these issues. This study attempts to examine risk and protective factors, as well as coping style of young South Africans at the University of Natal, Pietermaritzburg. Environmental risk and protective factors measured were related to family, peers, and financial support. Categories of risk behaviour and poor health outcomes measured were substance use, sexual behaviour, general risk behaviour and depression. Broad-based questionnaires were sent to 2000 randomly selected students aged between 18 and 24 years old, and completed by 678 students. Results indicated that there was a trend towards gender equalisation in levels of risk and poor health outcomes- that there were significant relationships between many risk behaviours and poor health outcomes- that coping styles were correlated with risk behaviour and poor health outcomes in the expected direction (avoidance coping correlated positively and approach coping correlated negatively with risk behaviour, poor health outcomes and environmental risk factors)- and that environmental risk factors (low family, peer, and financial support) were associated with high levels of risk behaviour and poor health outcomes including sexual risks and depression. A contextual model was employed to explain the importance of environmental factors and coping styles in the promotion of health and wellbeing. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

<p>HIV poses considerable social and health challenges in South Africa, particularly among young people aged 15-24. Research indicates a strong link between risky sexual behaviour and alcohol and illicit drugs. In the Western Cape drug-related behaviours is a growing concern among young people because of relatively high prevalence rates of drug abuse, particularly methamphetamine. Previous South African studies have tended to focused on the link between substance use and risky sexual behaviour among commercial sex workers. The theoretical approach of this study is the information motivation behavioural skills model. Participants were selected using non-probability sampling of 279 first year students registered for Psychology I at the University of the Western Cape. This study employed a quantitative research approach using a survey design. Results: Forty-six percent of students do not believe that the use of illicit drugs has an impact on a person&rsquo / s sexual behavior. However, the findings also showed that only 45% of students believed that there was a difference between illicit drug users correctly using condoms when compared to non-users. Data was analysed using descriptive and inferential statistics. Conclusion: Prevention is our best and most effective means of decreasing risk-taking behaviours associated with HIV infection. Information is the first line of intervention that is necessary to reduce risk-taking behaviours / however prevention strategies and interventions of risk-taking behaviours should aim to increase motivation and help young people integrate information in a way that it is personally relatable. This is vital to address the inconsistencies between perceptions of risk and the realities of risk-taking behaviour.</p>

The primary purpose of this study was to determine if a drug testing program could impact or change student drug use at the secondary education level. Secondary purposes were to 1) assess the perceptions of secondary education students toward licit and illicit drugs, drug use, and the newly implemented drug testing program, and 2) to examine why drug use may continue even after a drug testing program has been implemented. Data was collected through the use of questionnaires, discussion groups, and one-on-one interviews. Examination of the questionnaire data indicated that student drug use was not substantially deterred by the newly implemented drug testing program over a three to four month time period. Also, students' perceptions of the newly implemented drug testing program were mainly that of disagreement. Students commented that they felt the drug testing policy was implemented to "catch them" using drugs rather than "help them" with a possible drug addiction. One of the main reasons that the drug testing program did not have a great deterrent effect on student drug use, as suggested by the students, was that the odds were not high enough that they would be selected to be drug tested. In some instances, drug testing was not proving to be a deterrent to drug use, but rather a deterrent to participation in school activities. However, for some students, drug testing was proving to be a deterrent to drug use. As quoted from one of the discussion group members: "It's a step in the right direction." / School of Physical Education

This research was completed to deal with many unanswered questions regarding drug use, specifically drug use in areas of rural poverty. Look at any "Faces of Meth" billboard or listen to any corporate-news program and one might assume there is a drug epidemic in rural areas. Without research, this allows the viewer to assume that poverty is the fault of the drug user who happens to live in rural places. This study sought to take a qualitative and ethnographic methodology to "embed" the researcher in this setting to see for himself whether these views were valid or invalid. The questions of functional drug use were at the forefront of the study, as was the possible relationship between drug use and rural poverty. This study transformed into a serious analysis of a network of drug users in the town of Mulch Valley. While standard sociological (and policy issues) concerns are dealt with, this thesis moves beyond such concerns. Theoretical concerns are brought into questions as new concepts, such as: cultural narrative of addiction, master sociality, slave sociality, and Derridity." "Crushing. Cheating. Changing. Am I deaf or dead? Is this constricting construction or just streets with rusty signs of something violent coming?" (Manson, 2012)

New survey data indicate that injection drug users (IDU) in Victoria, BC who share syringes do so with a single person. These partnerships pose an obvious health risk to IDU, as blood borne illnesses are transmitted through the sharing of injection equipment. Here we formulate an ordinary di erential equation (ODE) model of pair formation and separation. Susceptible-infectious (SI) disease dynamics are built into this model so as to describe the syringe-mediated transmission of human immune de ciency virus (HIV) and hepatitis C virus (HCV) among IDU. We utilize a novel parameter estimation approach, and t the distribution of partnership durations observed in Victoria. The basic reproduction number is derived, and its qualitative behavior explored with both analytical and numerical techniques.

Thesis (Ed. D.)--University of Hawaii at Manoa, 1995. / Includes bibliographical references (leaves 161-167). / Microfiche. / x, 167 leaves, bound ill. 29 cm

Adolescence is a time of great changes, a time where experimentation and exploration is expected and when the values of authority figures are examined and challenged. Adolescents will experiment and push the boundaries of all aspects of their life in order to find their own place and identity in a world that has changed its expectations of them. Use of drugs is one of the ways that they do this. Australian adolescents grow up in a society where alcohol and tobacco is an acceptable part of daily life. Their use of drugs is at least on par with and in some cases exceeds that of the general population. The overall goals of this research were to gain more information on drug use of Australian adolescents, using existing data sets. This research examined, using a number of different age groups, the differences in adolescent drug use between urban and rural Australia for lifetime use, use in the last year and use in the last month using the 2002 edition of the Australian School Student Alcohol and Drug (ASSAD) survey series in conjunction with the 2001 National Drug Strategy Household Survey (NDSHS). It also used these data sets to investigate differences between indigenous adolescents and non-Indigenous adolescents and whether there were any differences in adolescent drug use across socio-economic status groups. Four hypotheses were developed. The first was that rural adolescents are more likely than urban adolescents to use licit drugs and the second was that urban adolescents are more likely than rural adolescents to use illicit drugs. Thirdly, that Indigenous adolescents are more likely than non-Indigenous adolescents to use both licit and illicit drugs and the fourth was that adolescents from low socio-economic status (SES) groups are more likely than adolescents from high SES groups to use licit and illicit substances. The data offered little support for any of the hypotheses. The hypothesis on rural adolescents being more likely to use licit drugs was supported by the ASSAD surveydata but not the NDSHS. All other hypotheses were not supported by either of the data sets. While there are aspects of the information from the two data sets that are contradictory making it difficult to prove or disprove the hypotheses formulated for this research, they highlighted a number of aspects of adolescent drug use. The first of these is that this research supports the premise that rural adolescent drug use rates are converging with urban drug use rates for younger adolescents. It also highlighted that there are a large number of rural school students who are using alcohol and cannabis. The ASSAD data also confirmed other Australian research showing that Indigenous adolescents are less likely than their non-Indigenous counterparts to use alcohol. Both data sets confirmed previous research by indicating that adolescents from the high SES groups are more likely than their counterparts in the lower SES groups to consume alcohol. Further investigation is needed to find out why the data sets did not substantiate each other and to gain further insight into the consumption of alcohol by Indigenous adolescents and adolescents from the higher socio-economic status groups. Increasing the samples of Indigenous people in both of the data sets and lobbying the Australian Bureau of Statistics to increase their sample for the Indigenous Social Survey to include 12-14 year olds should give more information on Indigenous adolescents that could be used in research and prevention activities.

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.

The New South Wales Medical Board established a Health Programme for the assessment and rehabilitation of doctors whose clinical performance was impaired by alcohol or psychoactive substance use, mental or physical illness. This programme was developed to be individualized to the needs of each registrant. The present study has three aims: 1. To describe those doctors who participated in the Board???s Health Programme. 2. To chart the duration of involvement of these doctors through the programme. 3. To examine the outcomes associated with this programme. The study is based on the prospective cohort of all 181 impaired doctors who participated in the Health Programme between July 1st 1993 and April 30th 2001. Information on each registrant was collected at the time of the initial assessment and at each review conducted as part of the programme. Additional qualitative data was also collected and supplemented by a file audit conducted in August and September 2001. One hundred and eighty-one doctors were prospectively monitored as part of this study. The largest source of impairment was psychiatric illness (45.3%), 77% of the doctors were male. The average age of the cohort was 41.6 (sd 11.1) years. Impaired doctors were more likely to be working in emergency medicine or psychiatry and be based in a rural area. Of those who had finished their involvement in the programme, successful graduates participated for a mean of 38.2 (sd 22.3) months. In general outcomes of involvement were positive, 64 of 113 (56.6%) of doctors successfully graduated from the programme. One hundred and ten of 168 (65.5%) improved during the period of their involvement and 111 of 126 (88.1%) were working in medicine. Five, 2.8% of the participants died during the period of this study. Measures of registrant insight and support tended to increase during the period of involvement with the Health Programme. Future studies will need to establish evidence for the most appropriate interventions with impaired doctors. This process would be strengthened by the collection of standardized data across intervention programmes, supplemented with functional assessments and the collection of qualitative data.

Made available in DSpace on 2016-12-12T20:34:13Z (GMT). No. of bitstreams: 1 Dissertacao Paulo em 17-9.pdf: 465544 bytes, checksum: 33b5b1a2b098715556b9cc2171800076 (MD5) Previous issue date: 2007-10-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In order to contribute for the evaluation of the Brazilian policies on generic drugs and their social relevance, this study investigated, by means of a case study on a public health unit, the knowledge that prescribers, dispensers, and users possess on generic drugs and their confidence on those drugs. First, the study investigated the history of the production and use of drugs in Brazil, from the colonial times to the present days. Then, by means of an examination of the legislation, the study investigated the characteristics of the Brazilian National Policy on Drugs, drawing a distinction between generic, similar and brand name drugs. Data were also obtained on the production and sales of drugs in Brazil. After that, by means of a case study, information was collected on the attitudes of health professionals and patients towards generics (knowledge, confidence, use, etc.). Subjects of this study were 62 patients of a policlinic in São José, Santa Catarina, Brazil, plus 14 prescribers (11 doctors and 3 dentists) and 2 dispensers (pharmacists), all of which work at the policlinic. The data were collected by means of questionnaires. Patients had a great difficulty to distinguish the classes of drugs based on the Law 9787/99 (Law of Generic Drugs). Most of them have the wrong conception that generics are cheaper than similar drugs. Prescribers also were also confused by the definitions of generic and similar drugs presented in the legal text. On the other hand, most of them are aware of the fact that generic drugs have the obligation to be cheaper than brand-name drugs only. Most of the prescribers rely on the quality of generic drugs, but they do not always make their prescriptions using the Brazilian Common Denomination, which would facilitate the acquisition of generics by patients. The pharmacists could easily identify drug classes, as presented in the legal text. They were also knowledgeable about the fact generics are normally more expensive than similar drugs. This research allowed for the following general findings, among others: a) Brazilian national policy for generics has warranted safety and efficacy of drugs, by establishing accurate criteria for the certification of the centers that test bioequivalence/bioavailability and pharmaceutical equivalence; b) the national policy for generics has favored the development of the Brazilian drug industry, because most the great majority of the generics sold in Brazil are produced by national laboratories; c) the national policy for generics has attended the principle of rational drug use, because it presupposes surveillance and control of drug production, prescription, and dispensing; d) generics are cheap enough to provoke a significant reduction on the cost of some treatments and bring some economy for the government concerning the acquisition of pharmaceuticals; e) in the last ten years, raises in drug prices caused a reduction in the consumption of drugs in Brazil, but it is probable that the increase in the use of generics forces a decrease in the price of brand name drugs; f) new public campaigns seem necessary in order to restate the distinctions among drug classes and to reinforce prescribers confidence in generics / Como forma de contribuir para a avaliação da política nacional de medicamentos genéricos e sua relevância social, este trabalho investigou, mediante estudo de caso em uma unidade pública de saúde, o conhecimento que têm prescritores, dispensadores e usuários relativamente aos medicamentos genéricos e a confiança que neles depositam. Para situar historicamente a pesquisa, traçou-se inicialmente um histórico da produção e uso de medicamentos no Brasil, desde os tempos coloniais até os dias atuais. A seguir, mediante exame da documentação oficial, procurou-se conhecer as características da Política Nacional de Medicamentos, distinguindo medicamentos genéricos de similares e de referência e obtendo também dados sobre a produção e comercialização de medicamentos no País. Depois, mediante estudo de caso, buscou-se obter informações quanto à relação de profissionais da saúde e usuários com os medicamentos genéricos (conhecimento, confiança, uso, etc.). Foram informantes da pesquisa 62 usuários da Policlínica Municipal de Campinas - São José/SC, 14 prescritores (11 médicos e 3 cirurgiões-dentistas) e 2 dispensadores (farmacêuticos), todos atuantes na Policlínica. Os dados foram colhidos mediante a aplicação de questionários. Os usuários tiveram bastante dificuldade para distinguir as classes de medicamentos a partir do texto da Lei 9.787/99 (Lei dos Genéricos). Mais da metade deles têm a percepção equivocada de que os genéricos são mais baratos que os similares. Já os prescritores também confundiram as definições para medicamento genérico e similar oferecidas no texto legal. Por outro lado, a maioria dos prescritores mostraram-se cientes de que os genéricos têm por obrigação serem mais baratos apenas que os medicamentos de referência. A maioria dos prescritores confiam na qualidade dos medicamentos genéricos, mas nem sempre fazem suas prescrições usando a DCB, o que facilitaria a aquisição de genéricos pelos pacientes. Os dispensadores identificaram sem dificuldade as classes de medicamentos, a partir do texto legal. Também sabem que os genéricos geralmente têm preço mais elevado que os similares. Entre outras, o trabalho permitiu as seguintes constatações gerais: a) a política nacional de genéricos tem garantido a segurança e eficácia dos medicamentos, mediante o estabelecimento de critérios apurados para certificação dos centros que realizam os testes de bioequivalência/biodisponibilidade e equivalência farmacêutica; b) a política de genéricos tem favorecido o desenvolvimento da indústria nacional de medicamentos, pois a grande maioria dos genéricos consumidos no País são produzidos por laboratórios nacionais; c) a política de genéricos tem favorecido ao princípio de uso racional de medicamentos, pois prevê acompanhamento e controle da produção, da prescrição e da dispensação de medicamentos; d) os genéricos são suficientemente baratos para provocar redução considerável no custo de alguns tratamentos e propiciar ao poder público alguma economia na aquisição de medicamentos; e) nos últimos dez anos, aumentos acima das taxas de inflação provocaram uma redução no consumo de medicamentos no País, mas é provável que o crescimento que se vem verificando no uso dos genéricos provoque uma queda no preço dos medicamentos de referência; f) parecem ser necessárias novas campanhas estabelecendo a distinção entre as classes de medicamentos e reforçando, nos prescritores, a confiança nos genéricos