A principal causa dos atendimentos psiquiátricos de emergência às crianças e adolescentes é o comportamento agressivo, presente inclusive no abuso/ intoxicação por drogas. As unidades de emergência que atendem esta clientela lidam com o imediatismo das situações de saúde, somados às dificuldades inerentes ao manejo das questões relacionadas ao uso de substâncias e a complexidade do processo de trabalho para esta demanda neste setor. O presente trabalho teve como objetivo caracterizar os atendimentos de emergência psiquiátrica às crianças e adolescentes com transtornos pelo uso de substâncias, analisando os aspectos operacionais e emocionais relacionados ao trabalho da equipe de enfermagem no cuidado a esta clientela, no Pronto-Socorro do Hospital das Clínicas de Marília no período de 2000 a 2011. Trata-se de um estudo na combinação das abordagens quantitativa e qualitativa, dividido em duas fases, cuja primeira foi quantitativa, com um estudo transversal, descritivo exploratório a partir de dados secundários referentes aos atendimentos de emergência psiquiátrica relacionados ao uso de substâncias para menores de 18 anos. A segunda fase foi qualitativa, também transversal, descritiva e exploratória na qual foi utilizada a técnica de entrevista semiestruturada para a coleta de dados. Foram realizados 4.198 atendimentos de emergência psiquiátrica para crianças e adolescentes, 1.010 foram por problemas relacionados ao uso de álcool e/ou outras drogas, sendo o ano de 2011 o que mais registrou atendimentos. A idade prevalente foi dos 10 aos 17 anos, com predomínio dos 16 anos de idade, da cor branca, cursando o Ensino Fundamental, religião católica e predomínio do consumo de múltiplas drogas. Dentre os profissionais de enfermagem que lidam com esta demanda, participaram das entrevistas 6 enfermeiros e 25 auxiliares de enfermagem. Para a maioria dos participantes, não há diferença entre o atendimento de crianças e adolescentes com adultos, quando há, justificam pelas emoções e sentimentos que esta clientela desperta. O acolhimento se dá com contenção física e química e consulta médica. Os saberes especificados foram o conhecimento teórico/prático, ética profissional e habilidade de comunicação. Foram citadas tecnologias leve-duras, como agilidade, postura firme, observação e atenção. Já as tecnologias leves foram citadas a abertura para diálogo, paciência, discernimento, afetividade, discrição e humanização. Identificaram-se também desafios para a realização destes atendimentos, como a carência de melhorias nos aspectos físico-estruturais e da própria organização do processo de trabalho, a falta de privacidade para o atendimento, o número reduzido de profissionais de enfermagem e a falta de treinamento/capacitação. Foi citada uma sala específica da psiquiatria e também o próprio corredor, como locais de atendimento. Conclui-se que os resultados do presente estudo contribuem com o contexto das políticas e práticas em saúde relacionadas ao uso de substâncias, pois fornece um panorama sobre a emergência desta problemática entre os adolescentes. Considerando o papel central da enfermagem nestes setores, os resultados possibilitarão uma reflexão crítica sobre a sua responsabilização em relação às possíveis atividades preventivas, a adequação do cuidado de enfermagem a essa clientela e, sobretudo sua responsabilidade em relação ao desfecho destes atendimentos / The main cause of psychiatric emergency care to children and adolescents is aggressive behavior, even in this abuse/drug intoxication. Emergency department that serve these clients deal with the immediacy of health situation, added to the difficulties inherent in the management of related to substance use issues and the complexity of the work process for this demand in this sector. The present study aimed to characterize the psychiatric emergency room visits for children and adolescents with substance use disorders by analyzing the operational and emotional aspects related to the work of the nursing staff in caring for these clients in the Emergency Room of the Hospital das Clinicas Marília in the period 2000-2011. This is a study on the combination of quantitative and qualitative approaches, divided into two phases, the first was quantitative, with a cross-sectional study, exploratory descriptive from secondary data relating to emergency treatment psychiatric related to substance use for children under 18 years. The second phase was qualitative, also cross sectional, descriptive and exploratory technique in which semi-structured interviews for data collection was used. 4,198 psychiatric emergency calls were made for children and teenagers, 1,010 were for problems related to alcohol and/or other drugs, and the year 2011 which recorded more visits. The prevalent age was 10 to 17 years, with predominance of the 16-year-old, white color, attending elementary school, Catholic religion and prevalence of polydrug use. Among the nurses who deal with this demand, participated in the interviews 6 nurses and 25 nursing assistants. For most participants, there is no difference between caring for children and adolescents with adults, when there justify the emotions and feelings this arouses clientele. The host is with physical restraint and chemical and medical consultation. The knowledge specified were the theoretical/practical knowledge, professional ethics and communication skills. Soft-hard technologies, such as agility, firm stance, observation and attention were mentioned. Have light technologies were cited openness to dialogue, patience, understanding, affection, discretion and humanization. We identified also challenges to achieving these cases, as the lack of improvements in physical and structural aspects of the organization of the work process, the lack of privacy for the service, the small number of nurses and lack of training/training. A specific room of psychiatry and the hall itself was also cited as areas of care. We conclude that the results of this study contribute to the context of policies and health practices related to substance use it provides an overview of the emergence of this problem among teenagers. Given the central role of nursing in these sectors, the results allow for a critical reflection on its accountability to possible preventive activities, the adequacy of nursing care to these clients and especially their responsibility in relation to the outcome of these consultations

Álcool e cigarro são as drogas lícitas mais consumidas no mundo. O uso abusivo tanto do álcool quanto do cigarro está associado à morbidade e mortalidade em função do risco de dependência e danos à saúde humana. Estas drogas de abuso estão associadas a diversas patologias, dentre elas as doenças hepáticas e renais. Apesar de diversos estudos mostrarem os efeitos deletérios do álcool e do cigarro em diferentes tecidos, a literatura é escassa no que se refere aos efeitos da associação dessas duas drogas de abuso. Portanto, nosso objetivo foi avaliar alterações hepáticas e renais em ratos expostos ao álcool, fumaça de cigarro ou sua associação. Ratos Wistar, machos, adultos (~280 g) foram subdivididos em 4 grupos (n = 10/grupo): controle (CTR), administrados com álcool (ALC), expostos à fumaça do cigarro (TAB) ou sua associação (ALTB). Os animais do grupo CTR e do grupo TAB recebiam solução glicosada 8% por via intragástrica (IG); os animais do grupo ALC e ALTB, eram administrados com 2 g/kg (20% p/v) de álcool, diluído em solução glicosada a 3%, também via IG. Todos os grupos foram tratados duas vezes ao dia, por 28 dias. No 29º dia os ratos foram eutanasiados e o sangue troncular coletado para determinação das enzimas alanina e aspartato aminotransferases (AST e ALT), creatinina e ureia. Fígado e rins foram dissecados, pesados e armazenados em solução fixadora para processamento histológico, para posterior avaliação das alterações morfológicas. Peso corporal também foi monitorado ao longo do experimento. Nossos resultados mostraram menor ganho de peso corporal nos animais TAB e ALTB (CTR: 49,0 ± 3,1; ALC: 38,0 ± 4,7; TAB*: 15,9 ± 3,2 e ALTB*: 23,4 ± 2,6 g, *P < 0,001). O grupo TAB também apresentou menor peso relativo da gordura retroabdominal (-36%) quando comparado ao grupo ALC. Ainda para o grupo TAB observamos redução significativa da enzima ALT (P = 0,020). Creatinina estava aumentada no grupo ALTB (P = 0,021). Considerando o efeito dos tratamentos sobre as alterações morfológicas no tecido hepático, observamos aumento de marcadores de necrose para os animais dos grupos ALC, TAB ou ALTB, quando comparados ao CTR. Verificamos também aumento da tumefação para os grupos TAB e ALTB e presença de infiltrado perivascular no grupo ALTB. Em relação as alterações sobre o tecido renal, constatamos a presença de necrose para os grupos ALC, TAB e ALTB quando comparados com o CTR. Relatamos ainda presença de vacuolização citoplasmática no grupo ALTB quando comparado com o grupo ALC. Podemos concluir que a exposição à fumaça de cigarro interfere sobre o ganho de peso corporal e deposição de gordura retroabdominal. Além disso, o uso crônico de doses moderadas de álcool, exposição à fumaça do cigarro ou sua associação provoca necrose hepática e renal. O risco de dano hepático foi maior pelo álcool, enquanto o risco de dano renal foi maior para o cigarro. A associação dessas duas drogas de abuso parece contribuir para aumento de risco de dano renal. / Alcohol and cigarette are the most consumed illicit drugs in the world. The abusive use of both alcohol and cigarette is associated with morbidity and mortality due to the risk of dependence and harm to human health. These drugs of abuse are associated with various diseases, among them, the liver and kidney diseases. Although several studies have shown the harmful effects of alcohol and cigarette in different tissues, the literature is scarce regarding the effects of the combined use of these two drugs of abuse. Therefore, our objective here was to evaluate the hepatic and renal damage in rats exposed to alcohol, cigarette smoke or their association. Male, adult, Wistar rats (~ 280 g) were divided into 4 groups (n = 10 / group): control (CTR), administered with alcohol (ALC), exposed to the cigarette smoke (TAB), or their association (ALTB). Animals in the CTR group and in the TAB group were administered with a 8% glucose solution, via intragastric (IG); ALC and ALTB groups received 2 g/kg (20% w/v) alcohol, diluted in 3% glucose solution, via IG. All groups were treated twice a day for 28 days. On the 29th day the rats were euthanized and trunk blood was collected for enzymes alanine aminotransferase and aspartate (AST and ALT), creatinine and urea determination. Liver, kidneys and retroabdominal fat were dissected, weighed, and stored in fixative solution for histological processing for further evaluation of the hepatic and renal morphological changes. Body weight was also monitored throughout the experiment. Our results showed lower body weight gain in animals TAB and ALTB than CTR and ALC (CTR: 49.0 ± 3.1; ALC: 38.0 ± 4.7; TAB *: 15.9 ± 3.2 and ALTB * 23.4 ± 2.6 g, * P < 0.001). The TAB group also showed lower relative weight of retroabdominal fat (-36%) compared to the ALC group. Still, for the TAB group we observed a significant decreases from ALT enzyme (P = 0.020). Creatinine was increased in ALTB group (P = 0.021). Regarding hepatic morphological changes, we found an increase in necrosis markers from ALC, TAB and ALTB than CTR rats. We also showed increased swelling in the TAB and ALTB groups and perivascular infiltrate in ALTB group. Regarding the changes on renal tissue, we also observed necrosis for all groups. Vacuolization were significant higher in ALTB than ALC group. Thus, we may conclude that cigarette smoke interferes with the body weight gain and retroabdominal fat deposition. Additionally, the chronic use of moderate doses of alcohol, exposure to cigarette smoke or their combined use is damaging to the hepatic and renal tissues. The risk of liver damage was higher by alcohol, while the risk of kidney damage was higher for cigarette smoke. The combination of these two drugs of abuse appears to contribute to increased risk of kidney damage.

Orientador: Luis Augusto Passeri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-08T17:57:50Z (GMT). No. of bitstreams: 1 SerenaGomez_Eduardo_M.pdf: 11456385 bytes, checksum: 72f4d8c136f572b962f9b8e1c42039ae (MD5) Previous issue date: 2007 / Resumo: O objetivo deste trabalho foi avaliar as complicações do tratamento de fraturas mandibulares, em pacientes com consumo de substâncias nocivas à saúde, atendidos pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba - Unicamp, no período de abril de 1999 a março de 2004, comparando sua relação com diversos fatores epidemiológicos, dados obtidos através dos prontuários pertencentes ao arquivo da área. Para a realização desta pesquisa foram agrupados os pacientes segundo o tipo de substância consumida, os resultados obtidos definiram cinco grupos específicos: pacientes sem vícios, pacientes fumantes, pacientes que abusam no consumo de álcool, pacientes consumidores de drogas não endovenosas e pacientes consumidoresde drogas endovenosas. Foram estudados nesta pesquisa diversos fatores dos pacientes em todos os grupos tais como dados pessoais, etiologia do trauma, atendimento, relação com outras fraturas e lesões, complicações apresentadas e tratamento das complicações. Os resultados foram significativos nos grupos de abuso no consumo de álcool e no grupo de consumo de drogas endovenosas, sendo que a principal causa do trauma nos grupos que abusam destas substânciasforam as agressões. As complicações mais relatadas foram as infecções alem de outras tais como não-uniao, má-uniao e exposição da fixação interna rígida, que precisaram de atendimento hospitalar. Pode-se concluir que o abuso de substâncias aumenta a vulnerabilidade dos pacientes para desenvolver uma complicação pós-cirurgica no tratamento de fraturas mandibulares, não só pelas alterações sistêmicas que as substâncias produzem, mas também pela pouca cooperação dos pacientes. Este estudo ajudou a entender a importância dos procedimentos pré-cirúrgicos e pós-cirúrgicos dos pacientes ue abusam de substâncias nocivas à saúde com o propósito de alcançar um melhor tratamento para eles / Abstract: The main objective of this study was to evaluate the mandibular fractures treatment complications on patients whose abuse substances, attended by the Maxillofacial Surgery Area of the Faculty of Piracicaba - UNICAMP, on a period from April 1999 to March 2004, comparing then, the relation with different epidemiologica factors. This information was obtained from the trauma formularies filled previously by the program students. For the elaboration of this investigation, the patients have been grouped depending what kind of substance they abused; non-drug abuse patients, smoke abuse patients, alcohol abuse patients, nonintravenous drug abuse patients and intravenous drug abuse patients. They were studied different factors of the patients on ali the groups like personal information, trauma etiology, medical support, relation with other fractures, presented complications and complications treatment. The results were significantly on the alcohol abusers group and on the intravenous drug abusers group, been; the main cause of trauma on the substance abusers groups was the violence assaults. The most frequent complication presented on this study was the infections, which with other complications like non-union, malunion and fixation plate exposure, needed hospital attending for their correct treatment. Can be conclude that the substances abuse increase the vulnerability of patients to a post surgical complication on the mandible fracture treatment and not only because the systemic alterations that substance produce, but because the non cooperation of the patients to the treatments. This study can help to understand the importance of the pre-surgical, trans-surgical and post-surgical procedures on patients who abuse substances with the purpose of offer them a better treatment / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-06-29T15:06:29Z No. of bitstreams: 2 Dissertação - Fernanda Rocha Couto - 2015.pdf: 2171413 bytes, checksum: 6286d44d56839b6ceb1d39de40241d04 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-06-30T11:08:53Z (GMT) No. of bitstreams: 2 Dissertação - Fernanda Rocha Couto - 2015.pdf: 2171413 bytes, checksum: 6286d44d56839b6ceb1d39de40241d04 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-06-30T11:08:53Z (GMT). No. of bitstreams: 2 Dissertação - Fernanda Rocha Couto - 2015.pdf: 2171413 bytes, checksum: 6286d44d56839b6ceb1d39de40241d04 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-12-19 / INTRODUCTION: Being a military police is stressful. The responsibility for providing security to society brings a health hazard, threats to his / her health and safety. The fear of not coming back home alive or even hurt can lead to anxiety and stress. The search for immediate relief increases the use of psychotropic drugs by the military police. Studies published until now that approached this theme showed methodological limitations. AIMS: To evaluate the use of psychotropic drugs of list B1 (Clonazepam, Bromazepam and Alprazolam) by military police of Goiás State, to identify the group age and gender that used it most, to quantify the time of military police service that they used the psychotropic and to evaluate the proportion of this use according to the military personnel (soldiers and officers). METHODS: A review article was written based on data published between 1990 and 2013 in PubMed and SciElo. Thereafter, and observational, descriptive and retrospective study was done. One hundred military police from Hospital of Military Police in Goiânia city were evaluated by collecting the data presented in medical prescriptions and corporate pharmacy database using a form specially designed for this. INCLUSION CRITERIA: All the controlled B1 prescriptions in 2011. EXCLUSION CRITERIA: Illegible prescriptions, other controlled prescriptions like C1 and patients that are dependent of military police. RESULTS: The frequency of use was divided according to: 1) Genre: men (68%), women (32%); 2) Age: 18 to 35 years old (4%); 36 to 50 years old (52%); 51 to 70 years old (12%); >71 years old (3%); uninformed (29%); 3) Psychotropics: Alprazolam (14%), Bromazepam (13%), Clobazam (1%), Clonazepam (53%), Cloxazolam (7%), Diazepam (1%), Flurazepam (1%), Midazolam (2%), Nitrazepam (7%);4) Trimester: Jan/Mar (22%), Apr/June (39%), July/Sept (31%), Oct/Dec (7%); 5) Service time:<5 years old (2%), 6 to 10 years old (5%), 11 to 20 years old (12%), 21 to 30 years old (48%); 6) Military rank: soldier (63%), officers (11%), pensionary (2%), uninformed (24%). CONCLUSION: The profile of the military police user of psychotropic drugs was female sex with an average age of 47. The most common psychotropic drug was Clonazepam. The service time when they most use the drugs was the one comprehended between 21 and 30 years of activity in the military force. From the Military Police personnel, there was no difference in relation to military officers. / INTRODUÇÃO: A profissão de policial por si só é uma profissão muito estressante. A responsabilidade de proporcionar à sociedade segurança traz uma perigosidade. O homem/mulher dentro da farda colocam a vida em risco. O medo de não voltar para casa com vida ou mesmo ferido acaba proporcionando alto nível de estresse e ansiedade. A busca por alívio imediato aumenta o uso de medicamentos psicotrópicos por policiais e outras profissões com alto nível de estresse. Os estudos que investigaram o tema apresentam limitação metodológica. OBJETIVOS: Avaliar o uso de medicamentos psicotrópicos controlados da Lista B1(Clonazepam, Bromazepam e Alprazolam) em policiais militares do estado de Goiás, identificar a faixa etária e o gênero que mais utilizou os psicotrópicos, identificar o psicotrópico B1 mais utilizado pelo policial militar do estado de Goiás, quantificar o tempo de serviço do policial militar que fez uso com maior assiduidade dos medicamentos psicotrópicos e avaliar a proporção do uso de psicotrópicos segundo o quadro de composição militar (praças e oficiais). CRITÉRIOS DE INCLUSÃO: Todos os receituários controlados B1 de 2011. CRITÉRIOS DE EXCLUSÃO: receituários ilegíveis, receituários de controle especial C1 e pacientes dependentes do policial militar. MÉTODOS: Foi redigido um artigo de revisão da literatura, construído a partir de pesquisas nas bases de dados PubMed/Medline e SciElO entre 1990 e 2013. Em seguida foi elaborado este estudo observacional, descritivo e retrospectivo. Foi desenvolvido com a coleta de dados de 100 receituários escolhidos aletoriamente de policiais atendidos na Farmácia Fundação Tiradentes no Hospital do Policial Militar no município de Goiânia. Foi utilizado formulário elaborado pelo pesquisador e orientador. Os dados foram coletados de receituários controlados B1 arquivados na Farmácia e sistema da corporação, após autorização do estabelecimento. RESULTADOS: A frequência de uso foi dividida em: 1) Gênero: homens - (68%), mulheres (32%); 2) Idade: de 18 a 35 anos (4%); 36 a 50 anos (52%), 51 a 70 anos (12%), > 71 anos (3%), não informado (29%); 3) Psicotrópicos: Alprazolam (14%), Bromazepam (13%), Clobazam (1%), Clonazepam (53%), Cloxazolam (7%), Diazepam (1%), Flurazepam (1%), Midazolam (2%), Nitrazepam (7%). 4) Trimestre: jan/mar (22%), abr/jun (39%), jul/set (31%), out/dez (7%), 5) Tempo de serviço: < 5 anos (2%), 6 a 10 anos (5%), 11 a 20 anos (12%), 21 a 30 anos (48%); 6) Patente: praça (63%), oficial (11%), pensionista (2%), não informado (24%). CONCLUSÃO: A idade média foi de 47,03 e o gênero proporcionalmente que mais usou o psicotrópico foi o sexo feminino, sendo o Clonazepam o mais utilizado. Observou-se ainda que o tempo de serviço militar, entre 21 e 30 anos, contribuiu para o uso. Não houve diferença em relação a patente de Praça e Official.

Orientador: Ronaldo Rômulo Machado de Almeida / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas / Made available in DSpace on 2018-08-24T02:19:26Z (GMT). No. of bitstreams: 1 Fiore_Mauricio_D.pdf: 2494345 bytes, checksum: f81c1c133860e6fb9ac4c79547e12d12 (MD5) Previous issue date: 2013 / Resumo: Assumindo o pressuposto de que o uso de algumas substâncias psicoativas, que se convencionou chamar de drogas, é um fenômeno ancestral alçado à condição de problema social recentemente por meio de um dispositivo de incitação e repressão, essa tese buscou investigar o uso dessas drogas por meio de longas trajetórias empíricas de consumo. A pesquisa, de natureza auto-etnográficas, teve como recorte as trajetórias de dois grupos de afinidade do autor - o grupo da rua e o grupo da universidade - que compartilham, entre continuidades e rupturas, o consumo de drogas psicoativas lícitas e ilícitas há cerca de duas décadas. A investigação buscou analisar o fenômeno do uso de drogas a partir de três chaves analíticas: as substâncias, descritas a partir de seus agenciamentos químicos, materiais e sociais peculiares; os sujeitos, tomados a partir das trajetórias pessoais e coletivas de uso de drogas e de seus posicionamentos no interior do dispositivo; e os eventos, descrições narrativas de algumas situações coletivas de uso de drogas com o objetivos de detalhar os conteúdos emocionais e as práticas de sociabilidade que marcaram a experiência dos sujeitos / Abstract: Based on the assumption that the use of some psychoactive substances, so-called drugs, is an ancient phenomenon recently converted into a social problem through dispositive of repression and instigation, this thesis investigates the use of these drugs by the analysis of long consumption trajectories. The auto-ethnographic research analyses trajectories within two groups that are close to the author - the street group and the university group - which have been sharing the consumption of licit and illicit psychoactive drugs for almost two decades. The study aimed to analyze the phenomenon of drug use from three analytical keys: the substances, described from its peculiar chemical, physical and social assemblages; subjects, taken from personal and collective trajectories of drug use and their positions within the arrangement; and events, narrative descriptions of some collective situations of drug use which aim to detail emotional content and practices of sociability that marked the subjects' experience / Doutorado / Ciencias Sociais / Doutor em Ciências Sociais

M.A. (Social Work) / This study constitutes a-reaction to the paucity of professional attention devoted.- to the primary prevention of alcohol and drug abuse. The basic objective of the study was to develop a programme for the primary prevention of alcohol and drug abuse in Eersterust. This programme was intended to achieve the total upliftment of the community, aimed at an effective lifestyle and a new orientation to values, and was to induce a decline in alcohol and drug abuse in the community on the long term. This developmental effort manifested in the formulation of general principles and guidelines for the primary prevention of alcohol and drug abuse, in the form of a manual for community workers at clinics for alcoholics and drug dependants. This seeks to make community workers more conversant with the primary prevention of alcohol and drug abuse and to induce in them an appreciation of the value thereof in combating the problem. Developmental research was utilized in the development of the new technological item. The developmental research and utilization model of Edwin Thomas was used as research design. In view of the unfamiliarity of developmental research, a separate chapter was devoted to this kind of research and the Thomas model. The different phases of the developmental research and utilization model used in the development of the programme for the prevention of alcohol and drug abuse, were the following: -The analysis phase, which included all the activities which preceded the development of the programme. These activities comprised of a problem analysis of Eersterust, a survey of the position of existing social technology in the handling of alcohol and drug abuse, a feasibility study and a comprehensive literature study. -The development phase, which included the design and implementation of the programme for the primary prevention of alcohol and drug abuse. -The evaluation phase, which comprised the process evaluation as well as the evaluation of the outcome of the programme. The process evaluation was done on a continuous basis, in order to ensure that the programme complied with implementation standards and was tuned to achieving the objectives which were set. The evaluation of the outcome was done with a view to measuring the effectiveness of the programme in achieving objectives. -.The diffusion and adoption phases, which comprised activities such as the preparation of means of dissemination, the dissemination of information on the product and the possible implementation by consumers. The product of the developmental research process was presented in a separate chapter, in the form of a manual for community workers at clinics for alcoholics and drug dependants. The conclusion reached in the study was that unless community workers were to launch comprehensive primary preventive actions seeking the total upliftment of the community to an effective lifestyle and new orientations to values, the constant increase in alcohol and drug abuse will not be reduced.

Abstract Making use of Bronfenbrenner’s ecological theory, the study examines the factors influencing the everyday life of children subject to child protection measures who have grown in an environment of prolonged family crisis. The theory of social pedagogy is used in the interpretation of the results. The research results and conclusions are also considered in view of the Child Protection Act. The basis for the methodological and methodical choices for the study is provided by the examination of the experiences of now young grown-ups who have grown subject to child protection measures. They report personally on their experiences as children subject to protection measures. In addition to interviews, documentary data is also used. The research is a qualitative case study in nature. Two research problems were formulated. The first one is concerned with the adolescents’ experiences of family, parents and other close environment in their everyday childhood. The second research problem is related to the young people’s indirect experiences at meso, exo and macro levels of social work support measures in child protection. Answers to both these problems are sought through thematisation. The themes are based on the concepts of the Child Protection Act and on the various contexts in the field of the micro, meso, exo and macro levels in Bronfenbrenner’s ecological theory. The research data was collected in 2004 and 2005. The study revealed that the parents had been supported a lot through various preventive support measures available in non-institutional child protection. In spite of this, the young people’s life as children in the families was precarious and the families would break up. The parents’ educational responsibility and ability to take care of their children did not meet the requirements of the Child Protection Act. The study highlighted the poor status of the child between two institutions. Little attention was paid in the social work practices to the children’s right, based on their status, to access the data on themselves and their families and to present their opinions. Contacts with the adolescents by the social services during the child protection process had been very few. The actors in the child welfare sector were not aware of how the children experienced the child protection support measures. The social work system fared quite badly in its practices stipulated in the Child Protection Act to support the children’s growth and to help them in their everyday lives in an insecure growth environment. Social work did not have any means to approach the child as an individual, nor the child and parents comprehensively together in family-based child protection work. / Tiivistelmä Tutkimuksessa tarkastellaan epävakaassa kasvuympäristössä ja perhekriisin olosuhteissa kasvaneiden lastensuojelulasten arkeen ja elämänkulkuun vaikuttaneita tekijöitä Bronfenbrennerin ekologista teoriaa hyväksi käyttäen. Tulosten tulkinnassa ja johtopäätösten tekemisessä hyödynnettiin sosiaalipedagogiikan teoriaa. Tutkimuksen tuloksia ja johtopäätelmiä tarkasteltiin myös lastensuojelulain valossa. Tutkimuksen metodologisten ja metodisten valintojen lähtökohtana on ollut lastensuojelulapsina kasvaneiden nuorten kokemusten tutkiminen. Haastatteluaineiston lisäksi käytetään asiakirja-aineistoa. Tutkimuksen lähestymistapa on laadullinen tapaustutkimus. Tutkimukselle asetettiin kaksi tutkimustehtävää. Ensimmäinen tutkimustehtävä kohdistuu mikrotasolla nuorten lapsuuden arjen kokemuksiin perheestä, vanhemmista ja muusta lähiympäristöstä. Toinen tutkimustehtävä kohdistuu nuorten meso-, ekso- ja makrotason välillisiin kokemuksiin lastensuojelun sosiaalityön tukitoimista. Molempiin tutkimustehtäviin etsittiin vastausta teemoittelun avulla. Teemat on asetettu Bronfenbrennerin ekologisen teorian mikro-, meso-, ekso- ja makrotasojen kentässä erilasiin konteksteihin ja lastensuojelulain käsitteistöön. Tutkimusaineisto kerättiin vuosina 2004 ja 2005. Tutkimuksessa tuli esille, että vanhempia oli tuettu runsaasti erilaisin lastensuojelun avohuollossa käytössä olevin preventiivisin tukimuodoin. Tästä huolimatta nuorten elämä lapsena perheissä oli epävakaata ja perheet hajosivat. Vanhempien kasvatusvastuu ja kyky huolehtia lapsistaan eivät toteutuneet lastensuojelulain määrittämällä tavalla. Tutkimuksessa tuli esille lastensuojelulapsen aseman heikkous kahden instituution välissä. Sosiaalityön toimintakäytännöissä vähälle huomiolle jäi, että lapsilla on asemansa puolesta oikeus itseään ja perhettään koskevaan tietoon sekä mielipiteen esittämiseen. Sosiaalitoimen järjestämät yhteydenpidot nuoriin lastensuojeluprosessin aikana olivat vähäisiä. Lastensuojelun toimijoilla ei ollut tietoa siitä, miten lapsi koki lastensuojelun tukitoimet. Sosiaalityön toimintakäytännöissä jäi nuorten kokemana heikoksi lastensuojelulain määrittämä lapsen kasvun tukeminen ja auttaminen arjen elämässä epävakaassa kasvuympäristössä. Sosiaalityössä ei näyttänyt olevan keinoja lähestyä lasta yksilönä eikä lasta ja vanhempia yhdessä kokonaisvaltaisesti perhekohtaisessa lastensuojelussa.

A drug abuse and all problems associated with it, affects not only the abuser him-/herself but the people surrounding that person as well. This study aimed to qualitatively investigate in detail the role and experiences of six relatives to a drug abuser in the city of Sundsvall. The study looked through the use of the theoretical framework of Travis Hirschi´s Social bond theory how the social bonds were affected. The use of open-ended interviews got stories of the development and reciprocal impact of a drug problem. Four main themes of the role and experiences of relatives to a drug abuser were identified using thematic analysis. The four key themes identified, including several sub-themes, were (a) Characteristics of relative's early experiences, (b) Negative consequences, (c) Role and reactions of relatives and (d) Frustration. The experiences and impact of having a child/sibling abusing narcotics was varied and highly personal but the four themes were emphasised as being significant and shared in the narrative of the majority of participants. The result of the analysis showed a profound negative impact on the relatives of the drug abuser on several levels, as well as roles of great sacrifices that were hypothesized to impact the abuser. These negative consequences did in turn affect the social bonds within the family, leading to stress, friction and in some cases disrupted bonds. The four main themes were connected to each other, presenting a multi-faceted impact on- and role of relatives. The answers attained were in line with earlier studies on the topic, illustrating profound negative effects and therefore the use of the term: secondary victims were considered appropriate in this context. / <p>2017-06-01</p>

Syftet med denna studie var att undersöka subjektiva upplevelser av vägen ut ur narkotikamissbruk. Centralt för studien har varit att undersöka vad som enligt intervjudeltagarna har föranlett uppbrottet samt vad som har varit viktigt för att vidmakthålla drogfrihet. Studien bygger på narrativa intervjuer med fem individer som har haft ett tidigare narkotikamissbruk. Huvudresultatet visade att intervjudeltagarnas motiv för att lämna missbruket var till följd av missbrukets negativa konsekvenser. Flera av intervjudeltagarna uppgav att de hade nått en personlig botten innan de beslutade sig för att lämna missbrukslivet. Studiens resultat visade även att viktiga faktorer för att lyckas lämna missbruket var att byta vänskapskrets samt bostadsort. Det viktigaste i detta avseende var dock den egna viljan att sluta. För att vidmakthålla det drogfria livet visade resultatet att flera faktorer var betydelsefulla. Framträdande i intervjudeltagarnas berättelser var betydelsen av att ha en sysselsättning. / The purpose of this study was to examine the subjective experiences of the way out of drug abuse. Central to the study has been to investigate what, according to the interviewees, has caused the break up and what has been important for maintaining the drug-free life. The study is based on narrative interviewes with five individuals who have previously had a drug abuse. The study´s main results showed that the participants motivation for leaving the drug abuse was due to the negative consequences of the abuse. Several of the interviewees stated that they had reached a personal bottom before the break up of abuse. The results also showed that important factors for breaking up was to break with old friends and move to a new city. The most important thing for the break up was an internal driving force. In order to ensure a drug-free life the results showed that employment were important.

In South Africa today, the numbers of drug-dependent adolescents are increasing at alarming rates. These adolescents require rehabilitation. The numbers of institutions that offer drug rehabilitation services are also growing exponentially. However, the programs followed by the institutions are wide ranging in nature and are not controlled by government or a professional body. Although these institutions claim individual successes, their success rates – especially in regard of adolescents – is highly subjective and suspect. The discipline of educational psychology is uniquely capable of setting objective criteria to which all programs for drug-dependent adolescents should comply. Educational psychology emphasizes two important aspects of human development: The educational and the psychological. Moreover, it gives considerable weight to the adolescent’s participation in her own development. The uncontrolled use of dependence-forming substances by adolescents negatively influences every level of their physical, emotional, cognitive, psychological and social development. To facilitate their growth to responsible adulthood, specialized treatment is required to address specific adolescent developmental tasks and needs. It has become imperative that the programs offered to adolescents in South Africa be analysed and examined critically in order to determine whether they comply with the dictates of a responsible educational-psychological approach. It is against this background that a research study was undertaken to investigate the current position of drug rehabilitation programs for adolescents offered by centres and clinics in South Africa. The aim of this study was to determine and describe educational-psychological criteria to evaluate the suitability of current programs that are offered to drug dependent adolescents in this country. A theoretical framework was developed by an extensive literary research. This framework formed the foundation of an empirical study. The initial stage of the empirical study – the identification of drug rehabilitation centres and clinics that offer in-patient treatment for adolescents – was hampered by the lack of government involvement in the registration and monitoring of such centres and clinics and the programs they offer. No database containing information on drug use, drug misuse and drug dependence, as well as places and methods of rehabilitation, exists. Identified institutions were contacted and requested to participate in this research. Several refused. The centres and clinics that were willing to assist and offered unique programs, were visited. In several instances one centre was visited and described as representative of several centres or clinics that offer programs based on a similar approach. Documentation regarding drug rehabilitation programs were perused. Interviews with adolescents – whose parents had given permission for their participation – and with available parents and staff were recorded and transcribed. The transcriptions were qualitatively analysed. Educational-psychological criteria that address the specific development needs of adolescents were identified. This research found that although some programs address some minor educationalpsychological aspects of the adolescent’s substance problem, not one of the in-patient programs addressed the problem holistically by emphasizing the development and needs of these adolescents. The effect of these programs on the educationalpsychological development of adolescents moving towards responsible adulthood, must be questioned. The educational-psychological criteria – as set out in this research study – should be applied to in-patient drug rehabilitation programs for adolescents in South Africa to increase the quality and success of the said programs. Through such an approach, adolescents are valued as individuals who have to complete general developmental tasks successfully to arrive at a responsible and meaningful adulthood. / Prof. J.C. Kok