The objective was to examine duloxetine 60–120mg/day treatment for relapse prevention in adults with generalized anxiety disorder (GAD). Adult patients (N=887; mean age=43.3 years; 61.0% female) with DSM-IV-TR-defined GAD diagnosis were treated with duloxetine for 26 weeks. Patients who completed open-label phase and were treatment responders (≥50% reduction in Hamilton Anxiety Rating Scale total score to ≤11 and “much”/“very much improved” ratings for the last 2 visits of open-label phase) were randomly assigned to receive duloxetine or placebo for a 26-week double-blind continuation phase. Relapse was defined as ≥2-point increase in illness severity ratings or by discontinuation due to lack of efficacy. During the double-blind phase, placebo-treated patients (N=201) relapsed more frequently (41.8%) than duloxetine-treated patients (13.7%, N=204, P≤0.001) and worsened on each outcome measure (P≤0.001, all comparisons). Duloxetine 60–120 mg/day treatment was efficacious and reduced risk of relapse in patients with GAD.

South Africa has witnessed radical policy reforms since the advent of the new democratic dispensation in 1994. As provincial, district and local practitioners developed responses to those new national education policies, implementation issues were revealed in all their complexity. Policy implementation became one of the most difficult challenges South Africa had to contend with. It necessitated the development of the capacity of the state and its people to implement policy. The complexities of the people development environment in South Africa create a range of challenges for development. The lack of multi-level empirical data on training effects continues to exacerbate this state of affairs. This context requires that comprehensive assessment mechanisms be put in place for training programmes aimed at the realisation of policy goals. The broad purpose of this inquiry, therefore, is to determine the impact of an education management development training intervention as it passes through different levels of the education system in South Africa - national, provincial, district and local. The following key questions guided this investigation. Firstly, how do stakeholder understandings of “education management development” transfer from one level to another in a cascade model of training? And secondly, what is the operational impact of an education management development-training programme at the different levels (i.e., province, district and school) of the education system? Questionnaires, free attitude interviews and observations were used as key data collection instruments. Data was analysed using a combination of quantitative and qualitative strategies for making sense of the training information. Data was interpreted against the backdrop of the literature on the “transfer of training”, and these findings are represented in the last three chapters of this thesis. This research generated four major findings, with a variety of subsidiary findings, which deepen our insights into policy implementation as it relates to education management development in South Africa. Some of the major findings of this study are that: a) The organisers did not in the first place conduct the baseline study on training needs and secondly, they did not take into consideration the organisational requirements of the anticipated training. This anomaly could ultimately compromise the outcomes of this intervention. b) The policy deployment processes of the North West Department of Education (of ensuring that the governmental policies for quality, cost and service delivery are understood from the highest to the lowest level of the organisation) are fraught with problems that undermined basic understandings of the Education Management Development training programme which was conducted between 1998 – 2000. c) Successful policy implementation depends crucially on resource allocation and, in the case of the Education Management Development Training Programme, the nature and magnitude of allocated resources e.g., transport provision could not guarantee positive training results; and d) The overly rationalistic view adopted by the trainers of the Education Management development-training programme did not take into account the complex contexts within which change unfolds. Resultantly, the changing of the roles of facilitators could not be planned-for in advance. The significance of this study is that it identifies the barriers to learning in training events, and sheds new light on the transfer of training problem that continues to undermine organisational change and human resource development. Some of the unique findings of the study can be found in the fact that the Expert Trainers could only recall a few intentions of the EMD modular training. The District Facilitators displayed limited knowledge of the disciplinary procedures in their areas of operation and there was limited conceptualisation of the EMD by the principals of schools. / Thesis (PhD (Education Policy Studies))--University of Pretoria, 2005. / Education Management and Policy Studies / unrestricted

Generalized anxiety disorder (GAD) is associated with painful physical symptoms (PPS). These post hoc analyses of previous trial data assessed PPS and their response to duloxetine treatment in GAD patients. Studies 1 and 2 (n = 840) were 9- to 10-week efficacy trials; study 3 (n = 887) was a relapse prevention trial comprising a 26-week open-label treatment phase and a 26-week double-blind, placebo-controlled treatment continuation phase. Mean baseline visual analog scale scores (VAS, 0–100; n = 1727) ranged from 26 to 37 for overall pain, headache, back pain, shoulder pain, interference with daily activities, and time in pain while awake. In studies 1 and 2, improvement on all VAS scores was greater in duloxetine-treated than in placebo-treated patients (p ≤ 0.01). In study 3, pain symptoms worsened in responders switched to placebo compared with those maintained on duloxetine (p ≤ 0.02). In conclusion, duloxetine was efficacious in the short- and long-term treatment of PPS, which are common in GAD patients.

Heroin use and dependency is a growing concern within South Africa, individuals face difficulty in remaining abstinent from the use of heroin due to constant relapse. The opioid antagonist known as the naltrexone pellet implant offers an alternative form of aid to relapse prevention in the recovery and abstinence from heroin dependency. This qualitative study explored the subjective experiences and perceptions of heroin dependent individuals, that made use of the naltrexone pellet implant. This study was rooted in the interpretive, qualitative paradigm where a phenomenological research design was used. Participants were selected using a purposive, snowball sampling technique and four individuals who had made use of the naltrexone pellet implant for the aid in heroin dependency for a minimum of three-months were interviewed. Interpretative Phenomenological Analysis (IPA) was used to extract recurrent themes across participants. The findings suggested that the use of the naltrexone pellet implant was beneficial in the aid for relapse prevention from heroin use. Furthermore, the exploration of difficulties that were faced in remaining abstinent, the attempt to make use of the naltrexone pellet implant and the physical and psychological aspects regarding the use of this alternative method of remaining abstinent were explored in this study. / Psychology / M.A. (Psychology (Research Consultation))

This study examines the link between the individual and social network, what social forces and social mechanisms involved in the interaction between individuals and groups and how we can explain and consider this relationship with the aim of understanding this connection. Through qualitative interviews, based on interviews of six active members in the organization Young KRIS (Young Criminal’s Return in the Society) examines the active social processes that the young members undergo, and motivates those who have been outside the expected conformed and regular society, to be included in the regular community and how this can be explained. The study shows that the organization through high availability, openness, knowledge of the needs of young people, good treatment, range of meaningful activities, has created a great venue for the young to develop and thus regain their place in the society. / Denna studie undersöker kopplingen mellan individ och sociala nätverk, det vill säga vilka sociala krafter och sociala mekanismer är verksamma i mötet mellan individen och gruppen, och hur man kan förklara och se på denna relation med målet att förstå denna koppling. Genom den kvalitativa metoden, baserad på intervjuer av sex medlemmar inom organisationen Unga KRIS, undersöker vi de verksamma sociala processer unga medlemmar genomgår och som motiverar dem som har befunnit sig utanför det förväntade, konforma och reguljära samhället, att komma att inkluderas i det reguljära samhället och hur detta kan förklaras. Studien visar att organisationen genom hög tillgänglighet, öppenhet, kunskap om ungdomarnas behov, gott bemötande och utbud av meningsfulla aktiviteter, har skapat en trygg arena för att unga medlemmarna ska kunna utvecklas och därmed återfinna sin plats i samhället.

M.A. / Dependency affects the family as a whole and forms part of the transactional patterns that regulates the behaviour of the family members. Seeing that the family and dependent person has a mutual effect on each other relapse prevention is also influenced by the family system. Therefore it is essential that social work intervention with the chemical dependant person focuses on the family as a whole. Relapses seems to be a factor that needs to be taken in to account in the field of chemical dependency because of the very high relapse rates. The dependant behaviour is altered through the anticipation and management of relapses. Through viewing relapse prevention from the systemic context the family system as a whole can be focused on relapse prevention and not just the individual. This study aimed at exploring the role of the family in relapse prevention, thus identifying family factors which are of importance in relapse prevention of the chemical dependent person. A Qualitative research methodology was utilised to explore the diverse experiences of families regarding relapse prevention. The focus of this research is therefore on the family processes through which families create, maintain and discuss their own reality thus was family context, interaction and dynamics studied. The theoretical basis for the intervention with the chemical dependant person is established in the discussion of the relapse prevention model as well as the general systems theory. From this theoretical basis a work protocol was compiled to which data that was gathered and analysed. For the aim of this study a nonpiobability purposive sample was used in the compiling of the two focus groups. The focus groups lend itself to interviewing with small groups where the respondents explore their own reality. The data was gathered by means of field notes and audio tapes which were transcribed. Analysis of data was.done according to schedules and these schedules were compiled according to the literature. The schedules were divided in to the family and relapse prevention categories. Coding was done by the researcher and a co-coder in order to compare the results. In the coding process the researcher and co-coder utilised the schedules to code the transcribed audio tapes and field notes. The information gleaned form the data gathering and analysis was used to identify central themes. These themes were offered as results. The results obtained were compared to relevant literature in order to further the reliability of the research. The reliability of the study was examined in the light of credibility, transferability, dependability, and confirmability. From the study methodological and theoretical conclusions could be drawn. The methodological conclusions have to do with the method of research which was utilised in this study. Regarding the contextual aims and context of the empirical study certain theoretical conclusions were drawn. The results and conclusions indicated certain family factors that play a role in relapse prevention in the family system. Recommendations were offered on the basis of the study and the conclusions drawn. The methodology and context of the empirical study directs the recomMendations drawn thus ensuring the practice orientation of the results and the connection of the results to the goal of this study. This, research indicates that the family plays an important role in relapse prevention of the chemical dependant person as well as the value of the application of the relapse prevention model with a systemic application in the social work intervention with the chemical dependant person.

The objective was to examine duloxetine 60–120mg/day treatment for relapse prevention in adults with generalized anxiety disorder (GAD). Adult patients (N=887; mean age=43.3 years; 61.0% female) with DSM-IV-TR-defined GAD diagnosis were treated with duloxetine for 26 weeks. Patients who completed open-label phase and were treatment responders (≥50% reduction in Hamilton Anxiety Rating Scale total score to ≤11 and “much”/“very much improved” ratings for the last 2 visits of open-label phase) were randomly assigned to receive duloxetine or placebo for a 26-week double-blind continuation phase. Relapse was defined as ≥2-point increase in illness severity ratings or by discontinuation due to lack of efficacy. During the double-blind phase, placebo-treated patients (N=201) relapsed more frequently (41.8%) than duloxetine-treated patients (13.7%, N=204, P≤0.001) and worsened on each outcome measure (P≤0.001, all comparisons). Duloxetine 60–120 mg/day treatment was efficacious and reduced risk of relapse in patients with GAD.

No description available.

The susceptibility of adolescents to chemical addiction has become a major international concern. Approximately 25% of people in Central Asia and Eastern Europe who inject chemical substances are under the age of 20 years (Youth at the United Nations, 2006), while up to 75% of unintentional injuries among adolescents in America are related to substance abuse (Page & Page, 2003:196). On the national level, approximately 25% of adolescents under the age of 20 are involved in substance abuse (Western Cape Department of Social Services and Poverty Alleviation Transformation Plan, 2006:13). Focusing on the Western Cape, a report from the South African Epidemiology Network (2007:3) highlights that the youngest patient in in-patient treatment was nine years of age, and among 2 798 persons who received in-patient treatment, 27% were under the age of 20, more than any other age group in treatment. Treatment of adolescent chemical addiction should include preparation for treatment, treatment, and also aftercare services to ensure that the addicted adolescent develops skills to maintain sobriety (Meyer, 2005:292-293). Section Six of the South African Prevention and Treatment of Drug Dependency Act (1992) prescribes that chemically addicted persons should have access to professional aftercare services to ensure that treatment is not terminated prematurely. The motivation for this study was based on the fact that, despite this statutory requirement, the Western Cape Drug Forum (2005:3) identified the need for the development of aftercare services in 2005, indicating the lack of focus on aftercare as part of treatment. This concern was confirmed by practitioners in the field of adolescent chemical addiction and findings resulted from previous research regarding relapse experiences of chemically addicted adolescents (Van der Westhuizen, 2007:129-130). / Social Work / D. Phil. (Social Work)

The susceptibility of adolescents to chemical addiction has become a major international concern. Approximately 25% of people in Central Asia and Eastern Europe who inject chemical substances are under the age of 20 years (Youth at the United Nations, 2006), while up to 75% of unintentional injuries among adolescents in America are related to substance abuse (Page & Page, 2003:196). On the national level, approximately 25% of adolescents under the age of 20 are involved in substance abuse (Western Cape Department of Social Services and Poverty Alleviation Transformation Plan, 2006:13). Focusing on the Western Cape, a report from the South African Epidemiology Network (2007:3) highlights that the youngest patient in in-patient treatment was nine years of age, and among 2 798 persons who received in-patient treatment, 27% were under the age of 20, more than any other age group in treatment. Treatment of adolescent chemical addiction should include preparation for treatment, treatment, and also aftercare services to ensure that the addicted adolescent develops skills to maintain sobriety (Meyer, 2005:292-293). Section Six of the South African Prevention and Treatment of Drug Dependency Act (1992) prescribes that chemically addicted persons should have access to professional aftercare services to ensure that treatment is not terminated prematurely. The motivation for this study was based on the fact that, despite this statutory requirement, the Western Cape Drug Forum (2005:3) identified the need for the development of aftercare services in 2005, indicating the lack of focus on aftercare as part of treatment. This concern was confirmed by practitioners in the field of adolescent chemical addiction and findings resulted from previous research regarding relapse experiences of chemically addicted adolescents (Van der Westhuizen, 2007:129-130). / Social Work / D. Phil. (Social Work)