This thesis deals with the school crisis plan as one of the methods to help teachers with solving situations in consequence of risk behavior of pupils. School crisis plan is a set of procedures solving risk situations which may occur in the school environment as a result of risk behaviour of pupils. The thesis is composed of five basic parts. The first four parts are theoretical. They deal with the general concept of the school crisis plan and its integration into the system of preventive action within the school risk behavior. An important part is also a description of the roles of teachers with regard to crisis situations in school and the possibility of their cooperation, which I see as one of the most crucial points of effective implementation of the crisis plan of the school. Another equally crucial point in the effective implementation of the school crisis plan are competence of teachers, which are also listed in this section of my thesis. The fifth part of the thesis deals with the practical use of school crisis plan. There are several approaches to solving specific situations that may appear in school within the risk behaviors. These procedures are shown graphically for easy orientation.

The aim of this diploma thesis is to describe the role of the Children´s socio-legal protection authority in dealing with risk behavior of children and youth and to analyze methods and instruments used by this authority to maximize the effectiveness of interventions, which should eliminate the risk behavior of children that negatively influences their personality development. The thesis also mentions the legislative regulation, which represents the base for socio-legal protection. In the theoretical part personality factors as well as impacts of family, school and social surroundings, which contribute to the creation and continuation of risk behavior, are analyzed. The thesis then focuses on the problem of truancy, which belongs to types of risk behavior. In the practical part the thesis presents, what curators for children and youth claim about their cooperation with schools in solving children's truancy during compulsory school attendance, which family and school factors they find risky and whether they consider current legal and methodical setting to be sufficient. At the end, the thesis deduces from results implications and recommendations for education staff in schools, i.e. class teachers, workers in education counselling and school directors, to prevent (or at least to minimize) truancy and emphasizes the possibility to cooperate with authorities of children´s socio-legal protection, which can be established already, when the first signals of absenteeism occur or in case of other educational problems, mainly poor interaction with children's parents.

This thesis deals with the topic of Primary prevention of student's risk behavior at the chosen primary schools in the district of Strakonice. The main goal of this thesis is to find out if the students are educated enough about the risk behavior and it's prevention, and to evaluate prevention activities that the schools implement within the risk behavior. To fulfil the main and partial goals two research methods are used - questionnaire designed for students and interview with school prevention methodologist. The theoretical part of this thesis deals with the charasteristics of risk behavior and detailed description of chosen types of risk behavior. Moreover it deals with primary prevention, it's characteristics and describes prevention programs that school can use. This part also points out the prevention base of schools, thus institutions cooperating with school and documents that the schools support within the prevention of risk behavior. In the practical part, information gained from the research are analyzed and evaluated and this serves to verify the set goals of the thesis. Based on the research that was done, recommendations for improving the school prevention are suggested. In the conclusion of the thesis it is stated that the upper students (2nd grade) of elementary schools are on one...

Approfondir les connaissances sur l'évolution et les facteurs associés aux comportements sexuels chez les PVVIH exposées aux traitements antirétroviraux en Afrique subsaharienne. Données collectées dans le cadre d'un essai randomisé conduit dans neuf hôpitaux de district ruraux au Cameroun. 459 PVVIH éligibles au traitement inclus et suivis sur 24 mois. Régression logistique à effets mixtes utilisée pour analyser les facteurs associés aux différentes variables réponses étudiées.La proportion des patients sexuellement actifs augmente de 32% à l'inclusion à 56% après 24 mois de traitement. Une augmentation supplémentaire du temps depuis l'initiation du traitement de 6 mois augmente de 30% de la probabilité de déclarer une activité sexuelle sous ARV. Proportion des patients ayant des comportements sexuels à risque (CSR) baisse significativement de 76% à l'inclusion à 66% au 24e mois, les patients obervants au traitement étaient moins susceptibles de rapporter les CSR. La proportion des patients susceptibles de transmettre le VIH par voie sexuelle (STVIH) baisse de 76% à l'inclusion à 27% après 24 mois de traitement ARV. Une augmentation du temps depuis l'initiation du traitement de 6 mois réduit de 66% la STVIH. Mes travaux montrent un impact positif des ARV sur l'activité sexuelle des PVVIH, les CSR et la STVIH, suggérant un effet positif de l'exposition des PVVIH aux traitements ARV sur la prévention de la transmission sexuelle du VIH. Mais, le risque potentiel de transmission du VIH persiste nécessitant le renforcement des interventions de réduction des risques dans les programmes d'accès aux ARV. / To evaluate the evolution and factors associated with sexual behavior among PLWHA exposed to antiretroviral therapy in sub-Saharan Africa. Data collected as part of a randomized trial conducted in nine rural district hospitals in Cameroon. 459 PLWHA eligible for treatment included and followed for 24 months. Mixed effects logistic regression used to analyze factors associated with different response variables studied. Proportion of patients sexually active increased from 32% at baseline to 56% after 24 months of treatment. An additional 6 months increase of the time since initiation of treatment increase in 30% the probability of reporting sexual activity. Proportion of patients with sexual risk behavior (SRB) decreased significantly from 76% at baseline to 66% at 24 months and patient obervants to treatment were less likely to report CSR. Proportion of patients likely to transmit HIV through sexual intercourse (STVIH) decrease from 76% at baseline to 27% after 24 months of HAART. Analyses shown that increasing in 6 months of time since initiation of treatment reduced STVIH by 66%. My dissertation show a positive impact of ART on sexual activity, CSR and STVIH among PLWHA, suggesting a positive effect of exposure to HAART on the prevention of sexual transmission of HIV. However, the potential risk of transmission of HIV persists requiring strengthening risk reduction interventions in HAART access programs.

Made available in DSpace on 2016-07-27T14:20:17Z (GMT). No. of bitstreams: 1 ANA CRISTINA GOMES MARQUES DE FARIA.pdf: 632100 bytes, checksum: be1dd5c9ff65b961dc870b478b9250df (MD5) Previous issue date: 2014-02-28 / PARTE I: Recent studies show that there was significant growth in the number of suicides among teenagers. Firstly, literature review on the topic was held. Subsequently, we developed an empirical study in a town in Goias, popularly known by the occurrence of suicides . Participated in the empirical study of 371 adolescents aged between 12 and 18 years living and studying in the city. Data were collected in two schools, one public and one private. Its objective was to evaluate rates of suicidal ideation and suicide attempts in adolescents. According to the data it is observed that the total of 371 adolescents surveyed 321 (86.5 %) reported never having attempted suicide. However, 47 (12.7%) reported having attempted suicide in the past 12 months. Furthermore, while 301 (81.4 %) of teenagers have not submitted suicidal ideation, 67 or 18.2 % reported having thought about suicide. Furthermore, we sought to evaluate the relationship between suicidal ideation and suicide attempt with self-reported behavior problems. The instrument used was the Youth Self Report (YSR) developed by Achenbach (1991). This study showed that as much as suicidal ideation suicide attempts were associated with behavior problems analyzed as anxiety and depression, social isolation and depression, somatic problems, social problems, thought problems, attention problems, rule-breaking behavior, aggressive, internalizing and externalizing problems. The present study may be a subsidy to assist in the development of public policy and the health care more geared to this population and the region, in view of the reports of representative bodies from the municipality about the large number of attempts and suicides in the past years. PARTE II: This article aims to evaluate rates of suicidal ideation and suicide attempts in adolescents from an inner city of Goiás popularly known by the occurrence of suicides. Furthermore, we sought to evaluate the relationship between suicidal ideation and suicide attempt with self-reported behavior problems. The study included 371 adolescents from two schools, one private and one public. At the time of data collection, participants were attending to the corresponding Secondary School (sixth to ninth year) school years. Their ages ranged from 13 to 18 years old. Of these, 163 or 43.9% were boys and 208 or 56.1 % were girls. The data indicate that the total of 371 adolescents surveyed 321 (86.5 %) reported never having attempted suicide. However, 47 (12.7%) reported having attempted suicide in the past 12 months. Moreover, while 301 (81.4 %) of teenagers have not submitted suicidal ideation, 67 or 18.2% reported having thought about suicide. Teens who think suicide attempt do so in the next 6 months. A significant relationship between suicidal ideation and suicide attempt with behavior problems analyzed . / PARTE I: Estudos recentes demonstram que houve um crescimento significativo no número de suicídios entre Adolescentes. Em um primeiro momento, foi realizada revisão teórica sobre o tema. Posteriormente, foi desenvolvido um estudo empírico em uma cidade do interior de Goiás, popularmente conhecido pela ocorrência de suicídios. Participaram do estudo empírico 371 adolescentes com faixa etária entre 12 e 18 anos que residem e estudam no município. Os dados foram coletados em duas escolas, uma pública e outra particular. Seu objetivo foi avaliar os índices de ideação e tentativa de suicídio dos adolescentes. De acordo com os dados observa-se que do total dos 371 adolescentes pesquisados 321 (86,5%) relataram nunca haver tentado suicídio. Contudo, 47 (12,7%) relataram haver tentado suicídio nos últimos 12 meses. Além disso, embora 301 (81,4%) dos adolescentes não tenham apresentado ideação suicida, 67 ou 18,2% relataram haver pensado em suicidar. Além disso, buscou-se avaliar a relação entre ideação e tentativa de suicídio com o autorrelato de problemas de comportamento. O instrumento utilizado foi o Youth Self Report (YSR) desenvolvido por Achenbach (1991). Este estudo mostrou que, tanto a ideação suicida quanto tentativas de suicídio tiveram relação com os problemas de comportamento analisados como: ansiedade e depressão, isolamento social e depressão, problemas somáticos, problemas sociais, problemas de pensamento, problemas de atenção, quebrar regras, comportamento agressivo, problemas internalizantes e externalizantes. O presente estudo pode ser um subsídio para auxiliar no desenvolvimento de políticas públicas e de atenção a saúde mais voltadas a esta população e à região, tendo em vista os relatos de entidades representativas do município estudado acerca do grande número de tentativas e suicídios ocorridos nos últimos anos. PARTE II: Este artigo tem como objetivo avaliar os índices de ideação e tentativa de suicídio em adolescentes de uma cidade do interior de Goiás popularmente conhecida pela ocorrência de suicídios. Além disso, buscou avaliar a relação entre ideação e tentativa de suicídio com o autorrelato de problemas de comportamento. Participaram deste estudo 371 adolescentes provenientes de duas escolas, sendo uma pública e a outra particular. No momento da coleta de dados, os participantes cursavam os anos escolares correspondentes ao Ensino Fundamental II (sexto ao nono ano). As idades variaram de 13 a 18 anos de idade. Destes, 163 ou 43,9% eram meninos e 208 ou 56,1% eram meninas. Os dados indicam que do total dos 371 adolescentes pesquisados 321 (86,5%) relataram nunca haver tentado suicídio. Contudo, 47 (12,7%) relataram haver tentado suicídio nos últimos 12 meses. Além disso, embora 301 (81,4%) dos adolescentes não tenham apresentado ideação suicida, 67 ou 18,2% relataram haver pensado em suicidar. Adolescentes que pensam em suicídio tentam fazê-lo nos próximos 6 meses. Observouse relação significativa entre ideação e tentativa de suicídio com os problemas de comportamento analisados.

Bakgrund: Ungdomars sexuella och reproduktiva hälsa och rättigheter (SRHR) är ett viktigt folkhälsoarbete och barnmorskan har en central roll när det kommer till att nå ungdomarna med kunskap och information. Det förefaller finnas få studier om barnmorskors uppfattningar om vad ungdomar behöver veta mer om när det kommer till deras sexuella och reproduktiva hälsa och rättigheter. Syfte: Syftet med denna studie var att beskriva barnmorskors uppfattningar om vad ungdomar behöver veta mer om inom området sexuell och reproduktiv hälsa och rättigheter. Metod: Kvalitativ intervjustudie med åtta semistrukturerade intervjuer med barnmorskor. Datamaterial analyserades med en kvalitativ innehållsanalys med induktiv ansats. Resultat: Barnmorskorna uppfattade att ungdomarna hade behov av att veta mer om kroppsutveckling. Även mer om sexuellt överförbara infektioner (STI) och preventivmedel samt att killarna behövde veta mer om deras reproduktiva ansvar. Ungdomarna behövde också veta mer om sexuella relationer och rättigheter, innefattande bland annat lagar och homosexualitet. Barnmorskorna ser idag en ökning av sexuella problem bland ungdomarna och barnmorskorna hade en gemensam uppfattning om att det beror på pornografikonsumtion. Slutsats: Barnmorskor har insikt i vad ungdomar behöver veta mer om inom SRHR. Det finns fortfarande brister i undervisning och utbildning till ungdomar inom SRHR och det är angeläget att fokusera och investera i arbeten för att stärka och främja ungdomars SRHR. Klinisk tillämpbarhet: Denna studie lyfter barnmorskors uppfattningar om vad ungdomar behöver veta mer om inom ämnet SRHR. Studien kan användas i klinisk verksamhet till förbättringsarbeten för olika yrkeskategorier som arbetar med ungdomar gällande SRHR. / Background: The sexual and reproductive health and rights (SRHR) of young people is an important public health work and the midwife has a central role in reaching the young people with knowledge and information. There seem to be few studies on midwives' perceptions about what young people need to know more about when it comes to their sexual and reproductive health and rights. Purpose: The purpose of this study was to describe the views of midwives about what young people need to know more about in the area of sexual and reproductive health and rights. Method: Qualitative interview study with eight semi-structured interviews with midwives. The data material was analyzed with a qualitative content analysis with inductive approach. Result: The midwives perceived that the young people needed to know more about body development. In addition, more about sexually transmitted infections (STIs) and contraceptives and that the young men needed to know more about their reproductive responsibilities. The youth also needed to know more about sexual relations and rights, including, among other things, laws and homosexuality. The midwives today see an increase in sexual problems among young people and the midwives had a common view that this is due to pornography consumption. Conclusion: Midwives have insight into what young people need to know more about in SRHR. There are still shortcomings in education for young people within SRHR, and it is important to focus and invest in work to strengthen and promote young people's SRHR. Clinical application: This study highlights the views of midwives on what young people need to know more about in the subject of SRHR. The study can be used in clinical activities for improvement work for various occupational categories that work with young people regarding SRHR.

<p>The overall aims of this research were to develop methods of identifying adolescents with unhealthy and/or risk-taking behavior with special reference to sexuality, and to evaluate support measures for young people in need of such interventions. A further aim was to assess strategies for preventing unhealthy and/or risk-taking behavior. Data were obtained by questionnaires (studies I, III, IV and V) and interviews (study II).</p><p>The results showed that young men involved in unintended pregnancies would benefit from active participation in the decision making regarding continuation or termination of the pregnancy, and from support at Outpatient Clinics for Adolescents in Sweden, including information together with the partner (I).</p><p>It was also concluded that consideration should be paid to questions and problems, e.g. feelings, apprehensions, moral issues and psychosocial factors, that require individual support from personnel with knowledge and resources to help young men in this difficult situation (II).</p><p>Among the most important findings regarding young men who had been involved in an unplanned pregnancy were that in this group a high percentage had previously considered suicide and that anabolic steroids were frequently used, compared with young men without experience of pregnancy (III).</p><p>The finding that unprotected intercourse occurred in a fairly high frequency among 13- to 18-year-olds, despite massive education and easy access to contraceptives, gives reason for further considerations regarding appropriate ways of providing information to young people (IV).</p><p>Girls and boys in vocational programs in Swedish high schools exhibit more risk-taking behaviors than those in theoretical programs and these two groups differ in clustering and accumulation of these behaviors. This means that preventive interventional strategies need to be elaborated with regard to these differences, with the aim of improving health maintenance among adolescents (V).</p><p>Child-and-youth centers with a developmental and research capacity need to be established with the broad purpose of drawing up health prevention programs for children and young people.</p>

The aim of this thesis is to describe the users visiting the syringe exchange clinic in Malmö with respect to what characterises the group, how they utilize the services of the clinic and how their patterns of participation relate to risk behaviour, physical and mental health and social development. The heterogeneity of the group has been captured by the use of Stimsons dimensions “integration in majority society” and “involvement in sub-culture”, yielding four different groups of syringe exchangers: “stables”, “loners”, “two-worlders” and “junkies”. The study rests on two sources of data: a register from the clinic including all syringe exchangers that have visited the clinic between 1989 and 2003, altogether 3660 individuals, and an interview of visitors at the clinic during 1995, including 496 persons. The results show that syringe exchangers, compared to other persons with severe addiction in Malmö, to a larger extent use amphetamine as their drug-of-choice, are older and inject more irregularly. The population visiting the clinic is heterogeneous with respect to integration in society and involvement in sub-cultures. The group classified as junkies do, as expected, display the highest inclination to share syringes and needles with other and hence have the most advanced risk behaviours. As to utilization of the programme, the results show that the longer the syringe exchangers stay in the programme, the more frequent they visit it. Also with respect to utilization-patterns, we find substantial variations within the studied group. Five categories are discernible: drop-in visitors with only one or two visits, sporadic visitors who in spite of contacts over a number of years never really establish a regular contact, intermittent visitors who have had contact over several years but display a very irregular visiting pattern, regular visitors who relatively fast establish a consistent contact with visits between uniform time intervals and frequent visitors who tend to stay longer than others and visit the clinic more often. Another aspect of utilization is to what extent the distribution of needles and syringes cover the needs of the visitors. With a strict definition of need, only a minority manages to cover their needs, but if we accept a more extensive individual re-use, around 90 percent of the average need is covered. Data also reveals that a very high proportion of the users on at least one occasion have visited the programme without syringe exchange taking place or any complementary service delivered. Basically these visits seem to be of a more social nature, reinforcing the contacts between the staff and the visitors. Data do not give any clear support for the basic assumption that syringe exchange reduce the incidence of HIV or hepatitis. Recent sharing of utensils or low coverage of syringe need through the programme do not predict a higher infection risk. Instead we find that the social contacts with the staff (without syringe exchange) function as a predictor of lower incidence. This indicates that the mechanisms may be more complex than just related to the provision of clean needles and syringes. The result shows that integration increase over time while sub-cultural involvement decreases. However, the patterns for different groups are very diverse and we find no evidence that more frequent contacts as such are related to increased integration. There is however, some evidence that social visits are positively related to increased integration. No support could be found for the assumption that the programme increases the number of severe addicts.

The overall aims of this research were to develop methods of identifying adolescents with unhealthy and/or risk-taking behavior with special reference to sexuality, and to evaluate support measures for young people in need of such interventions. A further aim was to assess strategies for preventing unhealthy and/or risk-taking behavior. Data were obtained by questionnaires (studies I, III, IV and V) and interviews (study II). The results showed that young men involved in unintended pregnancies would benefit from active participation in the decision making regarding continuation or termination of the pregnancy, and from support at Outpatient Clinics for Adolescents in Sweden, including information together with the partner (I). It was also concluded that consideration should be paid to questions and problems, e.g. feelings, apprehensions, moral issues and psychosocial factors, that require individual support from personnel with knowledge and resources to help young men in this difficult situation (II). Among the most important findings regarding young men who had been involved in an unplanned pregnancy were that in this group a high percentage had previously considered suicide and that anabolic steroids were frequently used, compared with young men without experience of pregnancy (III). The finding that unprotected intercourse occurred in a fairly high frequency among 13- to 18-year-olds, despite massive education and easy access to contraceptives, gives reason for further considerations regarding appropriate ways of providing information to young people (IV). Girls and boys in vocational programs in Swedish high schools exhibit more risk-taking behaviors than those in theoretical programs and these two groups differ in clustering and accumulation of these behaviors. This means that preventive interventional strategies need to be elaborated with regard to these differences, with the aim of improving health maintenance among adolescents (V). Child-and-youth centers with a developmental and research capacity need to be established with the broad purpose of drawing up health prevention programs for children and young people.

En el marc del model transteòric de canvi (Prochaska, DiClemente i Norcross, 1992) i del model de l'autocontrol (Rachlin, 1989), s'examinen les característiques de la conducta de fumar així com la percepció de la magnitud i la demora de les conseqüències positives i negatives d'aquest consum, a fi de conèixer la seva relació amb l'etapa de canvi en la cessació tabàquica.Amb aquest objectiu s'entrevista a una mostra representativa de 281 membres (54,8% homes i 45,2% dones; mitjana d'edat = 37,26 anys, DT = 8,77; 48,8% no fumadors, 27,4% fumadors i 23,8% exfumadors) del personal acadèmic i d'administració i serveis de la Universitat de Girona.Els resultats mostren que més de la meitat dels fumadors es troben a l'etapa de Precontemplació (sense intenció ferma d'abandonar el consum de tabac en els propers 6 mesos) i la majoria d'exfumadors se situen a l'etapa de Manteniment (mínim de sis mesos sense fumar).També s'observen diferències en algunes de les variables examinades segons l'etapa de canvi de manera que els fumadors en Contemplació-Preparació (amb intenció ferma d'abandonar el consum de tabac en els propers 6 mesos) presenten un elevat índex de perjudicis percebuts, informen d'haver rebut més consell mèdic i realitzen amb major freqüència inhalacions a cada cigarreta.En canvi, els fumadors en Precontemplació són els qui més responen consumir tabac baix en nicotina mentre que els exfumadors en Acció o Manteniment són els qui més tendeixen a relacionar de manera immediata fumar i les seves conseqüències negatives a curt i mitjà termini, i els qui presenten major puntuació en l'índex de beneficis percebuts. Aquestes dades corroboren la importància de les intervencions clíniques específiques en les diferents etapes de l'abandonament del consum de tabac, suggereixen que les campanyes preventives s'haurien de focalitzar preferentment en les conseqüències negatives immediates de fumar i apunten a la conveniència de tenir en compte la notable valoració positiva dels beneficis de fumar per part dels exfumadors en els programes de prevenció de recaigudes. Així mateix, la constatació del poder explicatiu de la variable demora en la diferenciació dels subjectes en funció de l'etapa de canvi, planteja la conveniència d'incloure aquesta variable en les avaluacions dels pros i contres de fumar a fi de conèixer amb major precisió els seus pesos relatius. / Whitin the frame of the transtheoretical model of change (Prochaska, DiClemente and Norcross, 1992) and the self-control model (Rachlin, 1989) the features of smoking cessation are studied as well as the perception of the magnitude and delay of both positive and negative consequences of this consumption, in order to know its relation with the changing stage when giving up smoking.To reach this goal a representative sample of 281 people are interviewed (54,8% men and 45,2% women; average age: 37,26 years old, SD: 8,77; 48,8% non-smokers, 27,4% smokers and 23,8 ex-smokers) of the academic and administrative staff at the University of Girona.The results show that more than a half of smokers are at the Precontemplation stage (without a strong intention of giving up smoking within the next six months) and most of ex-smokers are at the Maintaining stage (six months minimum without smoking).Some differences are also observed in some of the examined variables according to the changing stage, in a way that smokers who are at the Contemplation-Preparation stage (with a strong intention of giving up smoking within the next six months) show a high index of perceived cons of smoking and they also inform they have been given more medical advice. On the other hand, ex-smokers who are in the Action stage or Maintaining stage are those who tend closely relate smoking and its inmediate and delayed consequences, also those who show the highest scoring on the perceived benefit index. This data corroborates the importance of specific clinical actions in the different stages of giving up smoking process, it also suggest that preventive campaigns should focus preferably on the inmediate negative consequences of smoking and write down the convenience of taking into account the notable positive valuation of the benefits of giving up smoking on behalf of the exsmokers in the preventive relapse programs.Also this data evidence the convenience of including the delay parameter in the pros and cons of smoking evaluation with the aim of knowing with more precision their relative weights.