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In the United States (US), substance use, misuse, and substance use disorders are significant public health problems. Additionally, the difference between needing substance use treatment (SUT) and receiving treatment is becoming more pronounced. Therefore, the aims of this dissertation include, 1) to synthesize evidence of barriers and facilitators to integrating SUT into mainstream health care (MHC) after the Affordable Care Act was nationally implemented in 2014, 2) to examine the rate of treatment completion and dropout, along with its associated factors, among youth who received Medication-Assisted Opioid Therapy (MAT), 3) to determine the relationship between prior treatment episodes and length of stay (LOS) among adults in residential rehabilitation facilities (RRF) and explore other predictors of LOS and, 4) to determine whether experiencing multiple treatment episodes and being in certain age groups was associated with longer wait period to enter SUT. The literature synthesis involved data from five databases and was informed by PRISMA. Quantitative analysis (aims 2-4) included log-binomial, Poisson, and logistic regression models using the Treatment Episode Data Set-Admissions and Discharges. Andersen’s Behavioral Model for Health Services was the conceptual framework used to inform aims 2-4. For aim 1, several patient, provider, and program/system-level barriers and facilitators were identified, which highlights the need to use a comprehensive approach to improve SUT adoption in MHC. For aim 2, among youth who received MAT, 43.9% completed treatment and 56.1% dropped out. Factors positively associated with treatment completion included MAT use, males, self-help group participation, admission to detoxification and residential/rehabilitation settings, and being in the Midwest/Western US; while minority races (excluding Blacks/African Americans) and being in the South resulted in lower likelihood. For aim 3, the average LOS in RRF was 16.4 days, and having ≥ 1 prior SUT episode (PSUTE) was associated with slightly higher LOS. Some predictors associated with lower LOS included age (18-34 years), males, being employed, private insurance, and being in the Northeast. For aim 4, a longer wait period was identified among clients 25-49 years and those with ≥5 PSUTEs. These factors should be considered to improve SUT use, and future studies should corroborate these findings.

Tesis por compendio / [ES] La detección del lenguaje abusivo es una tarea que se ha vuelto cada vez más importante en la era digital moderna, donde la comunicación se produce a través de diversas plataformas en línea. El aumento de las interacciones en estas plataformas ha provocado un aumento de la aparición del lenguaje abusivo. Abordar dicho contenido es crucial para mantener un entorno en línea seguro e inclusivo. Sin embargo, esta tarea enfrenta varios desafíos que la convierten en un área compleja y que demanda de continua investigación y desarrollo. En particular, detectar lenguaje abusivo en entornos con escasez de datos presenta desafíos adicionales debido a que el desarrollo de sistemas automáticos precisos a menudo requiere de grandes conjuntos de datos anotados. En esta tesis investigamos diferentes aspectos de la detección del lenguaje abusivo, prestando especial atención a entornos con datos limitados. Primero, estudiamos el sesgo hacia palabras clave abusivas en modelos entrenados para la detección del lenguaje abusivo. Con este propósito, proponemos dos métodos para extraer palabras clave potencialmente abusivas de colecciones de textos. Luego evaluamos el sesgo hacia las palabras clave extraídas y cómo se puede modificar este sesgo para influir en el rendimiento de la detección del lenguaje abusivo. El análisis y las conclusiones de este trabajo revelan evidencia de que es posible mitigar el sesgo y que dicha reducción puede afectar positivamente el desempeño de los modelos. Sin embargo, notamos que no es posible establecer una correspondencia similar entre la variación del sesgo y el desempeño de los modelos cuando hay escasez datos con las técnicas de reducción del sesgo estudiadas. En segundo lugar, investigamos el uso de redes neuronales basadas en grafos para detectar lenguaje abusivo. Por un lado, proponemos una estrategia de representación de textos diseñada con el objetivo de obtener un espacio de representación en el que los textos abusivos puedan distinguirse fácilmente de otros textos. Por otro lado, evaluamos la capacidad de redes neuronales convolucionales basadas en grafos para clasificar textos abusivos. La siguiente parte de nuestra investigación se centra en analizar cómo el aumento de datos puede influir en el rendimiento de la detección del lenguaje abusivo. Para ello, investigamos dos técnicas bien conocidas basadas en el principio de minimización del riesgo en la vecindad de instancias originales y proponemos una variante para una de ellas. Además, evaluamos técnicas simples basadas en el reemplazo de sinónimos, inserción aleatoria, intercambio aleatorio y eliminación aleatoria de palabras. Las contribuciones de esta tesis ponen de manifiesto el potencial de las redes neuronales basadas en grafos y de las técnicas de aumento de datos para mejorar la detección del lenguaje abusivo, especialmente cuando hay limitación de datos. Estas contribuciones han sido publicadas en conferencias y revistas internacionales. / [CA] La detecció del llenguatge abusiu és una tasca que s'ha tornat cada vegada més important en l'era digital moderna, on la comunicació es produïx a través de diverses plataformes en línia. L'augment de les interaccions en estes plataformes ha provocat un augment de l'aparició de llenguatge abusiu. Abordar este contingut és crucial per a mantindre un entorn en línia segur i inclusiu. No obstant això, esta tasca enfronta diversos desafiaments que la convertixen en una àrea complexa i contínua de recerca i desenvolupament. En particular, detectar llenguatge abusiu en entorns amb escassetat de dades presenta desafiaments addicionals pel fet que el desenvolupament de sistemes automàtics precisos sovint requerix de grans conjunts de dades anotades. En esta tesi investiguem diferents aspectes de la detecció del llenguatge abusiu, prestant especial atenció a entorns amb dades limitades. Primer, estudiem el biaix cap a paraules clau abusives en models entrenats per a la detecció de llenguatge abusiu. Amb este propòsit, proposem dos mètodes per a extraure paraules clau potencialment abusives de col·leccions de textos. Després avaluem el biaix cap a les paraules clau extretes i com es pot modificar este biaix per a influir en el rendiment de la detecció de llenguatge abusiu. L'anàlisi i les conclusions d'este treball revelen evidència que és possible mitigar el biaix i que esta reducció pot afectar positivament l'acompliment dels models. No obstant això, notem que no és possible establir una correspondència similar entre la variació del biaix i l'acompliment dels models quan hi ha escassetat dades amb les tècniques de reducció del biaix estudiades. En segon lloc, investiguem l'ús de xarxes neuronals basades en grafs per a detectar llenguatge abusiu. D'una banda, proposem una estratègia de representació textual dissenyada amb l'objectiu d'obtindre un espai de representació en el qual els textos abusius puguen distingir-se fàcilment d'altres textos. D'altra banda, avaluem la capacitat de models basats en xarxes neuronals convolucionals basades en grafs per a classificar textos abusius. La següent part de la nostra investigació se centra en analitzar com l'augment de dades pot influir en el rendiment de la detecció del llenguatge abusiu. Per a això, investiguem dues tècniques ben conegudes basades en el principi de minimització del risc en el veïnatge d'instàncies originals i proposem una variant per a una d'elles. A més, avaluem tècniques simples basades en el reemplaçament de sinònims, inserció aleatòria, intercanvi aleatori i eliminació aleatòria de paraules. Les contribucions d'esta tesi destaquen el potencial de les xarxes neuronals basades en grafs i de les tècniques d'augment de dades per a millorar la detecció del llenguatge abusiu, especialment quan hi ha limitació de dades. Estes contribucions han sigut publicades en revistes i conferències internacionals. / [EN] Abusive language detection is a task that has become increasingly important in the modern digital age, where communication takes place via various online platforms. The increase in online interactions has led to an increase in the occurrence of abusive language. Addressing such content is crucial to maintaining a safe and inclusive online environment. However, this task faces several challenges that make it a complex and ongoing area of research and development. In particular, detecting abusive language in environments with sparse data poses an additional challenge, since the development of accurate automated systems often requires large annotated datasets. In this thesis we investigate different aspects of abusive language detection, paying particular attention to environments with limited data. First, we study the bias toward abusive keywords in models trained for abusive language detection. To this end, we propose two methods for extracting potentially abusive keywords from datasets. We then evaluate the bias toward the extracted keywords and how this bias can be modified in order to influence abusive language detection performance. The analysis and conclusions of this work reveal evidence that it is possible to mitigate the bias and that such a reduction can positively affect the performance of the models. However, we notice that it is not possible to establish a similar correspondence between bias mitigation and model performance in low-resource settings with the studied bias mitigation techniques. Second, we investigate the use of models based on graph neural networks to detect abusive language. On the one hand, we propose a text representation framework designed with the aim of obtaining a representation space in which abusive texts can be easily distinguished from other texts. On the other hand, we evaluate the ability of models based on convolutional graph neural networks to classify abusive texts. The next part of our research focuses on analyzing how data augmentation can influence the performance of abusive language detection. To this end, we investigate two well-known techniques based on the principle of vicinal risk minimization and propose a variant for one of them. In addition, we evaluate simple techniques based on the operations of synonym replacement, random insertion, random swap, and random deletion. The contributions of this thesis highlight the potential of models based on graph neural networks and data augmentation techniques to improve abusive language detection, especially in low-resource settings. These contributions have been published in several international conferences and journals. / This research work was partially funded by the Spanish Ministry of Science and Innovation under the research project MISMIS-FAKEnHATE on Misinformation and Miscommunication in social media: FAKE news and HATE speech (PGC2018-096212-B-C31). The authors thank also the EU-FEDER Comunitat Valenciana 2014-2020 grant IDIFEDER/2018/025. This work was done in the framework of the research project on Fairness and Transparency for equitable NLP applications in social media, funded by MCIN/AEI/10.13039/501100011033 and by ERDF, EU A way of making EuropePI. FairTransNLP research project (PID2021-124361OB-C31) funded by MCIN/AEI/10.13039/501100011033 and by ERDF, EU A way of making Europe. Part of the work presented in this article was performed during the first author’s research visit to the University of Mannheim, supported through a Contact Fellowship awarded by the DAAD scholarship program “STIBET Doktoranden”. / Peña Sarracén, GLDL. (2024). On the Keyword Extraction and Bias Analysis, Graph-based Exploration and Data Augmentation for Abusive Language Detection in Low-Resource Settings [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/203266 / Compendio

The aim of this study was to develop a Gestalt play therapy based hospital preparation program for children undergoing the surgical procedures of grommet insertion, or grommet insertion and adenoidectomy, at Tygerberg Hospital. Literature was reviewed according to relevant topics, namely otitis media in children, Gestalt play therapy, theories of child development, and children's experience of illness and hospitalisation. Semi-structured interviews were conducted with four subject groups and the data obtained was qualitatively analysed. Research findings were discussed and integrated with reference to the literature. This information was applied in the development of the proposed program. The aim, underlying principles, objectives and components of the program were discussed and guidelines for implementation were provided. The program was implemented and evaluated in a single subject pilot study, which yielded a positive response. Recommendations for both practical implementation in a therapeutic context and further study in a research context were made. OPSOMMING Die doel van hierdie studie was om `n Gestalt spelterapie-gebaseerde hospitaalvoorbereidingsprogram te ontwikkel vir kinders wat die chirurgiese prosedures van ventilasiebuis-plasing of ventilasiebuis-plasing en adenoïdektomie by Tygerberg-hospitaal ondergaan. `n Literatuurstudie is uitgevoer rakende relevante onderwerpe; naamlik, otitis media in kinders, Gestalt spelterapie, kinderontwikkelingsteorieë, en kinders se ervaring van siekte en hospitalisasie. Semi-gestruktureerde onderhoude is met vier subjekgroepe uitgevoer en die data wat verkry is, is kwalitatief geanaliseer. Navorsingsbevindinge is bespreek en geïntegreer met verwysing na die literatuur. Hierdie inligting is toegepas in die ontwikkeling van die voorgestelde program. Die doel, onderliggende beginsels, doelstellings en komponente van die program is bespreek en riglyne vir die implementering daarvan is verskaf. Die program is geïmplimenteer en geëvalueer in `n enkelsubjek loodsstudie, waar `n positiewe respons verkry is. Aanbevelings vir beide praktiese implementering in `n terapeutiese konteks en verdere studie binne navorsingskonteks is gemaak. / Social Work / M.Diac.

The pathways to manhood for young adult African men in urban settings are based more on socio-economic demands than socio-cultural expectations of being a man. This study was a qualitative explorative research on the perceptions of HIV-prevention practitioners on the different pathways to manhood among young adult African men in urban settings in Gauteng, South Africa. From the findings it was clear that there are diverse socio-cultural and socio-economic pathways to manhood, including the media, older men, peers, religion and women. These pathways affirm, confirm, validate and value a man as a man and not a boy in urban settings such as cities and informal settlements in Gauteng. The research concluded that a great deal more could be done to ensure that men get involved in HIV-prevention programmes by ensuring dialogue on manhood and masculinities between men and men, and men and women. / Sociology / M.A. (Social Science)

Text in English / The purpose of this study, was to identify and describe factors, which facilitate or impede learning in clinical learning settings. The study adopted an exploratory descriptive approach, incorporating both quantitative and qualitative designs. Data collection tool, comprised of two sections: Section 1 focused on demographic characteristics. While section 2 addressed study variables of clinical setting, staffing, patient care/ practice standards, nurse manager's commitment and interpersonal relationships. The last section had two parts; part 1 being close ended Likert type scale ranging from strongly agree to strongly disagree. Part 2, was open ended, and solicited respondents' feelings opinions and experiences on factors they perceived to facilitate or impede clinical learning. The findings indicate that the majority of settings studied did not provide adequate factors to facilitate clinical learning. Factors such as availability of learning experiences, acceptable unit organization, space and resource availability, and accessibility to students, adequate staffing with qualified staff who actively participate in teaching, appropriate and quality patient care role modelled, lecturer availability and involvement in clinical teaching, team building and inclusion of students in the team, committed nurse managers involved in students' learning, conducive relationships among staff, students and patients, comfort relationships, advocacy and creating conducive relationship by the nurse manager, were identified as necessary for learning. These factors however, were found to be either lacking, inadequate or inaccessible to students. Findings were based on data from a quota sample of 202 participants proportionately drawn from students, nurse managers and nurse lecturers. The study made recommendations to improve and enhance the conduciveness of clinical practice settings used for learning in Botswana. / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)

Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHA / Health Studies / D.Litt. et Phil. (Health Studies)

本研究旨在探討不同甄選情境中（視聽組、聽覺組、文字組），「人格印象」、「能力評估」、「喜好程度」及「應對表現」對「口試成績」的影響。 本研究以實驗法進行，採3「甄選情境」× 5「考生」二因子混合設計。其中「甄選情境」分為「視聽組」、「聽覺組」及「文字組」三組，「考生」則分為「甲生」、「乙生」、「丙生」、「丁生」及「戊生」五位。每組均由17位口試委員對5位考生進行評分。由於三組之口試委員不同，各組之評分不會彼此影響，因此「甄選情境」為獨立樣本，即受試者間設計；五位考生均會接受17位口試委員之評分，因此「考生」乃相依樣本，即受試者內設計。 本研究以碩博士班研究生為研究對象，請他們在觀看（聆聽或閱讀）口試錄影帶（謄本）後，以大學推甄口試委員的立場對影片中人物所形成之「人格印象」、「能力評估」、「喜好程度」及「應對表現」予以評分，並評定其「口試成績」。本研究採隨機分配，將研究對象分為「視聽組」、「聽覺組」及「文字組」三組。每組17位口試委員，共計51位。在觀看（聆聽或閱讀）口試錄影帶（謄本）前，受試者有5分鐘時間閱覽考生之書面資料，然後在觀看（聆聽或閱讀）考生之口試錄影帶（謄本）後，填寫「人格印象量表」及「口試評量表」。 本研究以3「甄選情境」× 5「考生」混合設計二因子變異數分析檢定不同的甄選情境在「人格印象」（他人親和取向、個人愉悅取向）、「能力評估」（專業能力、問題處理能力、人際關係處理能力、行政能力、外語能力）、「喜好程度」、「應對表現」及「口試成績」上之差異情形，結果發現處在不同甄選情境中的口試委員在這些變項上（外語能力除外）均可獲得頗為一致的判斷。研究者認為造成此結果的可能原因為：（1）參與推甄口試的考生無論是在課業或是人格特質、能力上均有相當程度的相似性；（2）大學推甄所使用的書面審查資料較職場口試中所使用的豐富，足以提供考生之人格、能力相關訊息；（3）實驗過程中口試委員閱讀書面審查資料的時間和口試時間的間隔太短，考生書面資料造成的初始效應過於強烈。 在不同甄選情境（視聽組、聽覺組、文字組）中，「人格印象」、「能力評估」、「喜好程度」、「應對表現」對「口試成績」之影響方面，研究結果發現：（1）「口試成績」與「應對表現」有高度相關；（2）「個人愉悅取向」與「視聽組」及「文字組」口試成績之間僅具低度相關，但卻與「聽覺組」口試成績具高度相關；（3）「專業能力」與「視聽組」及「文字組」口試成績之間僅具低度相關，但卻與「聽覺組」口試成績之間具高度相關；（4）「問題解決能力」與「視聽組」及「聽覺組」口試成績之間僅具低度相關，但卻與「文字組」口試成績之間具高度相關；（6）「喜好程度」與「視聽組」及「文字組」口試成績僅具低度相關，但與「聽覺組」口試成績則具高度相關；（7）「口試成績」與「他人親和取向」、「人際關係能力」、「行政能力」、「外語能力」僅有低度相關。 研究者認為本研究之所以發現「人格印象」與「視聽組」和「文字組」口試成績之間並沒有很高的相關，其可能的原因如下：（1）有些人格特質是無法在短時間內被覺察到的；（2）有些人格特質是比較容易用聽的方式覺察到的；（3）人格特質的判斷通常是以潛意識的方式在進行的；（4）人格特質是可以經由大學四年的教育慢慢成形的；（5）人格特質對口試的影響主要是在對應試者未來工作表現的預測上，而大學校系並不需預測考生未來工作表現。 綜合本研究發現，在大學推甄口試方面，考生的肢體語言、外表、聲音等對口試委員的影響並不是很重要。此外，人格特質在大學推甄口試上的影響亦非常輕微，因此研究認為大學學系應重新衡量是否應繼續保有口試？抑或改以其他方式進行學生的甄選，以達到既有效又節省的取才方式。 / The purpose of the study is to identify which of the following variables: personality impression, capability judgment, likeability, and interview performance, is actually affecting the outcome of the university enrollment interview with different settings. Subjects were 51 post-graduate students, randomly assigned to three groups – “Audio-visual Group”, “Audio Group”, and “Script Group”. Those in video group watched the video of the university enrollment interview, while those in audio group listened to the audio of the same interview, and those in script group read the transcript of the said interview. Vitae of the applicants were given to the subjects for reference prior to the stimulus. Each subject reviewed 5 applicants’ video (audio/transcript), and filled in the Personality Impression Form and Interview Assessment Form. 2-way ANOVA is used to examine the effect of different settings (audio-visual, audio, or transcript) on personality impression, capability judgment, likeability, and interview content, and it is found that all variable can be judged in coincidence among subjects within different settings. Pearson correlation is used to examine the effect of personality impression, capability judgment, likeability, and interview performance on the decision-making of interview in different settings, and it is found that interview result is (1) highly correlated to interview performance in all settings; (2) highly correlated to personality impression, specialty, and likeability in “audio group”, however, it is loosely correlated in other groups; (3) highly correlated to problem solving skills in “audio group”, however, it is loosely correlated in other groups; (4) loosely correlated to inter-personal skills, administrative skills and foreign language in all settings.