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1رسالة جامعية
المؤلفون: Mota, Daniela Cristina Belchior
مرشدي الرسالة: Ronzani, Telmo Mota, Perucchi, Juliana, Stralen, Cornelis Johannes van
المصدر: Repositório Institucional da UFJFUniversidade Federal de Juiz de ForaUFJF.
مصطلحات موضوعية: CNPQ::CIENCIAS HUMANAS::PSICOLOGIA, Políticas públicas, Implementação de políticas, Governo local, Álcool, Drogas ilícitas, Public policy, Policy implementation, Local government, Alcohol, Illicit drugs
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Embora o uso de álcool e outras drogas esteja associado a uma diversidade de danos, esta área não tinha até o início do século XXI uma política de atenção aos usuários. As políticas brasileiras voltadas para a abordagem deste tema na saúde pública foram recentemente formuladas pela Secretaria Nacional de Políticas sobre Drogas (SENAD) e pelo Ministério da Saúde. As principais diretrizes da implementação das políticas nacionais sobre álcool e outras drogas enfocam a descentralização das ações. Este estudo avaliou a implementação das políticas da SENAD e do Ministério da Saúde em nível municipal, identificando ações desenvolvidas e atores envolvidos. Foram realizados três estudos de campo em municípios selecionados intencionalmente, sendo “A” um município de grande porte que conta com rede especializada nesta área, “B” um município de pequeno porte que possui Conselho Municipal sobre Álcool e Drogas (COMAD), e “C” também considerado de pequeno porte e que não atende às duas condições anteriores. Procedeu-se à coleta de dados através de entrevistas com informantes-chave e consulta a documentos da política municipal. No total, foram realizadas 19 entrevistas. A análise dos dados foi realizada através da análise de conteúdo do tipo estrutural e temática. No município A, há entraves para a integração da rede de atenção aos usuários e para a articulação dos atores envolvidos, sendo que a implementação das políticas de álcool e outras drogas restringe-se ao que está sendo priorizado para o campo da saúde mental. No segundo município, observou-se uma articulação entre os atores locais através do COMAD recentemente implantado, no entanto há uma tendência de que a implementação das políticas seja identificada com a execução de ações através do COMAD. No município C não foram encontradas ações públicas locais na área de álcool e outras drogas, verificando-se uma atuação paliativa de atores não governamentais e a escassez de um debate local. Apesar das distinções entre os municípios e diferentes graus de dificuldades enfrentadas, verificaram-se fragilidades para a implementação das políticas propostas pela SENAD e pelo Ministério da Saúde, haja vista os obstáculos para se ter acesso à oferta assistencial e a fragmentação do tema álcool e drogas em relação ao cenário político mais amplo.
Although the use of alcohol and other drugs is associated with a variety of damage, this area was not a policy of attention to users until the early twenty-first century. Brazilian policies aimed at tackling this issue in public health have recently been formulated by the National Policy on Drugs (SENAD) and the Ministry of Health. The main guidelines of the implementation of national policies on alcohol and other drugs focus on the decentralization of actions. This study evaluated the implementation of SENAD and the Ministry of Health policies at a municipal level, identifying actions taken and actors involved. We conducted three field studies in selected cities by criteria of convenience, as "A" a large city that has a network specialized in this area, "B" a small city that has a City Council on Alcohol and Drugs (COMAD). And "C" also considered small and does not meet the two previous conditions. Data collection was performed through interviews with key informants, and documents of municipal politics. In total, 19 interviews were conducted. Data analysis was performed using the content analysis of a structural and thematic kind. In city A, there are barriers to the integration of the network of care to users and for the interaction of the actors involved, and the implementation of policies on alcohol and other drugs is limited to what is being prioritized for the mental health field. In the second city, we observed a linkage between local actors through COMAD recently deployed; however there is a tendency that the implementation of policies will be identified with the execution of actions through COMAD. In city C there were no local public actions in the area of alcohol and other drugs, and there are a palliative role of non-governmental actors and lack of a local debate. Despite the distinctions between the municipalities and different degrees of difficulties, it was found weaknesses in the implementation of the policies proposed by SENAD and the Ministry of Health, given the obstacles to have access to health care provision and the fragmentation of the subject alcohol and drugs in relation to a broader political scene. -
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المؤلفون: Fachini, Alexandre
مرشدي الرسالة: Furtado, Erikson Felipe
مصطلحات موضوعية: academic life, alcohol, álcool, college, drogas ilícitas, illicit drugs, longitudinal., universitários, vida acadêmica
الوصف: INTRODUÇÃO: Estudos sinalizam que a experiência universitária corresponde a um momento de maior vulnerabilidade para o consumo de álcool e outras drogas. Essa afirmativa decorre da maior prevalência do consumo de substâncias observada entre universitários em comparação a outras amostras populacionais, inclusive jovens não universitários. OBJETIVOS: Avaliar a associação entre o uso de álcool e outras drogas (ilícitas e medicamentos) com variáveis do contexto acadêmico e os significados atribuídos pelos estudantes sobre essa relação. METODOLOGIA: Estudo longitudinal prospectivo de tratamento quantitativo e qualitativo dos dados realizado com 85 estudantes da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Foi utilizado um questionário contendo questões estruturadas para avaliar os aspectos envolvidos na experiência estudantil e os instrumentos de pesquisa AUDIT (Alcohol Use Disorders Identification Test) e DUSI (Drug Use Screening Inventory) para avaliar o uso de álcool e de outras drogas, respectivamente. Também foram realizadas entrevistas semiestruturadas com alguns participantes e subsequente análise de conteúdo. RESULTADOS: Homens aumentaram o padrão de binge drinking, indicando um risco substancial nos períodos finais do curso universitário (p
INTRODUCTION: Several studies have indicated that college years are a period of greater vulnerability to alcohol and other psychoactive drugs use. This evidence stems from the higher prevalence of substance use observed among college students in comparison to others young adults. OBJECTIVE: To evaluate the association between alcohol and other drugs (illicit drugs) use and variables of the academic life, and the meanings attributed by students on this relationship. METHODOLOGY: Longitudinal study, quantitative and qualitative approach, design on a convenience sample of 85 undergraduate students from all courses of the School of Medicine of Ribeirão Preto of University of São Paulo. Alcohol Use Disorders Identification Test (AUDIT) and the Drug use Screening Inventory (DUSI) have been used as measures of alcohol use and others psychoactive drugs use respectively. Structured questionnaire evaluated aspects related to academic life. Semi-structured interviews are conducted with some participants and submitted to content analysis. RESULTS: Men increased binge drinking pattern, indicating a substantial risk in the final periods in college (pوصف الملف: application/pdf
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3رسالة جامعية
المؤلفون: Alexandre Fachini
مرشدي الرسالة: Erikson Felipe Furtado, Arthur Guerra de Andrade, Maria de Fátima Aveiro Colares, Jair Licio Ferreira Santos, Egberto Ribeiro Turato
المصدر: Biblioteca Digital de Teses e Dissertações da USPUniversidade de São PauloUSP.
مصطلحات موضوعية: álcool, drogas ilícitas, longitudinal., universitários, vida acadêmica, academic life, alcohol, college, illicit drugs
الوصف: INTRODUÇÃO: Estudos sinalizam que a experiência universitária corresponde a um momento de maior vulnerabilidade para o consumo de álcool e outras drogas. Essa afirmativa decorre da maior prevalência do consumo de substâncias observada entre universitários em comparação a outras amostras populacionais, inclusive jovens não universitários. OBJETIVOS: Avaliar a associação entre o uso de álcool e outras drogas (ilícitas e medicamentos) com variáveis do contexto acadêmico e os significados atribuídos pelos estudantes sobre essa relação. METODOLOGIA: Estudo longitudinal prospectivo de tratamento quantitativo e qualitativo dos dados realizado com 85 estudantes da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Foi utilizado um questionário contendo questões estruturadas para avaliar os aspectos envolvidos na experiência estudantil e os instrumentos de pesquisa AUDIT (Alcohol Use Disorders Identification Test) e DUSI (Drug Use Screening Inventory) para avaliar o uso de álcool e de outras drogas, respectivamente. Também foram realizadas entrevistas semiestruturadas com alguns participantes e subsequente análise de conteúdo. RESULTADOS: Homens aumentaram o padrão de binge drinking, indicando um risco substancial nos períodos finais do curso universitário (p
INTRODUCTION: Several studies have indicated that college years are a period of greater vulnerability to alcohol and other psychoactive drugs use. This evidence stems from the higher prevalence of substance use observed among college students in comparison to others young adults. OBJECTIVE: To evaluate the association between alcohol and other drugs (illicit drugs) use and variables of the academic life, and the meanings attributed by students on this relationship. METHODOLOGY: Longitudinal study, quantitative and qualitative approach, design on a convenience sample of 85 undergraduate students from all courses of the School of Medicine of Ribeirão Preto of University of São Paulo. Alcohol Use Disorders Identification Test (AUDIT) and the Drug use Screening Inventory (DUSI) have been used as measures of alcohol use and others psychoactive drugs use respectively. Structured questionnaire evaluated aspects related to academic life. Semi-structured interviews are conducted with some participants and submitted to content analysis. RESULTS: Men increased binge drinking pattern, indicating a substantial risk in the final periods in college (p -
4رسالة جامعية
المؤلفون: Mayet, Aurélie
مرشدي الرسالة: Paris 5, Chau, Nearkasen, Legleye, Stéphane
مصطلحات موضوعية: Addiction, Adolescent, Adulte jeune, Alcool, Cannabis, Drogues illicites, Tabac, Modèle multi-éclats, Modèle structural, Trajectoires d'usages, Young adults, Alcohol, Illicit drugs, Use trajectories, Structural equation model, Multi-state model, Young adult
الوصف: Selon la théorie de l'escalade, l'usage de tabac ou d'alcool est associé à l'usage de cannabis, qui peut lui-même conduire à l'usage d’autres drogues illicites (ADI). L'objectif de notre étude était de décrire les transitions entres usages de drogues licites, de cannabis et d’ADI. Les données de deux enquêtes en population générale (ESCAPAD pour l’adolescent et Baromètre santé pour l’adulte jeune (année 2005)) ont été utilisées. Les âges rapportés d’initiation des différentes substances ont permis de définir les étapes d’usages. L’analyse des transitions entre substances a été réalisée grâce aux modèles structuraux et aux modèles multi-états de Markov en prenant en compte certains cofacteurs. Les données recueillies ont permis de décrire un processus d'usage de substances partant des drogues licites et menant vers les ADI via le cannabis. Ces résultats étaient compatibles avec la théorie de l'escalade décrite par Kandel en 1975 et étaient renforcés par certains critères : force/stabilité des associations, effet dose-réponse, cohérence avec la littérature et relation temporelle. La théorie qui se dégage de nos travaux pourrait être celle d’opportunités en chaîne, l’apprentissage de la première substance psychoactive étant conditionné à son accessibilité et susceptible d’offrir des opportunités ultérieures d’usages d’autres substances. Il est cependant important de souligner que la théorie de l’escalade, si elle semble correspondre à la majorité des séquences d’usages observées, est actuellement remise en question par certains auteurs qui lui préfèrent l’idée d’un facteur de vulnérabilité commun aux addictions.
According to Gateway theory, tobacco or alcohol uses may lead to cannabis use, which may itself lead to initiation with other illicit drugs (OID). The aim of this study was to study the transitions between use of licit drugs, cannabis and OID. Data from two large population-based surveys (ESCAPAD for adolescents and Baromètre santé for young adults (year 2005)) were used. Self-reported ages at initiation of several substance uses permitted to define different stages of use. The analyses of transition between uses were performed using structural equation models and Markov multi-states models, taking into account some cofactors. Results of this study permitted to describe a drug use stage process, mediated by cannabis and susceptible to lead to OID use. These results were in accordance with the Gateway theory described by Kandel in 1975 and satisfied to some criteria: strength and stability of associations, dose-response trend, coherence with previous research and temporal relation. The theory which emerge from our research could be a “string of opportunities”, OID experiment being a consequence of initial opportunity to use the more accessible illicit drug, cannabis. However, it is important to mention that the Gateway theory, despite compatible with the majority of sequences of uses observed, is presently questioned by some authors which prefer the theory of a common vulnerability factor to addictions. -
5رسالة جامعية
المؤلفون: Legleye, Stéphane
مرشدي الرسالة: Paris 11, Chau, Nearkasen, Peretti-Watel, Patrick
مصطلحات موضوعية: Alcool, Tabac, Cannabis, Drogues illicites, Genre, Inégalités sociales, Alcohol, Tobacco, Illicit drugs, Gender, Social inequalities
الوصف: Les usages de produits psychoactifs contribuent fortement aux inégalités sociales de santé et sont aussi inégalement distribués suivant le sexe. En utilisant des enquêtes en population générale et adolescente, ce travail montre que les écarts de consommations d’alcool, de tabac, de cannabis et d’autres drogues illicites entre hommes et femmes varient suivant le milieu social, la génération de naissance, le statut scolaire et professionnel et les conditions de travail. Parmi les adolescents, les écarts de consommations entre garçons et filles dépendent moins du milieu social qu’à l’âge adulte, mais les risques d’expérimenter puis de progresser vers des usages fréquents ou problématiques en dépendent au contraire fortement. Ces résultats montrent que les différences d’usages entre hommes et femmes sont des différences de genre, socialement construites et en lien avec le système des inégalités sociales ; ils présentent également quelques déterminants des trajectoires d’usages de drogues.
Licit and illicit drug consumptions are strong contributors to the social inequalities in health, but they are also unevenly distributed among men and women. Using general population and adolescent surveys, this work shows that the differences between men and women in alcohol, tobacco, cannabis and other illicit drugs vary according to the social position, age and birth cohort, occupational and school status as well as according to working conditions. Among adolescents, the variation of the differences between boys and girls with the family socio-economic status are rather low, but the affluence of the family is a key factor for experimenting alcohol and drugs whereas it lowers the risk of transition to frequent and problematic drug use. These results show that the differences in drug use between men and women are gender differences, socially constructed and linked with the system of social inequalities; they also point out some key determinants of the drug use trajectories.
