Handläggning av tvångsvård : Socialsekreterares erfarenheter och upplevelser av att handlägga LVM ärenden

När en socialsekreterare ska handlägga ärenden enligt Lag om Vård av Missbrukare i vissa fall (LVM) behöver denne ta ställning utifrån många olika perspektiv. Syftet med denna studie är att ge kunskap om hur socialsekreterare upplever handläggning av LVM-ärenden samt vilka erfarenheter de har av en sådan process. Undersökningens material grundar sig på kvalitativa semistrukturerade intervjuer med sex socialsekreterare som alla har arbetat med LVM-handläggning. För att kunna tolka och analysera materialet användes gräsrotsbyråkrati, makt, etik i socialt arbete och handlingsutrymme som teoretisk referensram. Resultatet indikerar att socialsekreterarna upplever både för- och nackdelar i arbetet med lagstiftningen. De upplever handläggningen av LVM-ärenden likt ett dilemma. Socialsekreterarna anser att lagen är nödvändig då de i avsaknad av den skulle känna en stor maktlöshet av att inte kunna ingripa i allvarliga situationer där klienten riskerar att avlida eller skada sig själv och andra till följd av sitt missbruk. De anser även att tillämpningen av lagen medför inskränkningar i den enskilda klientens integritet och att klienten i mötet med socialtjänsten riskerar att bli kränkt utan noga eftertanke från socialsekreterarens sida. Resultatet visar även på att socialsekreterarna så långt som det är möjligt respekterar klientens autonomi men att autonomin vid fråga om liv och död måste förbises. 

Successes in South Carolina : S.C. Smoking Prevention and Cessation Program

This monthly update describes different aspects of smoking cessation and prevention programs in South Carolina. It gives statistics and results of the various programs such as investment of cigarette tax funds offered in South Carolina.

The big issue

This quarterly publication from the South Carolina Department of Alcohol and Other Drug Abuse Services covers news of events and legislation pertaining to addiction of alcohol and drugs. Information about the agency is sometimes included.

Uso de dexmedetomidina como tratamiento coadyuvante de síndrome de abstinencia alcohólica: revisión sistemática

El objetivo de este estudio es establecer si la dexmedetomidina (DEX) es segura y efectiva para el manejo coadyuvante de síndrome de abstinencia a alcohol (SAA) a través de la búsqueda de evidencia científica. Metodología: se realiza una revisión sistemática de literatura publicada y no publicada desde enero de 1989 hasta febrero 2016 en PubMed, Embase, Scopus, Bireme, Cochrane library y en otras bases de datos y portales. Los criterios de inclusión fueron ensayos clínicos aleatorizados y no aleatorizados, estudios cuasi-experimentales, estudios de cohorte, y estudios de casos y controles; que incluyeron pacientes mayores de 18 años hospitalizados con diagnóstico de SAA y donde se usó DEX como terapia coadyuvante. Resultados: 7 estudios, 477 pacientes, se incluyeron en el análisis final. Se encontraron dos ensayos clínicos aleatorizados, tres estudios de casos y controles y dos estudios de cohorte retrospectivo. Solo uno de los estudios fue doble ciego y utilizó placebo como comparador. Análisis y conclusiones: en los estudios experimentales se determinan que el uso de DEX como terapia coadyuvante en el manejo de SAA tiene significancia clínica y estadística para disminuir dosis de BZD en las primeras 24 horas de tratamiento; pero no demostraron tener otros beneficios clínicos. En los estudios no aleatorizados existe consenso que relaciona el uso de DEX con menores dosis de BZD de forma temprana. Recomendaciones: no se recomienda el uso de DEX en SAA de forma rutinaria. Se recomienda usar DEX solo en casos en el que exista evidencia fallo terapéutico a BZD.

El papel de la OEA en el establecimiento de los tribunales de tratamiento de drogas en Estados Unidos como mecanismo de reducción del daño (1989-2013)

La reducción de la demanda, específicamente por medios alternativos al sistema penal tradicional, ha sido uno de los componentes más discutidos en los análisis que abordan la lucha contra las drogas. Este artículo se propone determinar el papel de la Organización de Estados Americanos en el establecimiento de los Tribunales de Tratamiento de Drogas en Estados Unidos como mecanismo de reducción del daño en el periodo comprendido entre 1989 y 2013. Se sugiere que la organización internacional, a través de la CICAD, ha jugado un papel de promoción, y evaluación de los Tribunales de Tratamiento de Drogas en Estados Unidos, generando presión entre sus Estados miembro, dada la necesidad de instaurar alternativas legales de reducción del daño. Sin embargo, se presentan deficiencias en los mecanismos de evaluación, ya que las indicaciones realizadas no tienen un carácter obligatorio y por tanto las determinaciones de la CICAD no necesariamente son adoptadas.

Adicción al trabajo en el contexto Colombiano

Este estudio aborda el fenómeno de la Adicción al trabajo (AT) en el contexto de los sistemas de producción y de los escenarios del trabajo en Colombia como un país de economía emergente, donde el trabajo hace parte esencial de la cultura, es considerado un valor central de la sociedad y un medio para alcanzar la movilidad social y reducir las desventajas sociales propias de este tipo de economías. De modo que, el trabajo es esencial y determinante en la calidad de vida de las personas por su implicación física, psicológica, emocional y social (Polo, Briñez, Navarro, & Alí, 2016). De esta manera la AT extiende su impacto a la vida privada y familiar, por ello se profundiza en la comprensión de este fenómeno en el marco especifico de economías en donde la intensificación de tareas es un recurso clave para garantizar la eficiencia competitiva de las empresas y en el marco legal Colombiano.

Aproximaciones a mindfulness en la psicología contemporánea

Este trabajo es una revisión de literatura que abarca una selección de artículos disponibles en bases de datos especializadas y publicados en el periodo comprendido entre los años 2006 a 2016 para artículos científicos y entre los años 2000 a 2016 para libros. En total se revisaron: 1 tesis doctoral, 1 tesis magistral, 111 artículos y 9 libros o capítulos de libros. Se presentan diversas definiciones de mindfulness y formas de conceptualizarla, sus mecanismos de acción, sus enfoques psicoterapéuticos predominantes, los efectos de su práctica estable, sus principales campos de acción y la importancia de la formación de los docentes que imparten la práctica. Finalmente se presentan algunas conclusiones acerca del diálogo entre la literatura psicológica sobre mindfulness y algunas de las concepciones de la tradición budista en torno a la meditación.

Integrating Life-Design Counseling and Psychotherapy: Possibilities and Practices

The relationship between career counseling and psychotherapy is not a new subject. The debate allows the affirmation of career counseling as a dimension of personal counseling and recognizes the close relationship between psychosocial and career issues (Blustein & Spengler, 1995). The connection between these two approaches paves the way for the integration of career counseling with psychotherapy. Indeed, the inseparability of mental health and career issues frequently leads psychotherapists to help their clients to deal with work satisfaction, underemployment or unemployment through psychotherapy. Moreover, when working with specific populations (e.g., people with intellectual disabilities and people with addiction or mental health problems), psychotherapy calls for occupational integration to consolidate and enhance therapeutic gains (Blustein, 1987; Jordan & Kahnweiler, 1995; Leff & Warner, 2006).

A adicção à internet em jovens universitários: Estudo comparativo com estudantes portugueses e espanhóis

Esta investigação trata-se de um estudo com a população universitária Portuguesa e Espanhola sobre padrões de uso/abuso da Internet, assim como os recursos específicos mais usados. Foi usada uma amostra aleatória de 206 sujeitos, da Universidade Autónoma de Madrid e do Campus Universitário de Lisboa, de diferentes licenciaturas, de ambos os sexos e com idades compreendidas entre os 18 e os 40 anos. O instrumento usado foi um questionário adaptado do Internet Addiction Test, de Young (1998). As principais conclusões sugerem que, no que se refere ao tempo de conexão verificámos que a maior percentagem da amostra (46,1%) realiza um uso moderado da Internet (menos de 2 horas diárias) mas 36,9% podem já apresentar alguns indícios de adicção ao estarem de 2 a 5 horas diárias conectados à Internet. Na avaliação dos parâmetros do uso dos recursos específicos da Internet, podemos encontrar que a Web é o serviço mais procurado seguindo-se o e-mail (com 62,1% e 57,3% respectivamente). Encontrámos ainda que 16,5% da amostra apresenta valores representativos de adicção. /ABSTRACT: This research comes from a study with the Portuguese and Spanish university population on patterns of use I abuse of the Internet, as well as the specific resources used most. We used a random sample of 206 subjects, the Autonomous University of Madrid and the University Campus of Lisbon, in different degrees of both sexes and aged between 18 and 40 years. The instrument used was a questionnaire adapted from the Internet Addiction Test, Young (1998). The main findings suggest that with regard to the connection time found that the largest percentage of the sample (46.1%) carries a moderate use of the Internet (less than 2 hours) but 36.9% can introduce some evidence addiction are at one of the 2 to 5 hours a day connected to the Internet. ln assessing the parameters of the use of specific resources of the Internet, we find that the Web service is the most sought followed by email (with 62.1% and 57.3% respectively). We found also that 16.5% of the sample shows values representative of addiction.

Proposal for Labor Market Integration of Teachers in Contexts of High Social Vulnerability

The purpose of this paper is to share a proposal for teacher’s labor market integration in contexts of high social5 vulnerability. This paper is the result of a research conducted in a priority attention primary school6 of the central canton of Heredia7. It explored the labor market integration process of teachers, considering the community, family and student reality of a population social risk. The research that supports this proposal is based on a qualitative approach, since the diagnosis process is not intended to provide answers that could be commonly applied to other education centers in similar contexts, but to make an exploratory approach of teachers’ reality and their integration process into education institutions of high social vulnerability. Therefore, although this paper intends to share this experience, it does not aim to unify integration practices, but to be an input in carrying out similar processes.  (5) The concept of high social vulnerability is understood based on Sojo’s approach (2003), which defines it as marginal urban communities in areas considered by the Costa Rican government as priority areas with the greatest social, economic backwardness in the country, and high rates of violence, leisure, unemployment and drug addiction. (6) Translator’s note: The Costa Rican education system is composed of primary education (1st-6th grade) and secondary education (7th-11th grade). (7)A public primary school in the circuit 02 of the Province of Heredia.

Wheat proteins evolution and environmental triggers of Wheat-related diseases

Cereals, and in particular wheat, have always been recognized as a fundamental food worldwide. In particular, the success of wheat is linked with unique properties of the gluten protein fraction used in bread making process to obtain products that are widely used in traditional and modern diets. The rapid increase in the world population let to a parallel increases in food production, particularly of wheat. Increasing yield potential and selection of cultivars much more resistant to plant disease and to environmental factors could have negatively affected the quality of the grain. Moreover, the “green revolution” was characterized by a widespread use of agricultural chemicals and by industrialization of food production that led to a huge rise in the consumption of refined products. Modern baking practices have shortened bread leavening, increased the use of chemical/yeast leavening agents and there is well-documented scientific evidence of the negative effects of ultra-processed food in human healthy. All this changes profoundly modified the human diet and, as a result, may have affected Gluten-related disease (GRDs) that has arisen in the whole word populations. Gluten-related diseases (GRDs) are multifactorial pathologies in which environmental factors and genetic background contribute to a low-grade chronic inflammation of the gastrointestinal tract. Here, I investigated the potential pro-inflammatory effect of different wheat varieties and whether bread making processing are involved in the onset or worsening of gut inflammation. In vitro, ex vivo and in vivo studies conducted throughout my Phd period have shown a pro-inflammatory effect of wheat especially marked in modern varieties and a higher inflammatory response linked to the use of common raising agent as Saccharomyces Cerevisiae and to the addiction of chemical bakery improver substances.

Spatially defined peptidomimetics for pain relief and for targeted cancer therapy and diagnostics

Cancer is a disease that has plagued scientists for decades, and how to treat cancer and its complications are inevitable topics in current scientific research. Cancer pain is a major factor that reduces the quality of life of patients. Therefore, the development of analgesic agents with minimal adverse side effects, especially with low addiction, has attracted more and more attention. Among them, opioid analgesics are widely used to alleviate cancer pain and improve the quality of life of patients with advanced cancer, such as in the palliative therapy. Although peptide drugs are efficient, selective and safe, they have several unignorable disadvantages such as poor biological stability, rapid excretion, difficulty in penetrate blood brain barrier. In order to solve these problems, peptidomimetics were developed by introducing unnatural/modified amino acids, decorated peptide backbone, conformational restrictions and secondary structure mimics in peptide sequence. Compared with peptides, peptidomimetics have improved biological stability, increased bioavailability, high affinity and selectivity for receptor binding, and decreased adverse side effects. As the second part of this thesis, I explored the opportunity to design peptide-functionalized responsive biomaterials for the detection of cancer cell and the selective delivery of cytotoxic drugs. The conjugation of peptides with biomaterials enhanced the stability of the loaded drugs, improved targeted delivery, decreased side effects, and increased bioavailability. The precise and controllable drug delivery platform has profound application prospects in cancer treatment. Grafting specific peptides sequence on the surface of biomaterials can satisfy different drug delivery demands according to the characteristics of both peptides and biomaterials. For example, the introduction of tumor-targeting peptides can guide biomaterials into tumor lesions, and blood-brain barrier (BBB) shuttle peptides can lead biomaterials to penetrate the BBB, etc.

Analysis, modelling and design of a groin as coastal protection structure at Lido di Dante, Ravenna

An analysis and a subsequent solution is here presented. This document is about a groin design able to contrast the erosion actions given by waves in Lido di Dante. Advantages will be visible also for Fiumi Uniti's inlet, in the north side of the shoreline. Beach future progression and growth will be subjected to monitoring actions in the years after groin construction. The resulting effects of the design will have a positive impact not only on the local fauna and environment, but also, a naturalistic appeal will increase making new type of tourists coming not only for recreational purposes. The design phase is focused on possible design alternatives and their features. Particular interest is given to scouring phenomena all around the groin after its construction. Groin effects will impact not only on its south side, instead they will cause an intense erosion process on the downdrift front. Here, many fishing hut would be in danger, thus a beach revetment structure is needed to avoid any future criticality. In addiction, a numerical model based on a generalized shoreline change numerical model, also known as GENESIS, has been applied to the study area in order to perform a simplistic analysis of the shoreline and its future morphology. Critical zones are visible in proximity of the Fiumi Uniti's river inlet, where currents from the sea and the river itself start the erosion process that is affecting Lido di Dante since mid '80s, or even before. The model is affected by several assumptions that make results not to be interpreted as a real future trend of the shore. Instead the model allows the user to have a more clear view about critical processes induced by monochromatic inputed waves. In conclusion, the thesis introduce a wide analysis on a complex erosion process that is affecting many shoreline nowadays. A groin design is seen as a hard solution it is considered to be the only means able to decrease the rate of erosion.

Prevention of binge drinking in young adolescents through the promotion of a balanced level of psychological well-being: be-dry

This doctoral thesis presents a project carried out in secondary schools located in the city of Ferrara with the primary objective of demonstrating the effectiveness of an intervention based on Well-Being Therapy (Fava, 2016) in reducing alcohol use and improving lifestyles. In the first part (chapters 1-3), an introduction on risky behaviors and unhealthy lifestyle in adolescence is presented, followed by an examination of the phenomenon of binge drinking and of the concept of psychological well-being. In the second part (chapters 4-6), the experimental study is presented. A three-arm cluster randomized controlled trial including three test periods was implemented. The study involved eleven classes that were randomly assigned to receive well-being intervention (WBI), lifestyle intervention (LI) or not receive intervention (NI). Results were analyzed by linear mixed model and mixed-effects logistic regression with the aim to test the efficacy of WBI in comparison with LI and NI. AUDIT-C total score increased more in NI in comparison with WBI (p=0.008) and LI (p=0.003) at 6-month. The odds to be classified as at-risk drinker was lower in WBI (OR 0.01; 95%CI 0.01–0.14) and LI (OR 0.01; 95%CI 0.01–0.03) than NI at 6-month. The odds to use e-cigarettes at 6-month (OR 0.01; 95%CI 0.01–0.35) and cannabis at post-test (OR 0.01; 95%CI 0.01–0.18) were less in WBI than NI. Sleep hours at night decreased more in NI than in WBI (p = 0.029) and LI (p = 0.006) at 6-month. Internet addiction scores decreased more in WBI (p = 0.003) and LI (p = 0.004) at post-test in comparison with NI. Conclusions about the obtained results, limitations of the study, and future implications are discussed. In the seventh chapter, the data of the project collected during the pandemic are presented and compared with those from recent literature.