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Fischer B, Malta M, Messas G, Ribeiro M. Introducing the evidence-based population health tool of the Lower-Risk Cannabis Use Guidelines to Brazil. ACTA ACUST UNITED AC 2020; 41:550-555. [PMID: 31116260 PMCID: PMC6899352 DOI: 10.1590/1516-4446-2018-0239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/07/2019] [Indexed: 11/22/2022]
Abstract
Cannabis is the most commonly used illegal drug, and is associated with well-documented adverse health outcomes, both acute and chronic. Cannabis use prevalence in Brazil is lower than in high-use regions in the Americas (e.g., North America), but concentrated among young people. Frameworks for cannabis control are increasingly shifting towards public health-oriented principles, with some countries undertaking respective policy reforms. These frameworks require a continuum of population-level interventions (e.g., prevention and treatment) including targeted prevention of adverse health outcomes among users. In this context, and based on examples from other health fields, an international expert group developed the evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG), originally for Canada, including a set of 10 recommendations based on systematic data reviews and expert consensus methods. The LRCUG form a scientific population-health prevention tool to reduce adverse public health impacts for broad application among cannabis users. In Canada, the LRCUG have been formally endorsed and are supported by leading national health organizations and government authorities within the continuum of cannabis interventions. As the LRCUG are being internationalized, this paper introduces the LRCUG’s concept and content – including their original recommendations translated into Portuguese – to the Brazilian context as an evidence-based population-level intervention tool for uptake, dissemination, and discussion. Sociocultural adaptation may be required for meaningful implementation.
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Affiliation(s)
- Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Monica Malta
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Departamento de Ciências Sociais, Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Guilherme Messas
- Departamento de Saúde Mental, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil
| | - Marcelo Ribeiro
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Centro de Referência de Álcool, Tabaco e Outras Drogas (CRATOD), Governo do Estado de São Paulo, São Paulo, SP, Brazil
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França AA, Santos VD, Filho RL, Pires KF, Lagoa KF, Martins WR. 'It's very complicated': Perspectives and beliefs of newly graduated physiotherapists about the biopsychosocial model for treating people experiencing non-specific low back pain in Brazil. Musculoskelet Sci Pract 2019; 42:84-89. [PMID: 31054486 DOI: 10.1016/j.msksp.2019.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/10/2019] [Accepted: 04/16/2019] [Indexed: 01/06/2023]
Abstract
Non-specific low back pain is a common complaint frequently presented by patients and this complex clinical condition has challenged the biomedical model. The Biopsychosocial (BPS) model is recognized as an option for better guidance and patient management. However, physiotherapy training is based on the biomedical perspective, added to which, in clinical practice the applicability of the BPS model is a challenge for many professionals. In this article, we explore the feelings, beliefs, and attitudes of newly trained physiotherapists about using the BPS model to treat people with non-specific low back pain. It also aims to understand to what extent these physiotherapists are willing and prepared to use this model. Method: A qualitative phenomenological research was carried out in the Brazilian federal capital. A set of criteria was used to select 10 physiotherapists. The data were collected through semi-structured interviews and analyzed using five steps: familiarization, identification, indexation, mapping, and interpretation. Results: We identified one theme and three categories. The theme 'a practitioner physiotherapist can consider BPS aspects, but it is not necessary in his/her role to approach them' explains a shared belief about the use of BPS. The theme is better understood when looking at the three categories that explore and exemplify key elements of the theme: (i) understanding the BPS model and its relation to non-specific low back pain; (ii) the role of practitioner physiotherapists regarding the BPS model; and (iii) barriers: from undergraduate training to clinical settings.
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Affiliation(s)
- Andressa Alves França
- College of Physical Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil.
| | - Vagner Dos Santos
- College of Occupational Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil
| | - Reginaldo Lordelo Filho
- College of Physical Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil
| | - Kênia Fonseca Pires
- College of Physical Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil
| | | | - Wagner Rodrigues Martins
- College of Physical Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil
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Cordeiro Vasconcelos S, Botelho Sougey E, da Silva Frazão I, Turner NE, Pinheiro Ramos V, Duarte da Costa Lima M. Cross-cultural adaptation of the drug-taking confidence questionnaire drug version for use in Brazil. BMC Med Res Methodol 2016; 16:55. [PMID: 27193075 PMCID: PMC4870810 DOI: 10.1186/s12874-016-0153-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 05/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Drug-Taking Confidence Questionnaire evaluates a drug user's confidence in his or her ability to resist the urge to consume psychoactive substances in high-risk situations. This study's objective was to develop a cross-cultural adaptation of the eight-item version of the Drug-Taking Confidence Questionnaire (DTCQ-8) for all drugs except alcohol and to verify its content validity and reliability in a pre-test stage. METHODS The following steps were taken: (1) implementation of the translation protocol and transcultural adaptation, (2) validation of the adapted content, and (3) assessment of reliability. Nine experts participated in the process of adaptation, and the trial's sample comprised 40 drug users in treatment at a Psychosocial Care Center for Alcohol and Other Drugs (CAPSad). RESULTS The average indices of semantic agreement (0.989; 0.989; 1.00), idiomatic (0.967), experiential (0.956), conceptual (0.978) and content validity with respect to language clarity (0.972), practice relevance (0.958), theoretical relevance (0.958) and theoretical dimension (1.00) showed that the adaption was successful. The mean total score of the DTCQ-8 version for other drugs was 477.00 + 234.27-SD, and 57.5 % of the users were classified as having moderate self-efficacy to resist the urge to use drugs in high-risk situations. The Cronbach's alpha coefficient was 0.889 for the complete instrument and 0.863-0.890 between items. CONCLUSIONS The DTCQ-8 version for other drugs proved to be easy to use and understand, and its process of adaptation was satisfactory for use in the Brazilian context. In this sample, the questionnaire was adequate to measure users' self-efficacy to resist the urge to consume these substances in high-risk situations.
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Affiliation(s)
| | | | | | - Nigel Ernest Turner
- University of Toronto and Independent Scientist, Center for Addiction and Mental Health, Toronto, Canada
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Moreira TDC, Signor L, Figueiró LR, Fernandes S, Bortolon CB, Benchaya MC, Ferigolo M, Barros HMT. Non-adherence to telemedicine interventions for drug users: systematic review. Rev Saude Publica 2014; 48:521-31. [PMID: 25119947 PMCID: PMC4203077 DOI: 10.1590/s0034-8910.2014048005130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 02/26/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.
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Affiliation(s)
- Taís de Campos Moreira
- Programa de Pós-Graduação em Ciências da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil
| | - Luciana Signor
- Programa de Pós-Graduação em Ciências da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil
| | - Luciana Rizzieri Figueiró
- Programa de Pós-Graduação em Patologia. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil
| | - Simone Fernandes
- Programa de Pós-Graduação em Ciências da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil
| | - Cassandra Borges Bortolon
- Programa de Pós-Graduação em Ciências da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil
| | - Mariana Canellas Benchaya
- Programa de Pós-Graduação em Ciências da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil
| | - Maristela Ferigolo
- Departamento de Ciências Básicas da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil Brasil
| | - Helena MT Barros
- Departamento de Ciências Básicas da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, RS, Brasil Brasil
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