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Hesam, S. Journal of Health Accounting , 3 3 , Hesam; N. Honarvar; Sh. Journal of Health Accounting , ; 3 3 : Toggle navigation. Introduction: The present study has carried out a comparative analysis on the cost- effectiveness of maintenance treatment with Methadone and Buprenorphine to prevent the possibility of transmission of new cases from HIV infection among drug users. Method: This study is cross-sectional, and drug users who referred to a governmental and a private centers that provide services for maintenance treatment with Methadone and Buprenorphine under the supervision of Shiraz University of Medical Sciences have been studied in the form of evaluating after and before intervention without control group during one year and without the discount rate. The possibility of prevention from HIV transmission as a unit of effectivenesshas been calculated by using Decision Tree and Tree Age Software Version for high risk sexual and drug-injection behaviors before and after referral to the centers, and then it has been investigated via one-way analysis of sensitivity. Results: Buprenorphine costs less than Methadone, and it has more effectiveness. The cost- effectiveness ratio of Buprenorphine in relation to Methadone was ,,, Moreover, Buprenorphine and Methadone have caused the prevention of 14 and 47 new cases from infection with HIV, respectively. Conclusion: Regarding the distinction between the results of the research, we have to take precautions in using these drugs in the national and regional dimensions, and the decision-making related to this issue requires further study and discussion. Available at: www. Vahdani-nia Mostashary Mani Kashani Hui Treacy Maghan Sepehrvand Nezhad Naderi Karimi Kismi Nabaie Motamedi Heravi Baba-Mahmoodi Ebrahimzadeh Wang Wor ldbank. Sees Voigt Brandeau Simpson How to cite.
Vagus nerve stimulation during training fails to improve learning in healthy rats
How can I buy cocaine online in Vahdat
Official websites use. Share sensitive information only on official, secure websites. Email: luciana. Marijuana is the most widely used illicit drug worldwide. From an occupational perspective, its use is paradoxical in that although it can be harmful to health and has criminal consequences, it can also promote well-being. This study examined predictors of well-being to determine the effects of marijuana use and its prohibition on the daily lives of Brazilian adults. This cross-sectional study used an anonymous online questionnaire with a final sample of respondents. Utilizing logistic regression, variables were selected pertaining to use and prohibition risks, benefits of use, and harm reduction associated with the socioeconomic characteristics of the respondents. Social class, race, gender, and generation were predictors of well-being associated with marijuana use and its prohibition, indicating an interaction between different dimensions involving the use of illicit substances. Identifying the effects of the use and prohibition of marijuana in promoting well-being, from the conception of drug use as a non-sanctioned occupation, can broaden the understanding of this complex human phenomenon, with health and criminal repercussions, subsidizing the development of approaches more equitable and adequate into occupational therapy to reduce personal and social harm. Keywords: Cannabis, drug use, occupational therapy, substance use, non-sanctioned occupation, health. Since its inclusion as a concern of public order, expressed at the II International Opium Conference in Geneva by a representative, 2 Brazilian public policy proposals have been dominated by the negative effects of its use. These effects were later consolidated globally with its inclusion on the list of dangerous substances in the report of the Single Convention on Narcotic Drugs. Concurrently, since the mids, advances and scientific findings have intensified debates on the use of the cannabis plant, especially after the isolation of its main active ingredients 4 and the identification of the endocannabinoid system 5 which has promoted the human dimension of solutions to their potential as health issues. With increasing reports of positive effects on well-being, prohibitionist and punitive models that guide current drug policies in the field of public safety are being questioned as they do not reduce the supply and demand for drugs, 7 limit access to health care due to the stigma associated with drug users, 17 or greatly impact the prison system, 18 and have an inequitable impact on specific population groups, such as migrants, blacks, women and the poor. The illicit status of cannabis has been reviewed globally, demystifying the prohibitionist pillars that culminate in the incarceration and mortality of those involved in the so-called War on Drugs, 20 with disproportional impacts on some specific ethnic groups. The non-medical use of marijuana has also been legalized in Uruguay, Canada, the Netherlands, some jurisdictions in the United States, and Mexico the debate on its legalization is well underway. Since , when many elements of African culture were criminalized with strong racist and eugenicist biases, Brazil was one of the first nations to prohibit marijuana use. Additionally, 2. Recently, a Brazilian cross-sectional study of a non-probabilistic sample 31 involving more than adults recreational cannabis users and non-users assessed their quality of life, subjective well-being, anxiety, and depression with standardized scales using an online survey about cannabis and other substance use. The highest scores for quality of life were observed among habitual cannabis users, followed by occasional users, whereas both non-users and dysfunctional users presented less favorable scores. Subjective measures of well-being were higher among habitual and occasional users than non-users, whereas dysfunctional users were most adversely affected. Poor quality of life, depression, and anxiety were more prevalent among dysfunctional cannabis users, but non-users reported more depression or anxiety symptoms and a lower quality of life than occasional and habitual users. In , the World Health Organization WHO defined health as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. This definition recognized the concept of well-being as a key component of health of the individual in a comprehensive and holistic manner, influenced not only by individual characteristics but also by the social conditions in which people find themselves and the environment in which they reside. The dominant discourse in occupational therapy and occupational science literature on the relationship between occupation and health and well-being is positive. Conversely, discussions on the potential negative health or well-being implications of occupational engagement remain vague and limited. These authors proposed that occupations should be conceptualized as neutral, and that the health-promoting and illness-producing aspects are dependent on the physical, cultural, social, historical, and political contexts in which an individual engages in an occupation and the meaning that individual assigns to that occupation. Looking critically at the realm of healthcare, drug use and drug abuse have been deemed undesirable behaviors by society, 46 and typically labeled as problematic. Stewart and Fischer 47 acknowledged the complexity of occupation and the possibility of engaging in a profession that can affect the lives and well-being of individuals both positively and negatively through occupations, such as drug use. Thus, even for individuals with drug addiction, time spent in occupations that support the need to acquire drugs can create a role, a sense of identity, and organize their lives, allowing them to connect with, adapt to, and feel in control of their surroundings. In the occupational science field, studies have pointed out that viewing drug use as distinct from substance abuse, problematic use, dependence, or addiction, focusing on occupation can a stimulate new ways of understanding substance use and its relationship with the quality of life and meaningful experiences 50 ; b facilitate a better understanding of how people employ alternatives to achieve desired occupational outcomes 49 ; and c help identify factors that encourage and constrain use, expanding approaches to addressing substance use that go beyond the individual to social and institutional contexts. This attention can help to diversify the understanding of the occupation itself to challenge dualisms, given the politically constructed nature of all occupations. It also becomes an intervention tool centered on the needs of individuals, groups, and collectives, seeking to promote greater participation and autonomy, expressing the construction and transformation of concrete reality, encompassing adversities, decision making, and forging ways of being, living, and acting. This study aimed to identify a the effects of marijuana use and its prohibition on the daily lives of adults in Brazil, recognizing different types, justifications, and motivations for use, and b to examine the predictors of well-being for the characteristics of marijuana users. In this exploratory cross-sectional study, an anonymous online questionnaire was used on a non-probabilistic sample. The analytical sample comprised respondents. The socioeconomic characteristics of the respondents were used to select variables pertaining to the risks of use and prohibition, the benefits of use, and harm reduction. An analysis of logistic regression was performed. In collaboration with 12 specialists, including researchers in the fields of drugs and occupational therapy as well as representatives of organized social movements, an online and anonymous questionnaire was developed for data collection. This technique is used to establish consensus when no unanimity of opinion exists on a given topic or innovative topics, being used in health research, for clinical decisions, and to support decisions in the daily practices of health services. The expert panel was comprised of all who were invited and was recorded through the Google Meet platform. The consensus meeting was conducted by the primary researcher together with the assistant researcher, a scientific initiation student, an occupational therapist in the role of observer and annotator, and a researcher in the field. Considering that the marijuana user population can be criminalized in Brazil, insufficient information exists from which to draw an accurate sample. However, despite acknowledging the limits and restrictions on generalizability, probabilistic analyses were performed with the aim of seeking possible predictors of marijuana use to promote well-being for the characteristics of marijuana users. For the sample calculation, the variable marijuana use to promote well-being was used, with an expected prevalence of In this course, The link to the survey form was widely disseminated on social media networks, including groups on WhatsApp, university student groups on Facebook , groups for the legalization of marijuana, and Instagram stories. In addition, researchers and partner organizations were provided with the survey link and asked to disseminate it broadly, ensuring a good reach. A total of responses were obtained. There were no exclusion criteria. Two respondents who did not meet the inclusion criteria were excluded because they did not use marijuana. Viewing marijuana use for well-being as a complex and significant occupation, in interaction with the set of forces present in various daily lives, we chose 6 response variables: a 2 variables about the effects of use; b 2 variables about what we consider the effects of prohibition; and c 2 variables about harm reduction. These variables are viewed as important dimensions of well-being, and relevant to the goals of occupational therapy, whose significance and experience are always in relation to the forces of power and social hierarchy. For the statistical analysis, the categorical variables were described by their absolute and relative frequencies. To study these associations, univariate logistic regression models were first performed, and then multivariate logistic regression models were fitted. Variables without statistical significance were excluded, one by one, until the final model included only statistically significant variables. The R Core Team 56 software was used. The qualitative variables were summarized as absolute and relative frequencies in the descriptive analysis. Despite the small number of self-declared Indigenous peoples among the respondents, we believe it is important to maintain a separate category for them in this work, as such information was not included in the previous study on marijuana use for recreational purposes in Brazil. We emphasize that the small sample size had no impact on the estimates of the effects of the logistic regression models used in the data analysis. Some respondents chose more than 1 category. Therapeutic use was justified either through personal recognition of the benefits, reports of benefits by friends, or referrals from medical and non-medical professionals. Twenty-seven percent of users indicated that they used marijuana to reduce the consumption of alcohol or other licit substances, Regarding health problems, the respondents reported using marijuana to alleviate anxiety Finally, users who had used marijuana for a longer period were more likely to use it for fun than those who had used it for less than a year. Regarding religion, Catholics and Evangelicals were less likely than atheists and agnostics to fail at their jobs due to substance abuse. People who live with friends or alone were more likely to experience feeling stoned than those who lived with family members. People who use it more than once a month and for more than a year were more likely to feel stoned and unable to fulfill their tasks than those who used it for less than a year, once a month, or occasionally. Regarding gender, compared to the feminine, users who self-identified their gender as masculine have higher odds. As for the time of use, the more time spent using marijuana, the greater the chance of having problems with the police than for users with less than a year of use. Likewise, individuals who used marijuana more than once a month or daily had higher odds than users who used it less than once a month. The age of first use was associated in all age ranges, decreasing, with the mode of obtaining marijuana in a dangerous way, compared with those who used it for the first time under the age of 11, meaning the higher the age of first use, the less dangerous the way used to obtain it. The factors associated with this variable were age, education, frequency, and duration of use, as shown in Table 6. Level of education was shown to be positively associated with use at strategic times, with those who had completed high school more likely to use at strategic times than users who did not study or who only completed elementary school. For frequency of use, users with more intense use using it more than once a month or daily were more likely to use marijuana at strategic times compared to those who used it only once per month. Those users who self-identified their gender as feminine had lower odds of daily use compared to who self-identified as masculine. As for the age at first use, people who started using marijuana between the ages of 16 and 29 were less likely to use it daily. Epidemiological data from the Third National Survey on Drug Use in Brazil 30 revealed that the highest prevalence of regular marijuana use was among to year-olds with a postgraduate degree or higher residing in the capitals of the southeast region. A study on cannabis use frequency and use-related impairment among African American and white users supports that although participants did not differ in their cannabis use frequency or cannabis-related impairment, they appeared to use cannabis for different reasons. More specifically, social motives were differentially associated with cannabis-related impairment as a function of race. Although almost half of the respondents claimed their marijuana use was therapeutic, only a few had a medical prescription, even if the marijuana use was being reported to alleviate health problems like anxiety, insomnia, depression, chronic pain, and addiction. In the current study, we identified a therapeutic use of marijuana that went beyond the medical indications for marijuana use, including menstrual cramps, headaches, ADHD, and muscle spasms. Reducing the consumption of alcohol, other licit substances, and psychotropic drugs are among the motivations for use. The authors maintain that such separation has created a division that does not correspond to the experience, meaning, and function of drug use by the different people living in diverse contexts and cultures. The concept of occupation must expand to include complexities experienced in daily life, such as engaging in the activities with which people occupy themselves as well as those they are prevented from doing. It must also include an understanding of the social places people occupy or are prevented from occupying. Considering marijuana as an occupation, we recognize its potential for multiple meanings that are socially constructed and influenced by individual processes. We emphasize the importance of the generational factor, which indicates those over the age of 30 are nine times more likely to use recreational marijuana than those over the age of Although epidemiologically, marijuana use is more related to young people, some reported experiences seem to indicate that low-income young people may not have access to other recreational activities that do not involve drug use. An analysis of the scientific literature on the use of psychoactive substances among older adults revealed that alcohol is the most commonly used psychoactive substance in this age group, followed by drug use and a gradual increase in the use of illicit substances. In this study, older adult users of psychoactive substances were predominantly male, had low levels of education and income, were unemployed, unmarried, lived alone, and had organic and psychological comorbidities. Another study that sought to comprehend the significance that older adults ascribe to drug use and was limited to older adults being monitored by health services for people with drug problems identified the need to form relationships or occupy space as a motivation for drug use, such as voids resulting from effectual losses. Respondents reported using marijuana to stimulate creativity, manage stress, sleep better, promote well-being, and relax, among other reasons identified as positive effects by the researchers. Kiepek and Beagan 48 investigated the motivations for substance use among professionals and students in professional programs in Canada who used 1 or more non-prescription psychoactive substances and discovered that substance use was advantageous for relieving pain, enhancing sleep, supplying energy, and engaging in daily activities. Some individuals discovered that substance use reduced anxiety, allowing them to better manage occupational demands, enhance performance, or served as a reward for completing tasks. Sometimes, substance use is an occupation in and of itself, such as drinking alcohol or going out for coffee. Occasionally, a substance is used to enhance the performance of another occupation, such as taking erectile dysfunction medication to enhance sexual performance or amphetamines to enhance academic performance. Furthermore, the adverse effects of marijuana use are poor educational outcomes and cognitive impairment. Considering the racist social context of Brazil and that vulnerable populations, such as those with lower socioeconomic status, mental health problems, and minority populations, are more likely to experience the severe negative consequences of substance use, could whites face less stigma or repercussions if they are permitted to withdraw from their duties when they are ill? Other analyses that verify job placement, income, and other potential protective factors can help to expand this discussion. Indigenous peoples were 3 times more likely to have problems with police than white people; those aged 18 to 29 had approximately 10 times the likelihood of those aged 61 and older; and men were more likely to have problems with police than women. Similarly, users who used it more than once a month or daily were more likely to encounter the police than those who used it less frequently. Catholic, Spiritist, and Evangelical religious affiliations, living in the northeast, and older age at first use were identified as protective factors. In Brazil, marijuana became prohibited in the colonial period and was directly related to the enslaved black population. Pointing to the racist heritage that the country carries, marijuana descends from black culture, which led to the stigmatization that black people who used the weed were lazy, rowdy, and savage. Thus, a eugenics hygiene process prohibited marijuana from being circulated and preached as a degenerative element to health. As the findings on the indigenous population demonstrate, we refer to the work of Barreto, 65 who focused on the sociocultural issues associated with the use of coca leaves in the Andes and Amazon regions and historically reconstructed a tendency to indiscriminately link coca to cocaine and, consequently, to drug trafficking, demonstrating a bias of denial of the historical and cultural roots of the age-old use of this plant by traditional communities. According to this author, efforts to break the silence surrounding indigenous issues are due to science. We emphasize that the inclusion of Tupi Guarani indigenous people in our research group III seems to have favored access to information about this population to think about care policies. According to Carneiro 20 the youth are punished the most for their everyday recreational activities, making police violence more devastating for these age groups. The results indicate that users with longer use histories are more likely to be associated with this adverse effect, possibly indicating how the War on Drugs is perpetuated on a daily basis and predicting that at some point in their lives, they will encounter issues with the police. We are aware that the illegality of marijuana does not prevent its use, but rather exposes its consumers to danger on a daily basis, such as by requiring them to engage in risky behavior to obtain the drug. Thus, we question what it means for self-identifying as white to be more associated with exposure to risky means of obtaining while being less associated with issues with the police. Especially vulnerable populations, such as poor young people, blacks, and residents of the periphery, are more susceptible to incarceration as a result of prohibitionist policies, 73 , 74 it appears that for whites, exposure to dangerous modes of shopping does not necessarily correlate with problems with the police, an institution that has historically operated on the basis of racial bias and for which the importance of anti-racist educational processes has been indicated. In the process of regulating marijuana use, the prior distension of police forces in the face of ongoing decriminalization 62 has been highlighted. This strategy was more prevalent among individuals with postgraduate and graduate degrees, who use it more frequently and for longer durations, indicating that this type of information can reach experienced marijuana users more easily. In a study that explored the different meanings of substance use and associated occupations, Kiepek et al 50 found similar strategies among marijuana users. Given the reflection on the critical perspectives of occupation that aim to overcome dualisms, recognizing that its social validation takes place in the context of power struggles, social values, and moral points of view, and that its nature is politically constructed, 45 we agree that the concept of negative consequences is correlated with social marginalization and oppression. Women-gender people had lower odds of using it daily compared to men. Occupations such as sex work, engaging in crime, selling or using drugs, panhandling, and vagrancy are often judged as poor choices or evidence of a poor moral character. This perspective assumes that agency occurs at the individual level and that all potential options are equally available to all people; it fails to unearth the social forces that shape occupations. Thus, drug use can result in varied daily lives, which can be evaluated from the standpoint of occupational engagement. In addition to having therapeutic potential, drug use can play a role in determining health, articulating or not well-being, justice, the organization of behaviors, and being forged together with various lifestyles and contexts. Kiepek et al 45 took the construct of resistance as a lens for analyzing how non-sanctioned occupations defy prevailing expectations and may not fail attempts to meet expectations, but rather active practices of transgression—everyday acts of resistance that oppose power relations that validate certain ways of doing things, thereby generating opposition to occupational inequities. Non-sanctioned occupations as forms of resistance can contribute to the development of a knowledge base regarding the transformative potential of occupation, while avoiding the danger of perpetuating the marginalization of private and collective actions. With the aim of promoting self-care and establishing new political, cultural, and economic relationships, we posit that harm reduction, as a reference for occupational therapists in caring for people who use drugs, can anchor actions to value the diversity of bodies, knowledge, and cultures, directing efforts toward care in freedom with the goal of social transformation of those who experience process addiction. As a matter of social justice and contributing to social legitimacy, occupational science can play a significant role in developing a critical understanding of the social construction of occupations as moral or immoral, deviant or normal, and healthy or unhealthy, as well as different ways of acting and being. The probabilistic analyses conducted using non-probabilistic sampling, and the use of a closed online survey. In addition to being criminalized in Brazil, the population of interest is not listed so that an accurate sample can be drawn; therefore, the sample size was used as a strategy to qualify our efforts but does not permit generalizability of the results presented. Nonetheless, despite these limitations, the results shed light on a subject that has been inadequately explored and on which further research is required. This exploratory study aimed to provide a general and descriptive overview of the findings, requiring further studies to deepen the highlighted aspects. The exploratory study allows for a descriptive approach to prevalence with less generalization ability due to the biases of the respondents. This is the second study conducted in Brazil involving a non-clinical population of marijuana users and the first from an occupational perspective to examine predictors of well-being among the effects of marijuana use and its prohibition on the daily lives of adults. Identifying the effects of the use and prohibition of marijuana in promoting well-being from the conception of drug use as a non-sanctioned occupation can broaden the understanding of this complex human phenomenon, which includes health and criminal repercussions that can subsidize the development of approaches more equitable and adequate in occupational therapy to reduce personal and social harm. In: Surjus, L. Author Contributions: Luciana Togni de Lima e Silva Surjus was responsible for the conceptualisation, study design, literature search, data interpretation, writing and review. Natalia Cavalcante Dainesi was responsible for the study design, data collection, data interpretation and writing. As a library, NLM provides access to scientific literature. Subst Abuse. Find articles by Felipe Granado de Souza. Received Jul 12; Accepted Feb 21; Collection date Open in a new tab. Abbreviations: aOR, adjusted odds ratio; cOR, crude odds ratio. Abbreviations: aOR, adjusted odds ratio; cOR: crude odds ratio. Felipe Granado de Souza was responsible for data design, data analysis, writing and review. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.
How can I buy cocaine online in Vahdat
Vagus nerve stimulation during training fails to improve learning in healthy rats
How can I buy cocaine online in Vahdat
How can I buy cocaine online in Vahdat
Vagus nerve stimulation during training fails to improve learning in healthy rats
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