Maria da Gloria Miotto Wright

International research capacity-building programs for nurses to study the drug phenomenon in Latin America: challenges and perspectives

The First International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas is a result of a partnership between the Inter-American Drug Abuse Control Commission (CICAD) of the Organization of American States (OAS) and the Faculty of Nursing in the University of Alberta, with financial support from the Government of Canada. The program was divided into two parts. The first part of the program was held at the University of Alberta in Edmonton, Alberta, Canada. It involved capacity-building in research methodologies at the Faculty of Nursing, which lead to the preparation of four multi-centric research proposals for drug demand reduction in the home countries of the eleven participants in the program. The second part of the program was related to the implementation of multi-centric research proposals in seven countries in Latin America and in Canada. This program presented expertise in research methodology to members of Latin American Schools of Nursing and introduced Latin American expertise to members of a Canadian Faculty of Nursing. The International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas has fostered the kind of inter-cultural respect and mutual appreciation necessary to confront the global health problem of the abuse of both licit and illicit drugs.O Primeiro Programa Internacional de Capacitacao para Enfermeiros no Estudo do Fenomeno das Drogas nas Americas e resultado de uma parceria entre a Comissao Interamericana para o Controle do Abuso das Drogas (CICAD) da Organizacao dos Estados Americanos (OEA) e a Faculdade de Enfermagem da Universidade de Alberta, com apoio financeiro do Governo do Canada. O programa foi dividido em duas partes. A primeira parte do programa foi realizada na Universidade de Alberta em Edmonton, Alberta, Canada. Compreendeu a capacitacao em metodologias de pesquisa na Faculdade de Enfermagem, que levou a preparacao de quatro propostas de pesquisas multicentricas para a reducao da demanda de drogas nos paises de origem dos onze participantes no programa. A segunda parte do programa estava relacionada a implementacao de propostas de pesquisa multicentricas em sete paises da America Latina e no Canada. Este programa apresentou expertise em metodologias de pesquisa a membros de Escolas de Enfermagem latino-americanas e introduziu expertise latino-americana a membros de uma Faculdade de Enfermagem canadense. O Primeiro Programa Internacional de Capacitacao para Enfermeiros no Estudo do Fenomeno das Drogas nas Americas estimulou o tipo de respeito intercultural e apreco mutuo necessario para confrontar o problema de saude global do abuso das drogas licitas e ilicitas.

Consumo percibido y uso de drogas lícitas e ilícitas en estudiantes universitarios en la Ciudad de Medellín, Colombia

El proposito de este estudio fue estimar la diferencia entre el consumo percibido en los pares y el uso real de drogas que tienen los estudiantes universitarios de segundo y tercer ano, entre 18 y 24 anos de edad, de una universidad publica en la ciudad de Medellin, Colombia. Se trata de un estudio descriptivo transversal basado en una encuesta. Todos los estudiantes de segundo y tercer ano de las facultades de Medicina, Odontologia, Enfermeria y Salud Publica fueron invitados a responder un cuestionario anonimo. Participaron 427 estudiantes. Se encontro una sobreestimacion del consumo de tabaco, marihuana y cocaina en los ultimos doce meses. El consumo de alcohol es percibido de manera exacta. Los estudiantes que consumieron drogas, en el periodo mencionado, sobreestiman mas que los que no lo hicieron; tambien se encontro que las mujeres sobreestiman mas que los hombres el consumo de marihuana.

Normas percebidas por estudantes universitários sobre o uso de álcool pelos pares

O alcool e a droga licita de maior prevalencia entre estudantes universitarios e consumida de forma recreacional. Os objetivos deste estudo foram identificar as normas percebidas sobre o uso de alcool entre estudantes universitarios, contrastar a percepcao dos estudantes em relacao ao uso de alcool por seus pares com a atual prevalencia do uso de alcool e comparar o proprio uso de alcool com a percepcao do uso de alcool pelos pares. Utilizou-se a tecnica (survey) com 275 estudantes de uma universidade publica do Rio de Janeiro (Brasil), em 2008. A percepcao dos estudantes sobre o uso de alcool pelos pares uma vez na vida e nos ultimos doze meses foi acurada, porem, em relacao aos ultimos trinta dias houve percepcao erronea (hiperestimativa). Os estudantes consomem bebidas alcoolicas de forma recreacional, principalmente em festas e bares, em companhia de amigos e pares. O consumo se mostra acima dos padroes estabelecidos.

Políticas e leis sobre drogas ilícitas no Brasil e a perspectiva de familiares e pessoas próximas a usuários de drogas: estudo na Cidade de Ribeirão Preto, São Paulo, Brasil

A legislacao brasileira sobre drogas evoluiu de um sistema proibicionista para um sistema menos repressor no que diz respeito aos usuarios de drogas. O objetivo desta pesquisa foi identificar a percepcao dos familiares e pessoas proximas a usuarios de drogas da cidade de Ribeirao Preto, Sao Paulo, Brasil, sobre as leis e politicas relacionadas as drogas no pais. Os dados foram coletados atraves de questionario estruturado e a amostra foi constituida por 100 familiares ou pessoas proximas a usuarios de drogas, recrutados em um servico publico de saude. Quanto a relacao dos respondentes com o usuario de drogas, 31% eram amigos, 23% irmaos, 15% filhos e 7% conjuges. Setenta e oito por cento dos usuarios eram homens, com idade media de 26 anos. Os resultados obtidos na pesquisa confirmam a influencia direta das leis e politicas nacionais nas atitudes e comportamentos dos individuos. Indicam a falta de confianca na policia e retratam a percepcao de que, apesar das mudancas recentes, em beneficio da reabilitacao dos usuarios, as leis sobre drogas nao respeitam os seus direitos humanos.

Experiencia de cooperación entre universidad y organización internacional para capacitar enfermeros docentes de la America Latina para la investigación del fenomeno de las drogas

This article reports on the experience of the specialization course called: research training program for nurses to study the drugs phenomenon in Latin America, which was offered by two institutions, one of which is local (University of São Paulo at Ribeirão Preto College of Nursing) while the other is an international organization (Interamerican Drug Abuse Control Commission - CICAD of the Organization of American States - OAS). This program was offered consecutively in 2002 and 2003. The report discloses data on the negotiation and didactical planning process for the first course, the distribution of contents and activities, experiences acquired during the teaching process and student evaluations. According to the participating students, teachers and institutions involved, offering partially in-class and partially distance courses, like the above mentioned program, has proved to be a successful experience with political, academic and social repercussions for the participants.

A PESQUISA SOBRE O FENÔMENO DAS DROGAS NA PERSPECTIVA DOS ESTUDOS MULTICÊNTRICOS NA AMÉRICA LATINA E CARIBE

l fenomeno de las drogas constituye uno de los mayores desafios para los paises en el Siglo XXI. Essabido que el uso y abuso de las drogas tiene impactos y consecuencias adversas en la salud del individuo, dela familia y de la comunidad, asi como, en el desarrollo, estabilidad social y seguridad, tanto a nivel nacionalcomo internacionalThe drugs phenomenon is one of the greatest challenges countries are confronted with in the 21 century. It is well known that drugs use and abuse influence and negatively affect the health of people, families and communities, as well as national and international development, social stability and security. The globalization process can direct or indirectly facilitate drugs trade, as well as the development of money laundry mechanisms, contributing to increased drugs consumption in different population groups. That makes the drugs phenomenon a global problem. Many countries have emphasized the association between drugs and terrorism and have direct or indirectly reinforced drugs control laws. In the context of the black market, drugs are considered a lucrative source of money; at the same time, this market can be associated with arms trade and violence against civilians and governments all over the world. National policies highlight the importance of reducing drugs consumption, taking into account, for example, the risk of acquiring HIV/AIDS among injection drugs user, or greater accident risks, or the chronic damage that can be associated with drugs use. Psychoactive substance consumption affects users’ body and mind. These effects range from alterations in physiological functions to modified time and space perceptions, as well as alterations in states of awareness about the consumers’ environment. It can be affirmed that drugs abuse and addiction result from a combination of three factors: a product (alcohol and other drugs), a person with his history and individual vulnerabilities and a social, cultural, political and economic context. In particular, it is fundamental to integrate the importance of social determinants of health and development into the analysis of and answers given to substance consumption, including the strong inequities that exist in the region. Likewise, it should be considered that many people present comorbidities due to addiction and mental health problems at the same time. In view of the above, a comprehensive approach is needed, which does not remain limited to an emphasis on the substance alone. Hence, the drugs phenomenon is an old problem in a new context. Countries face difficulties to control production and trade and reduce demand. That makes drugs use and abuse into a paramount theme on the national and international agenda, due to the damage they cause in countries’ social, economic and political aspects. The current global context demands specialized professionals, who are capable of analyzing problems and presenting solutions and/or strategies with national and international perspectives, based on scientific data. Most OAS members states do not have specialized professional staff at their disposal, with scientific knowledge and sufficient research experience on drugs and related problems to work in national drugs commissions, research centers or academic professional training programs. In general, countries have neither established long-term programs or planning to research on the drugs phenomenon, nor have they managed to incorporate research results into national drugs control policies. To solve this problem, however, some developing countries have linked up with developed ones to outline strategies for scientific advances in research on the drugs phenomenon. In that context, CICAD (Inter-American Drug Abuse Control Commission) has developed strategies to strengthen institutional capacities and human resources related to drugs demand reduction, security and money laundering in its member-states..O processo da globalizacao, direta ou indiretamente, pode facilitar o comercio de drogas, assim como o desenvolvimento de mecanismos de lavagem de dinheiro, contribuindo para o incremento do consumo de drogas entre diferentes grupos populacionais. Por isso, o fenomeno das drogas torna-se problema global. Muitos paises tem enfatizado a associacao entre drogas e terrorismo e tem reforcado as leis de controle de drogas, de forma direta ou indireta. No contexto do mercado negro de venta de drogas, as mesmas sao tidas como fonte lucrativa para ganhar dinheiro; ao mesmo tempo, tal mercado pode se associar a compra de armas, assim como a geracao de violencia contra a populacao civil e os governos em todo o mundo (3) . As politicas nacionais ressaltam a importância em se reduzir o consumo de drogas, considerando, por exemplo, o risco de adquirir HIV/AIDS entre usuarios de drogas injetaveis, ou maior risco de acidentes, ou o dano cronico que pode se associar ao uso de drogas (3) . O consumo de substâncias psicoativas tem efeitos no corpo e na mente dos usuarios. Esses efeitos vao desde alteracoes das funcoes fisiologicas, ate a modificacao da percepcao em relacao ao tempo e espaco, assim como alteracoes nos estados de consciencia sobre o entorno do consumidor. Pode-se afirmar que o abuso e a dependencia de drogas sao o resultado do encontro de tres fatores: um produto (alcool e outras drogas), uma pessoa com a sua historia e vulnerabilidades individuais e um contexto social, cultural, politico e economico. Em particular, e fundamental integrar na analise e nas respostas, frente ao consumo de sustâncias, a importância dos determinantes sociais de saude e desenvolvimento, incluindo as fortes iniquidades existentes na regiao. Igualmente, e necessario considerar que muitas pessoas apresentam comorbilidade por adicao e problemas de saude mental, simultaneamente. Pelo exposto, e necessario realizar abordagem integral que nao se limite somente a enfase na substância. Assim, o fenomeno das drogas e velho problema dentro de novo contexto. Os paises enfrentam dificuldades para o controle da producao, comercio e reducao da demanda. Por isso, o uso e abuso de drogas passam a ser tema primordial na agenda nacional e internacional, devido aos danos que causam nos aspectos sociais, economicos e politicos dos paises. O atual contexto mundial requer profissionais especializados, capazes de analisar problemas e apresentar solucoes e/ou estrategias com perspectivas nacionais e internacionais, baseadas em dados cientificos. A maioria dos Estados membros da OEA nao conta com quadro de profissionais especializados, com conhecimento cientifico e suficiente experiencia em pesquisa sobre drogas e os seus problemas relacionados, para trabalhar nas comissoes nacionais de drogas, em centros de pesquisa ou em programas academicos de formacao de profissionais. Em geral, os paises nao tem programas ou planejamento de longo prazo estabelecidos para pesquisar o fenomeno das drogas, e nem tem conseguido incorporar os resultados das pesquisas em politicas nacionais

Use of illicit drugs and critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro (City), Brazil

This article presents the partial results of a multicenter, qualitative study, which involved seven Latin-American countries and Canada. The results presented refer to Northern Rio de Janeiro (city), Brazil. The objective of the study was to describe the perspective of relatives/acquaintances of illicit drug users about protective and risk factors, prevention initiatives, treatment services, and legal aspects regarding illicit drugs. Interviews were performed with 99 individuals, who reported being affected by their relationship with an illicit drug user (relative or acquaintance), approaching their perspectives regarding the key-domains. Most participants were women (73.7%); relatives who used drugs were mostly men (78.2%); the most consumed drug was marijuana (77.8%). The highlighted protective factor was having recreational-sports activities in the community (88.9%), and the risk factor was curiosity for trying something new (94.4%). The main treatment services were Church Groups (51.5%), and participants stated that laws should be more punitive (82.8%). In conclusion, this information is essential to fight against drug use/abuse, showing that there is a need for actions that consider different perspectives at different levels.

Partnership between a university and an international organization with a view to drugs research training for Latin American nursing teachers

This article reports on the experience of the specialization course called: research training program for nurses to study the drugs phenomenon in Latin America, which was offered by two institutions, one of which is local (University of São Paulo at Ribeirão Preto College of Nursing) while the other is an international organization (Interamerican Drug Abuse Control Commission - CICAD of the Organization of American States - OAS). This program was offered consecutively in 2002 and 2003. The report discloses data on the negotiation and didactical planning process for the first course, the distribution of contents and activities, experiences acquired during the teaching process and student evaluations. According to the participating students, teachers and institutions involved, offering partially in-class and partially distance courses, like the above mentioned program, has proved to be a successful experience with political, academic and social repercussions for the participants.

Factores de riesgo relacionados al uso de drogas ilegales: perspectiva crítica de familiares y personas cercanas en un centro de salud público en San Pedro Sula, Honduras

This article presents quantitative data from a multicenter, cross-sectional study, which was performed at a public health center in San Pedro Sula, Honduras, using multiple methods. The objective of the study was to describe the critical perspective of people who reported being affected by their relationship with an illicit drug user (relative or acquaintance) in terms of risk factors. Data collection was performed using 100 questionnaires. Most participants were women with low education levels. Drug users were mostly men, with an average age of 23.3 years. The most consumed drug was marijuana (78%), followed by crack/cocaine (72%), glue/inhalants (27%), hallucinogens (ecstasy/LSD) (3%), amphetamines/stimulants (1%), and heroin (1%). The identified risk factors include: previous experience with alcohol/tobacco, having friends who use drugs, lack of information, low self-esteem, age, and other personal, family and social factors. In conclusion, prevention and protection should be reinforced.Sao apresentados, aqui, dados quantitativos de um estudo multicentrico, multimetodos, de corte transversal, realizado em um centro de saude publica em San Pedro Sula, Honduras. O objetivo foi descrever a perspectiva critica dos membros da familia ou pessoas que se sentem afetadas por terem alguem proximo que usa ou usou drogas ilegais, em relacao aos fatores de risco. Os dados foram coletados atraves de questionario aplicado em 100 individuos. A maioria era composta por mulheres pobres, com pouca escolaridade. Os consumidores eram majoritariamente varoes, com idade media de 23,3 anos. A droga mais utilizada foi a maconha (78%), seguida por crack/cocaina (72%), cola/inalantes (27%), alucinogenos (ecstasy/LSD) (3%), anfetaminas/estimulantes (1%), heroina (1%). Entre os fatores de risco identificados estao: experiencia anterior com alcool/fumo, ter amigos/amigas que usam drogas, falta de conhecimento, baixa autoestima, idade, entre outros fatores pessoais, familiares e sociais. Em conclusao, deve-se reforcar a prevencao e protecao.

Enhancing nursing knowledge through democratic cross-national collaboration

Enhancing nursing knowledge requires the exchange of ideas worldwide through the collaboration of nurse scientists. Healthy partnerships abide by the values of collaboration, mutual trust, respect and dignity. However, a lack of information exists regarding the nature of cross-national academic partnerships in nursing. The purpose of this article is twofold: to explore democratic cross-national collaborations in nursing and to pose theoretically-based interventions to enhance future democratic collaborations cross- nationally in nursing. While a review of the literature revealed some model nursing partnerships, nursing can benefit from having a better evidence based understanding of the topic. Theoretical formulations from education, philosophy and critical anthropology offer complementary lenses to aid in the analysis. The process can help nursing academics to think more critically about the issues and to delineate theory driven protocols for democratic cross-national collaboration with the ultimate aim of enhancing nursing knowledge. DESCRIPTORS: Nursing. Knowledge. Collaboration. Globalization. International aspects.