Samenvatting Arts en maatschappij 1: Medische sociologie (deel 2/4)
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Course
Arts en maatschappij 1 (1022GENGE1)
Institution
Universiteit Antwerpen (UA)
Deze samenvatting bestaat uit het onderdeel medische sociologie van het vak arts en maatschappij 1. Dit vak wordt in het eerste jaar aan de UA gegeven. Dit onderdeel is het 2de deel van deze cursus en bevat onder andere de onderwerpen rilatine, drugs, tabak, alcohol etc. De andere delen zijn ook ve...
Medische sociologie
UNIVERSITEIT ANTWERPEN – GENEESKUNDE BACHELOR 1 – ARTS EN MAATSCHAPPIJ 1
,Inhoud
1. Rilatinegebruik bij studenten..............................................................................................................6
Gebruik van medicatie........................................................................................................................6
Bij studenten..................................................................................................................................6
Overzicht............................................................................................................................................6
Literatuur............................................................................................................................................6
Medische informatie..........................................................................................................................7
Effectiviteit.....................................................................................................................................7
Waarvoor wordt Rilatine ingenomen.............................................................................................7
Ander gebruik van methylfenidaat: narcolepsie.............................................................................7
Hoe werkt Rilatine?........................................................................................................................7
Waarschuwingen............................................................................................................................8
Bijwerkingen...................................................................................................................................8
Opiumwet Nederland.....................................................................................................................8
Medicalisering: ADHD als voorbeeld..................................................................................................8
Voorbeelden...................................................................................................................................9
Medicalisering................................................................................................................................9
DSM as a categorical touchstone....................................................................................................9
Evolutie van ADHD in DSM.............................................................................................................9
Biomedische verbetering als vorm van medicalisering.................................................................10
3 soorten biomedische/cognitieve verbetering............................................................................10
Resultaten doctoraatsonderzoek......................................................................................................11
Situering onderzoek......................................................................................................................11
Problematisch?.............................................................................................................................11
Nieuwe aandacht..........................................................................................................................11
Definities.......................................................................................................................................11
Kwantitatief onderzoek................................................................................................................12
Kwalitatief onderzoek – interviews...............................................................................................16
Conclusie en aanbevelingen.............................................................................................................19
Onbedoelde effecten....................................................................................................................19
Artsen...........................................................................................................................................19
2.(G)Een vies klusje: Rioolwater als informatiebron over druggebruik.................................................20
Indeling presentatie..........................................................................................................................20
Achtergrond......................................................................................................................................20
Waste water-based epidemiology....................................................................................................21
1
, Overzicht uitgevoerd onderzoek......................................................................................................22
Staalafname..................................................................................................................................22
Analyse.........................................................................................................................................23
Terugrekening...............................................................................................................................23
COWAT-project (cocaïne in afvalwater)........................................................................................24
Resultaten.....................................................................................................................................24
Europese vergelijking....................................................................................................................26
Onderzoek in Lier (SEWPROF => SEWage PROFiling)....................................................................27
Wat kan er nog meer gedaan worden met afvalwater?...............................................................30
3.Gecontroleerd gebruik van roesmiddelen (‘drugs’)...........................................................................31
Drugs en zelfcontrole...........................................................................................................................31
1.Drugsepidemiologie in België........................................................................................................31
Drugsepidemiologie in België =....................................................................................................31
Norman Zinberg............................................................................................................................32
2.Studies naar gecontroleerd gebruik...............................................................................................32
Gecontroleerd gebruik van legale drugs: onderzoeksresultaten..................................................32
Gecontroleerd gebruik van heroïne..............................................................................................32
Gecontroleerd gebruik van cocaïne: wat wordt verondersteld?..................................................33
Gecontroleerd gebruik van drugs: wat stelde men vast?.............................................................33
Spontaan stoppen met drugs.......................................................................................................33
Veranderingen in drugscarrières na 20 jaar..................................................................................33
Craving..........................................................................................................................................34
3.Cocaïne-onderzoek in Antwerpen (1996-1999).............................................................................34
Heersend paradigma....................................................................................................................34
‘Worst case scenario’....................................................................................................................34
Niet-problematische gebruikers in kaart brengen........................................................................34
Processen van zelfregulering bij illegale druggebruikers..............................................................35
4.Implicaties voor het drugbeleid in België......................................................................................36
Hulpverlening en preventie als formele controle.........................................................................36
Soorten controlemechanismen....................................................................................................37
Gecontroleerd omgaan met illegale drugs...................................................................................37
Beleid en ontwikkeling en overdracht van normen......................................................................37
4.Verslaving..........................................................................................................................................38
Slavernij (of lijfeigenschap)...............................................................................................................38
Basisbegrippen en definities.............................................................................................................38
Leerdoelen....................................................................................................................................38
2
, DSM..............................................................................................................................................38
“Werkaholisme”...........................................................................................................................42
Jongeren gokken massaal.............................................................................................................43
Gokverslaving...............................................................................................................................43
5.Drugs: Het verhaal van Adam en Eva?...............................................................................................44
I. Intoxicatie/ vergiftiging?................................................................................................................44
Welke producten?........................................................................................................................44
Definities.......................................................................................................................................44
Achtergrond..................................................................................................................................44
Tekens..........................................................................................................................................45
Mydriase, grote pupil (alles wat opwindt)....................................................................................45
II. HIGH, OF TOCH NIET...?................................................................................................................45
1a) Amfetamines..........................................................................................................................45
1b) Cocaïne...................................................................................................................................47
1c) Planten: hallucinaties (waanbeelden) ….................................................................................48
1d) LSD..........................................................................................................................................50
2a) Cannabis.................................................................................................................................50
2b) Heroïne...................................................................................................................................51
2c) GHB.........................................................................................................................................53
2d) Ketamine................................................................................................................................53
2e) Lach gas..................................................................................................................................53
2f) Andere (onderdrukkend…)......................................................................................................54
III. Hoe detecteren?.........................................................................................................................55
Achtergrond..................................................................................................................................55
Staalname.....................................................................................................................................55
Terugrekening...............................................................................................................................55
Geen combinaties maken!!!.........................................................................................................56
Quiz...............................................................................................................................................56
6.Jongeren en alcohol...........................................................................................................................58
Onderzoek van leerstoel Reinier de Graaf jongeren en alcohol.......................................................58
1.Leerstoel Reinier de Graaf Jongeren en alcohol........................................................................58
2. Cijfers jongeren en alcohol België.............................................................................................58
4.Wat leren we uit deze resultaten?.............................................................................................60
5. Toekomstplannen & aanbevelingen: alcoholcampagne studenten + alcoholpolikliniek
jongeren.......................................................................................................................................61
5.Take Home Messages................................................................................................................62
3
, Jongeren en alcohol..........................................................................................................................63
Jongeren met alcoholintoxicatie, een groeiend probleem...........................................................63
Poliklinieken jeugd en alcohol kindergeneeskunde......................................................................63
Schadelijke effecten alcohol.........................................................................................................64
Metabolisme.................................................................................................................................65
Voorlichting..................................................................................................................................68
Onderwijsplan...............................................................................................................................71
Samenvattend...............................................................................................................................73
7.Tabak.................................................................................................................................................75
Resultaten gezondheidsenquête 2018: België..................................................................................75
In Vlaanderen...............................................................................................................................75
Interventies..................................................................................................................................77
Resultaten.....................................................................................................................................77
Tabaksbeleid.....................................................................................................................................78
Hoe was het?................................................................................................................................78
Nu.................................................................................................................................................78
Voor nu en de toekomst...............................................................................................................79
WHO en roken..................................................................................................................................80
Financiële consequenties.................................................................................................................80
Enquête stichting tegen kanker........................................................................................................81
Preventie..........................................................................................................................................81
De e-sigaret......................................................................................................................................82
De reglementering Europa 2014...................................................................................................82
E-sigaret niet zonder gevaren.......................................................................................................83
Voornaamste kernboodschappen: advies van hoge gezondheidsraad.........................................83
Ondertussen … COVID-19.................................................................................................................84
Quod erat demonstrandum..........................................................................................................84
In de VS.........................................................................................................................................84
Preventie..........................................................................................................................................85
Rol van de overheid......................................................................................................................85
Alliantie voor een rookvrije samenleving......................................................................................85
Gidsland Australië.........................................................................................................................86
In België........................................................................................................................................86
‘Derde’ interventie?......................................................................................................................87
Een volksgezondheidsbeleid tegen de inmening van de big tobacco...........................................87
8.Gezondheidspromotie.......................................................................................................................90
4
, Duurzaam werken aan preventie => vaak niet snel resultaten.........................................................90
Inleiding........................................................................................................................................90
Memorandum VIGeZ....................................................................................................................90
Gezondheidspromotie..................................................................................................................90
Het begrip gezondheid volgens WHO...........................................................................................91
Gezondheidspromotie en ziektepreventie in Vlaanderen................................................................92
Plaatsbepaling van GVO in Vlaanderen.........................................................................................92
Het Vlaams preventiedecreet.......................................................................................................92
Logo’s............................................................................................................................................92
Modellen en theorieën.................................................................................................................93
Evaluatie van preventieactiviteiten in Vlaanderen...........................................................................93
Effectiviteit van preventie.............................................................................................................93
Borstkankeropsporing..................................................................................................................95
Relatie ‘gezond gedrag’ – gezondheid..........................................................................................97
Kosteneffectiviteit van preventie..................................................................................................97
Blijvende vragen...........................................................................................................................98
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