The study was divided into two parts having both parts a qualitative focus. In the first part of the study, an online questionnaire was sent to all harm reduction teams and two focus groups were carried out with eight harm reduction professionals and six people who use(d) drugs. The second part used an online questionnaire applied to 143 participants aged between the age of 18 and 25 complemented by two semi-structured interviews.
The study was conducted at two different moments in time. In the first part of the study and with the intention of responding to the first research question, an online questionnaire and two focus groups were the selected instruments. The online questionnaire was chosen in order to retrieve some information about the use of drugs in adolescents through the perspective and the work experience of the harm reduction teams.Footnote 2 On the other hand, the focal group was chosen due to its capacity to assess various perspectives about the same phenomenon through the interaction and discussion of the various participants [43].
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The second part of the study used semi-structured interviews and another online questionnaire. These two instruments had the goal to retrieve information for the other two research questions that focus on the perspective of the adolescents. The online questionnaire was chosen due to the pandemic situation that prevented the researchers to be physically present to conduct the interviews on this sensible topic. Moreover, this instrument served as a connection between the participants and the researcher to hold the interviews by telephone. Although there were only two interviews collected, the data provided allow us to contextualize and triangulate the material from the other sources.
This study comprised of different sample recruitment. In relation to the online questionnaire for the harm reduction teams, this was sent to all of them through SICAD (General Directorate for Intervention on Addictive Behaviours and Dependencies), a national organisation responsible for the coordination of all harm reduction teams. From 36 projects, 26 of those responded. Regarding the focus groups, the sampling was purposive in order to select the participants on the basis they will provide meaningful information [43, 44]. There was a focus group in the north of the country and another in the centre. The one conducted in the north was composed of two technicians with decision-making competence in the context of addictive behaviours, two people who use(d) drugs older than 18 and three harm reduction professionals. The focus group in the centre was constituted of one technician with decision-making competence in the context of addictive behaviours, four people who use(d) drugs older than 18 and two harm reduction professionals.
In relation to the quantitative data obtained in the online questionnaires, it was only conducted a descriptive analysis using SPSS. At the same time, the qualitative data that resulted from all the methods and instruments were analysed based on the Thematic Analysis of Braun and Clarke [43, 45]. This qualitative analytic method has the goal to identify, analyse and report patterns (named themes) within the data [43, 45]. The first step of the analysis was the familiarization with the data through the transcription and reading of all the verbal data. Then the second phase involved the production of the initial codes through a semantic and inductive analysis. This means that all verbal data relevant to the research questions were coded without any previous framework. Ultimately, the codes were sorted out into themes and sub-themes. The themes capture a pattern that is important for answering the research questions, and the sub-themes give structure to those previous [43, 45].
Of the 143 young people who answered the online questionnaire, 46.2% used some psychoactive substance before the age of 18. However, only one claimed to have attended a service due to their drug use and only 12 of the 133 participants that had used some psychoactive substance knew of any service for drug use in adolescence.
Alcohol marketing also can lead to youth and young adults developing alcohol brand preferences (Albers et al. 2014; Ross et al. 2015), which can influence their reports of alcohol consumption (Roberts et al. 2014). For example, youth reported on average 11 more drinks per month when responding to an online survey that used brand-specific measures compared with a survey using more general alcohol measures (Roberts et al. 2014). The relationship between alcohol brand receptivity and alcohol brand consumption also has been linked to whether and when adolescents begin to binge drink (Morgenstern et al. 2014).
These findings, however, must be interpreted with caution, as it is difficult to determine whether advertisements directly result in increased alcohol consumption. To begin with, a variety of marketing strategies including distribution, product development, pricing, and targeted marketing all may affect links between advertising and consumption (Alaniz and Wilkes 1998; Roberts et al. 2014). For example, Molloy (2015) found that after controlling for targeting, only moderate advertising effects are seen, despite the strong correlations between alcohol advertising and drinking among youth. It also is unclear which aspects of online social media advertisements are related to the observed correlations. Research shows that drinkers like advertising about alcohol more than nondrinkers do, respond neurologically to the advertising more intensively than nondrinkers do, and may recall the advertising more clearly (Snyder et al. 2006), making it harder to distinguish among the specific mechanisms behind the observed relationships. As a result, making causal statements about alcohol use and marketing is problematic because the temporal order between using alcohol and seeing advertisements is not frequently established (Snyder et al. 2006).
Alcohol research should also more actively acknowledge new social contexts among youth culture. A better understanding of the influence online social networking sites and new media have on alcohol use is particularly important among adolescent populations, and this should be explored more fully in future studies.
The multibasins of attraction and resilience as the science of surprise became the theoretical foundation for the work with active adaptive management of ecosystems where Buzz Holling, Carl Walters, Bill Clark, and colleagues mobilized a series of studies of large scale ecosystems subject to management (Holling and Chambers 1973, Holling 1978, Walters and Hilborn 1978, Clark et al. 1979, Walters 1986, Walters and Holling 1990). The adaptive management process allowed for comparative analyses of the theoretical foundations of ecosystems behavior and ecosystems management. The conceptual underpinnings of adaptive management are simple; there will always be inherent uncertainty and unpredictability in the dynamics and behavior of complex systems, as a result of nonlinear interactions among components and emergence, yet management decisions must still be made, and whenever possible, learning should be incorporated into management (e.g. Allen et al. 2011). The resilience approach began early to influence work and discussions in fields outside ecology like anthropology, ecological economics, environmental psychology, human geography, the management literature, and others (reviewed in, e.g., Scoones 1999, Abel and Stepp 2003, Davidson-Hunt and Berkes 2003, Folke 2006).
As a reflection of the significance of a resilience lens for understanding complex social-ecological systems, the research program The Resilience Network was initiated through a collaboration of the Beijer Institute (Mäler and Folke) and University of Florida (Holling and Gunderson), a program that engaged pioneering resilience thinkers and that triggered a lot of interesting and path-breaking work on resilience including the rich Panarchy volume (Gunderson and Holling 2002), a volume on the significance of nonlinear dynamics and regime shifts in economics, The Economics of Non-Convex Ecosystems (Dasgupta and Mäler 2004), and the Berkes, Folke, Colding 2003 book Navigating Social-Ecological Systems: Building Resilience for Complexity and Change emphasizing the challenge of governing dynamic interactions between gradual and abrupt changes in social-ecological systems. This book presented a major synthesis of resilience challenges for social-ecological systems (Folke et al. 2003).
The resilience approach, as part of complex systems understanding (e.g., Holland 1995, Cillier 2008), emphasizes that systems of humans and nature exhibit nonlinear dynamics, thresholds, uncertainty, and surprise, and in particular how periods of gradual change interplay with periods of rapid change and how such dynamics interact across temporal and spatial scales (e.g., Gunderson and Holling 2002, Berkes et al. 2003). Complex systems have multiple attractors and there may be shifts from one attractor on a certain pathway to a new attractor and a contrasting pathway (stability domain or basin of attraction). Sharp shifts take place in ecosystems that stand out of the blur of fluctuations around trends and may have different causes (e.g., Scheffer and Carpenter 2003, Scheffer 2009). The likelihood of such shifts increases with loss of resilience (e.g., Scheffer et al. 2001). During the last decades it has become clear that human actions cause such shifts by altering resilience and disturbances (e.g., Folke et al. 2004, Biggs et al. 2012b, Schoon and Cox 2012) as is now illustrated from a growing set of examples of both ecosystems and social-ecological systems (Rocha et al. 2015) and even large-scale reorganizations like historical shifts from foraging to farming (Ullaha et al. 2015). The Regime Shifts DataBase provides examples of different types of regime shifts that have been documented. The database focuses specifically on regime shifts that have large impacts on ecosystem services and therefore on human well-being. Hence, in resilience thinking, social and ecological systems are intertwined, exhibiting emergent properties and they can exist in qualitatively different states or basins of attraction. 2ff7e9595c
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