Thesis (PhD)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Some academics are of the generalist opinion that ancient Egyptian beer was only consumed by the lower classes because of its low social status. This is based on the generalization that individuals only consume alcoholic beverages matching the status of their social class. Therefore the lower classes consumed beer while the upper classes consumed an alcoholic beverage of higher status, i.e. wine. However, other academics are of the universalist opinion that Egyptian beer was universally consumed by all Egyptian social classes irrespective of the status of beer. This study aims to test the validity of these opposing academic opinions and also strives to understand how statements of status in Egyptian society were devised, and what they were conveying. This was achieved by determining the status of Egyptian beer and wine and then comparing them to the respective status of beer and wine drinkers in the New Kingdom period (c. 1550-1069) according to the factors of production, consumption, health, economic exchange & distribution, and religion. Use is made of an anthropological approach which allows the researcher to limit social bias and understand ancient Egyptian society on its own terms. Results of this study indicate that Egyptian beer had a much lower status than Egyptian wine and all social classes consumed beer while only the upper classes consumed wine. The generalist opinion, therefore, is falsified and the universalist opinion validated. The results also indicate that the upper classes justified their beer consumption by producing, consuming and exchanging an elite beer of higher status in a manner reminiscent of wine so that it compared more favourably with the status of their social classes. This study, therefore, not only settles an old academic dispute but also provides new insight into Egyptian beer. / AFRIKAANSE OPSOMMING: Sommige akademici huldig die algemene siening dat antieke Egyptiese bier uitsluitlik deur die laer klasse gebruik is, omdat bier ‘n laer status geniet het. Dit is gegrond op die veralgemening dat individue slegs alkoholiese drank gebruik het wat ooreenstem met hul eie sosiale klas. Die laer klasse het dus bier gedrink terwyl die hoër klasse alkoholiese drank van ‘n hoër status, naamlik wyn, gedrink het. Ander akademici is egter van mening dat Egiptiese bier deur alle Egiptiese sosiale klasse gebruik is, ongeag die status van bier. Hierdie studie poog om die geldigheid van hierdie teenstrydige akademiese menings te toets en poog ook om te verstaan hoe stellings oor status in die Egiptiese samelewing bedink is en wat hulle wou oordra. Dit is bereik deur die status van Egiptiese bier en wyn te bepaal en dit dan te vergelyk met die besondere status van bier en wyndrinkers in die Nuwe Koningkryk tydperk (c. 1550-1069) volgens die faktore van produksie, verbruik, gesondheid, ekonomiese uitruiling & verspreiding en godsdiens. ‘n Antropologiese benadering is gevolg omdat dit die navorser in staat stel om sosiale partydigheid te beperk en sodoende die Egiptiese samelewing in eie reg te kan verstaan. Resultate van hierdie studie dui aan dat alhoewel Egiptiese bier ‘n veel laer status as Egiptiese wyn geniet het, het alle sosiale klasse nietemin bier gedrink, terwyl net die hoër klasse wyn gedrink het. Die algemene mening is gefalsifiseer, terwyl die universele mening gestaaf word. Die resultate dui ook aan dat die hoër sosiale klasse hul bierverbruik geregverdig het deur ‘n elite bier van hoër status te produseer, uit te ruil en te gebruik op ‘n wyse soortgelyk aan diè van hul wynverbruik, sodat dit gunstig vergelyk met die status van hul sosiale klasse. Hierdie studie los dus nie net ‘n ou akademiese meningsverskil op nie, maar gee ook ‘n nuwe insig in Egiptiese bier en die gebruik daarvan deur die hoër klasse.

An estimated 13.9% of Americans currently meet criteria for an alcohol use disorder. Ultimately, chronic alcohol use may result in neurological deficits, with up to 85% of alcoholics exhibiting signs of cognitive decline. However, biochemical and behavioral factors contributing to this decline have remained elusive. Our ongoing research program encompasses a multi-tiered screening of a natural product library and validation process to provide novel information about mechanisms underlying these deficits and to identify novel chemical scaffolds to be exploited in the development of pharmacological treatments for alcohol use disorders in a rodent organotypic hippocampal slice culture mode. Experiment 1 sought to establish a 48 h high throughput model for testing novel scaffolds against ethanol (EtOH) toxicity. Experiment 2 tested multiple natural product compounds for their ability to attenuate ethanol-induced cytotoxicity. Results from Experiment 1 revealed EtOH (100 mM) induced significant cytotoxicity at 48 h. Trolox (100 µM), a potent antioxidant, was found to reduce ethanol-induced cytotoxicity in this assay. Experiment 2 revealed two spoxazomicins (1, 1-1) demonstrated potent cytoprotective effects against ethanol toxicity. These findings highlight the potential applications of these novel scaffolds for use in the treatment of alcohol use disorder.

published_or_final_version / Community Medicine / Master / Master of Public Health

Chronic ethanol exposure results in neuroadaptations that drive the progression of an alcohol use disorder (AUD). One such driving force is alcohol-induced neurodegeneration. Neuroinflammation has been proposed as a mechanism underlying this damage. Although neuroinflammation is a physiological response to damage, overactivation of its pathways can lead to neurodegeneration. A hallmark indicator of neuroinflammation is microglial activation, but microglial activation is a heterogeneous continuum of phenotypes that can promote or inhibit neuroinflammation. Furthermore acute microglial activation is necessary to restore homeostasis, but prolonged activation can exacerbate damage. The diversity of microglia makes both the level and timecourse of activation vital to understanding their role in damage and/or recovery. The current set of experiments examines the effects of ethanol on microglia within the hippocampus and entorhinal cortex in a binge model of alcohol-induced neurodegeneration. In the first set of experiments, the phenotype of microglia activation was assessed using Raivich’s 5-stages of activation that separates pro- and anti-inflammatory forms of microglia. Morphological and functional assessments suggest that ethanol does not elicit classical microglial activation but instead induces partially activated microglia. In the second set of experiments, the earliest signs of microglial activation were determined to understand the initiation of microglial activation. Experiments indicated that activation occurred subsequent to previous evidence of neuronal damage; however, activation was accompanied by a loss of microglia and the discovery of dystrophic microglia. The final set of experiments examined whether alcohol-induced partial activation of microglia would show a differential response with further alcohol exposure. Experiments showed that animals previously exposed to ethanol showed a greater response to a second ethanol insult. Overall, these studies suggest that although alcohol may initially interrupt the normal microglia response, during abstinence from ethanol a partial activation phenotype appears that may contribute to recovery. Once activated, however, data suggest that these microglia are primed and upon subsequent exposure show an increased response. This heterogeneous microglial response with respect to time does not necessarily reflect a neuroinflammatory response that would be neurodegenerative but does imply that chronic ethanol consumption affects the normal neuroimmune system.

Bakgrund: Alkoholkonsumtion bidrar till sjukdom, funktionsnedsättning och tidig död världen över. Behandlingsalternativ för den med problematiska alkoholvanor är främst medicinska- och/eller terapeutiska åtgärder. Återfall i det problematiska bruket är dock relativt vanligt. Det föreligger därför ett behov att fortsätta utveckla den vård som ges till personer inom alkoholvården. Fysisk aktivitet är en omvårdnadsåtgärd som sjuksköterskan kan använda för att främja hälsa och lindra sjukdom. Det finns inledande forskning kring den positiva effekt som fysisk aktivitet har för patienter med skadligt alkoholbruk och alkoholberoende men det saknas forskning kring huruvida åtgärden används i det kliniska arbetet. Syfte: Att beskriva sjuksköterskans uppfattningar och erfarenheter av fysisk aktivitet för patienter med skadligt alkoholbruk och alkoholberoende. Metod: Kvalitativ design där semistrukturerade intervjuer genomfördes med sju sjuksköterskor verksamma på mottagningar inom beroendevårdens öppenvård. Som analysmetod användes kvalitativ innehållsanalys. Resultat: Sjuksköterskorna beskrev fysisk aktivitet som en grundläggande del av hälsa och som en nödvändighet i patientens vardag. Fysisk aktivitet var ett sätt för patienten att bryta vanor förknippade med alkohol. Den fysiska aktiviteten ansågs lindra flera av de tillstånd som skadligt alkoholbruk och alkoholberoende för med sig, ökade patientens självkänsla och var ett sätt för patienten att självständigt påverka sin hälsa. Sjuksköterskorna sökte informera och motivera patienten till rätt nivå av fysisk aktivitet. Det saknas struktur för användandet i den kliniska vardagen och sjuksköterskorna efterfrågade praktiska möjligheter och bättre riktlinjer inom verksamheten för att underlätta främjandet av fysisk aktivitet hos patienterna. Diskussion: Resultatet diskuteras utifrån Orems egenvårdsteori samt relevant forskning. / Background: Alcohol consumption contributes to disease, disability and increased morbidity worldwide. Treatment options for those with problematic alcohol use are primarily medical- and/or therapeutic interventions. Relapse in the problematic behaviour is relatively common. There is therefore a need to continue to develop the care provided to people undergoing alcohol treatment. Physical activity is a nursing intervention that the nurse can use to promote healthy lifestyles and alleviate disease. There is preliminary research on the positive impact that physical activity have for patients with alcohol use disorders but no research is to be found on whether the intervention is used in the clinical practice. Aim: To describe nurses' perceptions and experiences of physical activity for patients with alcohol use disorders. Method: Qualitative design with semi-structured interviews was conducted with seven nurses working at outpatient dependence clinics. Qualitative content analysis was used to analyse the data. Results: The nurses described the physical activity as a fundamental element of health and as a necessity in the patient's everyday life. Physical activity was a way for the patient to break habits associated with alcohol. Physical activity was considered to decrease many of the comorbid conditions related to alcohol use, increased the patient's self-esteem and was a way for the patient to independently affect their health. The nurses searched to inform and motivate the patient to the right level of physical activity. There was a lack of structure in the everyday clinical practice and nurses demanded practical possibilities and better guidelines within the organization to facilitate the promotion of physical activity to patients. Discussions: The results are discussed from Orems self-care theory and relevant research.

The purpose of this study was to examine the impact of parental divorce, level of family conflict, and family history of alcoholism on the alcohol use patterns of college students. Gender differences were also explored. Multivariate Analysis of Variance revealed mixed results. Parental marital status was found to have no significant effect on college students' alcohol behavior. High family conflict had a significant impact on both level of current alcohol use and level of alcohol related problems. A positive family history of alcoholism was found to have effects on the level of alcohol related problems encountered by students. Gender played a significant role, with males reporting higher levels of alcohol-related problems. No significant interactions were found. Results, contributions and limitations of the study are discussed.

The purpose of this study was to examine the heritability, stability, and outcomes of antisocial behavior from adolescence into adulthood in a longitudinal twin sample. Specifically, the genetic and environmental influences on conduct disorder, adult antisocial behavior, and alcohol dependence were examined. The influence of genes and environment on the relationship between these disorders was also examined. The study utilized a subset of FinnTwin12, a population-based twin study that consists of five consecutive birth cohorts. The subsample consisted of 1035 twin pairs (N = 2070) and of that 2070, 1854 completed the intensive interview at age 14. At age 22, 1345 twins completed the interview. Participants in the study completed age-appropriate variations of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Analyses were run separately by gender. Results provide support for the significant influence of genetic factors on the development and persistence of antisocial behavior. For both males and females, model fitting indicated that genetic influences are the most influential contributor to the association between conduct disorder and adult antisocial behavior and its stability across time. Additionally, there were no age specific genetic effects suggesting that the genes influencing conduct disorder are the same as those influencing adult antisocial behavior. Results for the relationship between conduct disorder and alcohol dependence differed by gender. For females, insufficient power made it difficult for the model to discriminate between the effects of genetics and shared environment, but the full model suggested that shared environmental influences explained the greatest proportion of variance in the relationship. For males, genetic influences were primarily responsible for the relationship between conduct disorder and alcohol dependence. Similar results were found for males when the relationship between alcohol dependence and adult antisocial behavior was explored. For females, genetic and nonshared environmental influences were the primary source of covariation between these two disorders. The data suggest that the etiology of conduct disorder, adult antisocial behavior, and alcohol dependence vary by gender.

A research study submitted to the Faculty of Commerce, Law and Management, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Management in Strategic Marketing (MMSM) Wits Business School May 2017 / The research investigated the impact of three socialisation agents (i.e. advertising, parents and peers) and personal attitudes on alcohol consumption among South Africa youth. There is a growing concern of the high and year-on-year increase in alcohol consumption in the country which has not only been linked to social ills such as crime, violence, sexual abuse, but also to health concerns. Of greater concern is the ever growing penetration of alcohol consumption among young people. The South African government has pledged its support to the World Health Organisation to reduce the harmful use of alcohol; and appointed an Inter-Ministerial Committee (IMC) to develop programs that seek to reduce alcohol-related harm. The findings generated from this study provide insights into social influences and social interventions that might assist in reducing the harmful use of alcohol. The research employed a quantitative approach and was cross-sectional in design. Non-random quota sampling was employed and a total of 300 youths from Gauteng were issued with self-administered questionnaires. The young people were at different life stages; students, blue and white collar workers. Using SPSS 22 and AMOS 22 software programs, structural equation modelling (SEM) was performed to analyse the data set. The results revealed that personal attitude, peer influence, and advertising exposure have positive and significant influences on youth alcohol consumption. Parental influence had a positive, yet weak and unimportant, effect on youth alcohol consumption. The implication of the results in this study is that government, alcohol manufacturers and the community at large need to consider, and possibly prioritise, other harmful uses of alcohol interventions and address personal attitudes that young people have developed to reduce the effects of peer pressure. / MT2017

Esse estudo teve como objetivo avaliar a evolução dos pacientes com síndrome de dependência de álcool nas dimensões sociais e de saúde. Metodologia: O desenho metodológico do estudo é do tipo longitudinal e a mensuração da evolução do tratamento ocorreu por meio da abordagem quantitativa. A amostra foi composta por 35 pacientes de ambos os sexos com diagnóstico de síndrome de dependência alcoólica em tratamento no CAPS - AD II de Ribeirão Preto-SP. A evolução do tratamento foi realizada por meio de duas avaliações, sendo a primeira consulta no primeiro mês e a segunda agendada para três meses posteriormente ao início do tratamento. Para a coleta de dados utilizouse o The Addiction Severity Index ASI, um questionário que possibilita mensurar a evolução do tratamento considerando seis áreas de maior importância da vida da pessoa. Resultados: identificou-se que os usuários em tratamento no CAPS - AD II são adultos, a maioria do sexo masculino, de cor branca, solteiros/separados, católicos, possui baixo nível de escolaridade, quase a metade está desempregado e os que trabalham recebem uma renda mensal entre R$380 a R$1000. Para a análise estatística das áreas do ASI, dos dados sociodemográficos e do padrão de uso utilizaram-se o modelo estatístico da análise linear de efeitos mistos. Desse modo, a idade, a escolaridade, o estado civil, a religião, o emprego, a renda, os anos de consumo de álcool, a freqüência de uso e o valor em dinheiro gasto com o uso foram as variáveis que influenciaram na evolução do tratamento em cada área. Os resultados indicaram que a evolução do tratamento foi positiva ao longo dos três meses nas Áreas Uso de Álcool, Legal, Relação Família/Social e nas Condições Psiquiátricas. Conclusão: A relação entre o consumo do álcool e as conseqüências sociais e de saúde são complexas e multidimensionais. Avaliar a evolução do tratamento de pacientes alcoolistas de um CAPS - AD possibilitou identificar as características sociais e de saúde que podem contribuir de maneira mais apropriada no norteamento e planejamento da assistência a essa população. / This study aimed to evaluate the evolution of patients with alcohol dependency syndrome in terms of social and health dimensions. Methodology: The methodological design is longitudinal and the measurement of the treatment evolution occurred through qualitative approach. The sample was composed of 35 patients, both genders, with diagnosis of alcohol dependency syndrome in treatment at CAPS-ad II in Ribeirão Preto - SP, Brazil. The treatment evolution was measured through two evaluations, the first consultation in the first month and the second one scheduled for three months after the beginning of the treatment. The Addiction Severity Index ASI, a questionnaire that measures the treatment evolution considering six areas of high importance in a persons life, was used for data collection. Results: It was identified that users at CAPS-ad II, in treatment for alcoholism, are adults, male in their majority, white, single, catholic, with low schooling, almost half of them are unemployed, and those who work have a monthly income ranging from R$ 380 to R$ 1000. For the statistical analysis of the socio-demographic data, pattern of use, and ASI areas, the linear mixed-effects statistical model was used. This way, age, schooling, marital status, religion, work, income, years of alcohol consumption, frequency of use, and amount of money spent in each area were the variables that influenced the treatment evolution in each area. Results indicate that the treatment evolution was positive over the three months in the areas of Alcohol Use, Legal, Family/Social Relation and Psychiatric conditions. Conclusion: The relation between the consumption of alcohol and social and health consequences are complex and multidimensional. Evaluating the treatment evolution of alcoholic patients in one of the CAPS-ad allowed the identification of social and health characteristics that can contribute in a more effective way in the planning and guiding the care delivered to the services users.

O consumo abusivo do álcool e suas conseqüências vêm aumentando significativamente, constituindo sério problema para a saúde pública. Esses problemas representam alto custo social e comprometem diversas áreas da saúde. O presente estudo é do tipo descritivo e tem como objetivo identificar o apoio social para dependentes do álcool e analisar suas relações. A amostra foi composta por 50 usuários, cadastrados, e em atendimento no Centro de Atenção Psicossocial -Álcool e Drogas - CAPS ad.II, de Ribeirão Preto, com diagnóstico de síndrome de dependência do álcool. Para a coleta de dados foi utilizado questionário estruturado com perguntas fechadas, dividido em três partes: as informações sociodemográficas, o teste de identificação do uso do álcool (Audit) e o instrumento de apoio social Medical Outcomes Study (MOS). Resultados: 43(86%) do sexo masculi no, 26(46%) solteiros, 26(52%) adultos, faixa etária entre 30 e 49 anos, com baixo nível de escolaridade 31(62%), pois tinham o ensino fundamental completo ou incompleto, e 21(42%) estavam desempregados. Com relação ao uso do álcool, 44(88%) apresentaram níveis de provável dependência, ou dependência, do álcool, e 31(62%) iniciaram o uso do álcool na adolescência, entre 12 e 18 anos. Referente ao apoio social (apoio material, apoio afetivo mais interação social positiva, apoio emocional mais apoio de informação) de um modo geral, observou-se que os usuários apresentaram apoio social baixo, quando comparados os tipos de apoio, encontrou-se associação entre apoio afetivo e interação social positiva e a faixa etária, principalmente na idade de 50 anos, pois a chance de não terem apoio é 15 vezes maior quando comparado aos mais jovens. Os achados do presente estudo apontam para o desenvolvimento de programas direcionados a fortalecer o apoio social durante e após o tratamento do uso abusivo o álcool. / Binge drinking and its consequences have been increasing significantly, thus becoming a serious health problem. Such problems represent a high social cost and they adversely affect several health sectors.The present descriptive study aims to identify social support among alcohol dependent individuals and evaluate their association. The sample consisted of fifty alcohol users who signed up for treatment at the Center for Psychosocial Attention- Alcohol and Drugs (CAPS ad.II) in Ribeirão Preto, diagnosed with Alcohol Dependence Syndrome. For data collection, a questionnaire, divided into three parts, containing closed ended questions on social demographic information, the Alcohol Use Identification Test (Audit), and the Social Support Instrument Medical Outcomes Study (MOS) was used.RESULTS: 43 (86%) of the subjects were male, 26 (52%) were single, 26 (52%) were adults between thirty and forty nine years old with low educational level (they had not completed elementary school), and 21 (42%) were unemployed. As for alcohol use, 44 (88%) of the subjects presented level of probable dependence or alcohol dependence and 31 62%) started using alcohol between the age of twelve or eighteen. As regards social support, (material support, affective support plus positive social interaction, emotional support plus information support) subjects were found to count on low social support. When types of support were compared, an association between affective support and positive social interaction and age group emerged, mainly around the age of 50, for this age group is one fifteenth times as likely to count on social support when compared with younger subjects. These findings present indicators for the development of programs aiming to strengthen social support during and after binge drinking treatment.