Thesis (M.S.)--University of Wisconsin. School of Nursing, 1976. / eContent provider-neutral record in process. Description based on print version record.

Dissertation (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Vita. Bibliography: pp. 193-208.

It is generally accepted that alcohol impairs haemodynamic physiology in normal subjects. Alcohol is also thought to have a detrimental effect in shock states. However, most research has concentrated on haemorrhagic shock, whereas in cardiac tamponade, the pathophysiology of shock is very different. Although some studies have mentioned alcohol as a negative factor in patients with cardiac tamponade, none have adequately assessed its effect. In a clinical study of 50 patients who presented to Groote Schuur Hospital Trauma Unit with acute cardiac tamponade due to penetrating chest injury, those who were intoxicated fared the same as their sober counterparts. Although more patients in the intoxicated group were "moribund" or "in extremis" on admission, this did not lead to a higher overall mortality. Haemodynamic parameters and results of special investigations in the two groups were also similar. These findings suggested that intoxicated patients with cardiogenic shock, specifically acute cardiac tamponade, behaved differently from intoxicated patients with haemorrhagic shock. However, the multitude of variables and the stress involved in treating patients with life-threatening acute conditions, makes studies such as this difficult. Because of these limitations, an animal model of acute cardiac tamponade was developed, so that actions of alcohol on haemodynamic physiology could be studied in a controlled environment. Fourteen young pigs were randomly assigned to receive either 30% alcohol or tap-water via a gastrostomy. The former resulted in blood alcohol levels which were compatible with moderate to severe intoxication. Cardiac tamponade was then induced by instilling warmed plasmalyte-8 into the pericardia! sac using a pressure-cycled system. Despite the fact that animals in the tamponade/alcohol group were more hypotensive, and reflex increase in heart rate was inhibited, cardiac output was similar in the two groups. The actions of alcohol in isolation were also studied in eight sham-operated pigs. The only noticeable effect in this instance were higher pulmonary artery wedge pressures in the sham/non-alcohol group. In other words, cardiac performance in both the tamponade/alcohol and sham/alcohol groups was at least equal to, or even better than that in animals that did not receive alcohol. It would seem therefore, that alcohol does not have a negative effect on haemodynamic physiology of acute cardiac tamponade. Theoretically, alcohol may "protect" patients with acute cardiac tamponade by decreasing peripheral vascular resistance and "afterload". It is also possible that inhibitory actions on the respiratory centre may prevent hyperpnoea or tachypnoea, and thereby diminish competitive filling of the right and left ventricles. However, further studies of cardiac function in intoxicated subjects with tamponade using more sophisticated techniques are necessary, before mechanisms will become apparent. In practice, an aggressive approach should be adopted towards moribund patients with penetrating chest injuries; if they have acute cardiac tamponade and are intoxicated, their prognosis is not necessarily dismal. This is of particular relevance in Cape Town, where both alcohol abuse and assault are endemic. As for a therapeutic effect of alcohol, these studies do not support its use for pharmacological manipulation of cardiac tamponade.

Esse estudo tem por objetivo validar o Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) e identificar os problemas relacionados ao uso de bebida alcoólica entre os idosos usuários da Unidade Saúde da Família (USF) do município de São Carlos (SP). O desenho metodológico do estudo é do tipo descritivo de abordagem quantitativa. Os dados foram coletados por meio de um questionário contendo as informações sociodemográficas e o MAST-G, seguindo as etapas de tradução e adaptação transcultural. A amostra foi constituída por 111 pessoas com idade igual ou superior a 60 anos cadastrados na USF do município de São Carlos. Do resultado, a idade média foi de 70 anos, sendo 45% do sexo masculino e 55% do sexo feminino, escolaridade média de 3 anos e 92% residem com a família. O MAST-G apresentou um bom índice de confiabilidade, com Alfa de Cronbach ? = 0,7873 e por meio da curva de ROC mostrou uma boa especificidade e sensibilidade no valor de corte de 5 respostas positivas, corroborando a literatura internacional. Pode-se concluir que o instrumento é de fácil aplicação e pouco intimidativo, além de ser possível averiguar diversas questões acerca do comportamento do beber do idoso e assim, possibilitando um atendimento especializado, pontual para que o idoso tenha uma assistência de qualidade. / This study aims to validate the Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) and to identify the pattern of consumption and alcohol use among elderly users of Family Health Units (USF) in the municipality of São Carlos (SP), Brazil. The methodological design of the study is a descriptive quantitative approach. Data were collected using an instrument that contains sociodemographic information and the MAST-G, following the steps of translation and cultural adaptation. The sample consisted of 111 people aged over 60 years who were enrolled in the USF of São Carlos. The result, the average age was 70 years, 45% male and 55% female, average schooling for 3 years and 92% living with family. The MAST-G had a good level of reliability, with Cronbach\'s alpha ? = 0.7873 and shows a good specificity and sensitivity in cut-off of 5 positive answers, as observed by the ROC curve, in good agreement with the literature. It could be concluded that the instrument is easy to be applied and less intimidating, besides being able to ascertain other questions about the behavior of the life of the elderly so it can allow a specialized service, timely so that the elderly have a better quality of assistance.

Esse estudo tem por objetivo validar o Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) e identificar os problemas relacionados ao uso de bebida alcoólica entre os idosos usuários da Unidade Saúde da Família (USF) do município de São Carlos (SP). O desenho metodológico do estudo é do tipo descritivo de abordagem quantitativa. Os dados foram coletados por meio de um questionário contendo as informações sociodemográficas e o MAST-G, seguindo as etapas de tradução e adaptação transcultural. A amostra foi constituída por 111 pessoas com idade igual ou superior a 60 anos cadastrados na USF do município de São Carlos. Do resultado, a idade média foi de 70 anos, sendo 45% do sexo masculino e 55% do sexo feminino, escolaridade média de 3 anos e 92% residem com a família. O MAST-G apresentou um bom índice de confiabilidade, com Alfa de Cronbach ? = 0,7873 e por meio da curva de ROC mostrou uma boa especificidade e sensibilidade no valor de corte de 5 respostas positivas, corroborando a literatura internacional. Pode-se concluir que o instrumento é de fácil aplicação e pouco intimidativo, além de ser possível averiguar diversas questões acerca do comportamento do beber do idoso e assim, possibilitando um atendimento especializado, pontual para que o idoso tenha uma assistência de qualidade. / This study aims to validate the Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) and to identify the pattern of consumption and alcohol use among elderly users of Family Health Units (USF) in the municipality of São Carlos (SP), Brazil. The methodological design of the study is a descriptive quantitative approach. Data were collected using an instrument that contains sociodemographic information and the MAST-G, following the steps of translation and cultural adaptation. The sample consisted of 111 people aged over 60 years who were enrolled in the USF of São Carlos. The result, the average age was 70 years, 45% male and 55% female, average schooling for 3 years and 92% living with family. The MAST-G had a good level of reliability, with Cronbach\'s alpha ? = 0.7873 and shows a good specificity and sensitivity in cut-off of 5 positive answers, as observed by the ROC curve, in good agreement with the literature. It could be concluded that the instrument is easy to be applied and less intimidating, besides being able to ascertain other questions about the behavior of the life of the elderly so it can allow a specialized service, timely so that the elderly have a better quality of assistance.

Thesis--Helsinki. / Errata slip inserted. Includes bibliographical references (p. 152-164).

Thesis--Helsinki. / Errata slip inserted. Bibliography: p. 152-164.

Compared with the population at-large, the Emergency Department (ED) population sees a high percentage of people with alcohol use and abuse problems. Therefore, the ED is well suited for the implementation of alcohol screening and interventions. It is important to be able to identify at risk drinkers who come to the ED for treatment for injury or other medical problems so that interventions may occur. Project ED Health conducted intensive interviews with harmful and hazardous drinkers presenting to the ED for treatment of injury or medical problem. The data was entered into a database and analyzed to find differences between injured and non-injured at risk drinkers. We found that 2/3 of at risk drinkers presented without injury. Compared to participants without injuries, injured individuals were significantly younger and more likely to be male. Injured and non-injured individuals had similar drinking patterns and health behaviors. Individuals at risk for alcohol-associated problems are similar in terms of drinking patterns and consequences and health status. Any screening tactic that is less than comprehensive, (i.e. that targets only injured individuals), will miss a significant number of at risk drinkers.

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 3 uppsatser.

Orientador: Paulo Dalgalarrondo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T11:23:44Z (GMT). No. of bitstreams: 1 SantosJunior_Amiltondos_M.pdf: 13683671 bytes, checksum: f0c8ea50d3f16860abe2649a14841e96 (MD5) Previous issue date: 2011 / Resumo: Objetivos: Pesquisar, em uma amostra de estudantes de graduação da Universidade Estadual de Campinas, se relatos de diferentes tipos de experiências de se sentir discriminado podem se relacionar a piores indicadores de qualidade de vida e a repercussões psicopatológicas, identificando possíveis fatores sociais, étnicos, demográficos e culturais com possível modulação sobre essas percepções. Métodos: Estudo de corte transversal, entre outubro de 2.005 a novembro de 2.006, incluindo estudantes de ambos os sexos, regularmente matriculados em diversos cursos dos períodos diurno e noturno e dos campi Barão Geraldo (Campinas) e Limeira, no qual foram analisadas respostas a um questionário anônimo, de autopreenchimento, aplicado em sala de aula, utilizando-se um tipo de amostra proporcional por áreas dos cursos de graduação. Foram utilizados instrumentos quantitativos para a avaliação de qualidade de vida (WHOQOL-Bref: World Health Organization Quality of Life assessment - forma abreviada), saúde mental (M.I.N.I.: Mini International Neuropsychiatric Interview); uso de risco de álcool (AUDIT: The Alcohol Use Disorder Identification Test); e uso de outras substâncias psicoativas (questionário baseado no método do Centro Brasileiro de Informação sobre Drogas Psicotrópicas - CEBRID). Respostas quantitativas de estudantes brancos, negros e pardos foram comparadas por análise bivariada simples e respostas abertas de perguntas aplicadas apenas a negros/pardos foram estudadas por grupamentos temáticos. Seguiu-se um pareamento do banco de dados primário em dois subgrupos: "brancos" e "negros/pardos", estratificados de acordo com características socioeconômicas deste último e analisados tanto descritivamente quanto por testes não paramétricos (qui quadrado e Mann-Whitney) e modelos de regressão linear e logística (univariadas e multivariadas). O nível de significância adotado para a análise estatística foi de 5%. Resultados: 1.174 alunos foram incluídos no banco de dados primário (89,8% dos respondedores, sendo 1.001 brancos, 144 pardos e 29 negros) e 346 no banco secundário, pareado. Negros/pardos foram o grupo com mais desvantagens socioeconômicas, pior qualidade de vida e com diferenças internas em termos de assunção de identidade étnica ou racial, com negros referindo mais discriminação, porém demonstrando mais orgulho e exploração da cultura afro que pardos. Nos dois grupos, em conjunto, houve predomínio de alunos menores de 26 anos, do sexo feminino e provenientes de famílias de baixo e médio nível socioeconômico. Indicadores de possíveis transtornos mentais e relatos de experiências de discriminação foram frequentes, principalmente os ligados à aparência física e ao nível socioeconômico. Houve correlações entre determinadas características sociodemográficas, tipos referidos de discriminação e respectivas influências sobre qualidade de vida, grupamentos de queixas psicopatológicas e uso potencialmente de risco de substâncias psicoativas. Conclusões: Categorias de discriminação e características pessoais sugestivas de mais sentimentos de inferioridade se relacionaram predominantemente a queixas psicopatológicas afetivas, internalizadas, e a pior qualidade de vida, enquanto aquelas sugestivas de sentimentos de estar à parte da maioria, por características pessoais específicas, relacionaram-se mais a queixas ansiosas e a potencial uso de risco de álcool e de outras substâncias psicoativas / Abstract: Objectives: To research, on a sample of undergraduate students from the University of Campinas, if reports of different kinds of experiences of feeling discriminated can be related to worse indicators of quality of life and to psychopathological repercussions, identifying possible social, ethnic, demographic and cultural factors which can exert modulation on these perceptions. Methods: Cross-sectional study, with data collected from October 2,005 to November 2,006, including students of both genders, regularly enrolled in various courses of daytime and nighttime periods from the campuses of Barão Geraldo (Campinas) and Limeira, in which there were analyzed answers to an anonymous self-administered questionnaire, applied in the classroom. Sample was proportional to the areas of the courses. Quantitative instruments were used to assess quality of life (WHOQOL-Bref: abbreviated World Health Organization Quality of Life assessment), mental health (M.I.N.I.: Mini International Neuropsychiatric Interview); potentially hazardous use of alcohol (AUDIT: The Alcohol Use Disorders Identification Test), and use of other psychoactive substances (an inventory based on the method of the Brazilian Center for Information on Psychotropic Drugs - CEBRID). Quantitative answers of White, Black and Brown students were compared by simple bivariate analysis and open answers to questions applied only to Black/Brown students were analyzed by thematic groupings. Secondly, it was performed a sample pairing procedure, with two groups ("Whites" and "Blacks/Browns"), matched according to socioeconomic characteristics of the latter. Subsequent analysis consisted of descriptive frequencies, non-parametric tests (chi-square and Mann-Whitney) and linear and logistic regressions models (both univariate and multivariate). The level of significance for the statistical analysis was 5%. Results: 1,174 students were included in the initial sample (89.8% of the respondents: 1,001 Whites, 144 Browns and 29 Blacks), and 346 in the matched sample. Black/Brown students were the group with more socioeconomic disadvantages, less quality of life and with internal differences in terms of assumption of ethnic or racial identity, with Blacks reporting more discrimination, but showing more pride and exploration of Afro culture than Browns. Considering the two groups together, there was a predominance of under than 26 year-old students, females and individuals from families of low and middle socioeconomic income. Indicators of possible mental health disorders and experiences of discrimination were common, mostly those related to physical appearance and to socioeconomic status. There were correlations between certain social and demographic characteristics, specific reports of discrimination and influences on quality of life, on groups of psychological complaints and on potentially hazardous use of psychoactive substances. Conclusions: Categories of discrimination and personal characteristics suggestive of feelings of inferiority were mainly correlated to affective and internalized psychological complaints and to worse quality of life, while those suggestive of being apart from the mainstream, by specific personal characteristics, were more related to anxious complaints and potentially hazardous use of alcohol and other psychoactive substances / Mestrado / Saude da Criança e do Adolescente / Mestre em Ciências