Orientador: Juliana Alvares Duarte Bonini Campos / Banca: Juliana Alvares Duarte Bonini Campos / Banca: João Bosco Faria / Banca: Patrícia Petromilli Nordi Sasso Garcia / Resumo: O objetivo deste estudo foi identificar o padrão de consumo de álcool entre estudantes do ensino médio do município de Passos-MG e sua associação com fatores sócio-demográficos. Para tanto, apresenta-se três capítulos. No capítulo 1 realizou-se uma revisão de literatura para identificar a magnitude, os fatores de risco e de proteção e as consequências do consumo de bebidas alcoólicas na adolescência. No segundo capítulo, estimou-se a confiabilidade do Teste de Identificação de Desordens Devido ao Álcool (AUDIT) em 62 estudantes do ensino médio do município de Passos - MG e verificou-se excelente consistência interna ( =0,77) e reprodutibilidade ( =0,92). O capítulo 3 foi realizado com o objetivo de identificar o padrão de consumo de álcool entre estudantes do ensino médio de Passos - MG e sua associação com fatores sóciodemográficos. Para tanto, adotou-se delineamento amostral probabilístico estratificado segundo o tipo de instituição de ensino (pública e privada), número de estudantes por escola, série cursada e sexo. Participaram do estudo 1.967 adolescentes. Para identificação de desordens devido ao álcool utilizou-se o questionário AUDIT. Realizou-se estatística descritiva, o teste de qui-quadrado e regressão logística múltipla. O nível de significância adotado foi de 5,00%. A média de idade dos participantes foi de 15,84±1,23 anos e 57,38% eram do sexo feminino. O primeiro contato com o álcool ocorreu aos 13,37±1,92 anos. Dos adolescentes, 30,96% eram abstêmios, 45,76% apresentaram comportamento de beber moderado, 16,47% beber de risco, 3,51% beber de alto risco e 3,31% possível dependência. Houve associação significativa entre o risco de beber e o sexo ( 2=9,640, p=0,002), relacionamento do adolescente com a mãe ( 2=14,603, p=0,001), trabalho ( 2=8,754, p=0,003), nível econômico ( 2=4,074, p=0,044) e escolaridade do chefe... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The aim of this study was to identify the pattern of alcohol consumption among high school students in the municipality of Passos-MG, and its association with socialdemographic factors. For both, has three chapters. In Chapter 1 there was a literature review to identify the magnitude, risk factors and protection and the consequences of alcohol consumption in adolescence. The second chapter aims to estimate the reliability of the Alcohol Use Disorder Identification Test (AUDIT) in 62 high school students in the municipality of Passos - MG and there was excellent internal consistency ( =0.77) and reproducibility ( =0.92). Chapter 3 was carried out to identify the pattern of alcohol consumption among high school students from Passos-MG and its association with social-demographic factors. Thus, adopted probabilistic sampling design was stratified by type of education institution (public and private), number of students per school, set course and sex. Study participants were 1,967 adolescents. For identification of disorders due to alcohol using the AUDIT questionnaire. There was descriptive statistics, the chi-square test and multiple logistic regression. The significance level was 5.00%. The average age of participants was 15.84±1.23 years and 57.38% were female. The first contact with alcohol occurred at 13.37±1.92 years. Of adolescents, 30.96% were abstainers, 45.76% had moderate drinking behavior, drinking risk 16.47%, 3.51% high-risk drinking and 3.31% possible dependency. There was a significant association between the risk of drinking and sex ( 2=9.640, p=0.002), with the relationship of adolescent mothers ( 2=14.603, p=0.001), work ( 2=8.754, p=0.003), economic level ( 2=4.074, p=0.044) and education of the head of the family ( 2=8.754, p=0.003). In multivariate analysis was a higher risk for adolescent males (OR=1.292, 95%CI=1.038- 1.608), with lack of good... (Complete abstract click electronic access below) / Mestre

Orientador: Selma Maria Michelin Matheus / Resumo: A ingestão de etanol compromete a estrutura do cérebro, apresentar efeitos bifásicos sobre a atividade motora, agindo como um estimulante ou depressor dependendo da dose ou a duração de utilização. Ele interfere na absorção e metabolismo de vitamina D3, o que se correlaciona com alguns distúrbios neurológicos e neuropsiquiátricos. Há relatos sobre a associação de etanol com alterações ósseas, incluindo baixos níveis de vitamina D3. Com base nisso, o objetivo deste estudo foi avaliar os efeitos em testes de comportamento da administração isolada de vitamina D3 ou a sua administração em associação com etanol, durante alcoolismo crônico. A fim de conseguir isso, foram utilizados dois grupos experimentais: ratos Wistar machos (n = 20) e ratos UChB linhagem machos (n = 20) (bebedores voluntários de etanol). Ambos os grupos foram divididos em dois subgrupos: Vitamina D3 - 12.5μg / kg / dia (500 UI) de colecalciferol (WV, n = 10, e UV, n = 10), e de controle (CC, n = 10, e UC, n = 10), durante um período de 75 dias. O peso corporal análises e testes de comportamento (reflexo de sobressalto acústico e campo aberto) foram realizados em 90 e 165 dias de idade. Além disso, os níveis de plasma de corticosterona foram medidos a 165 dias, sem diferença estatística entre os grupos experimentais. O grupo Wistar apresentou valores mais baixos ASR no momento final (Controle e completada), enquanto as percentagens PPI foram maiores no grupo inicial. No grupo UChB houve nenhuma diferença em perc... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Ethanol intake compromises brain structure, presenting biphasic effects over motor activity, acting as a stimulant or depressor depending on the dose or duration of use. It interferes in vitamin D3 absorption and metabolism, what correlates to some neurologic and neuropsychiatric disorders. There are reports on the association of ethanol with bone alterations, including low levels of vitamin D3. Based on that, the objective of this study was to evaluate the effects in behavior tests of isolated administration of vitamin D3 or its administration in association with ethanol, during chronic alcoholism. In order to achieve that, two experimental groups were used: male Wistar rats (n=20), and UChB lineage male rats (n=20) (volunteer ethanol drinkers). Both groups were divided in two subgroups: Vitamin D3 – 12.5µg/kg/day (500 UI) of cholecalciferol (WV, n=10, and UV, n=10), and Control (WC, n=10, and UC, n=10), for a period of 75 days. Body weight analyses and behavior tests (acoustic startle reflex and open field) were conducted at 90 and 165 days of age. In addition to that, corticosterone plasma levels were measured at 165 days, with no statistical difference between the experimental groups. The Wistar group presented lower ASR values in the final moment (Control and supplemented), while the PPI percentages were higher in the initial group. In the UChB group there was no difference in PPI percentages with the pre-stimuli used. When the ASR responses were compared between groups ... (Complete abstract click electronic access below) / Mestre

abstract: The purpose of this study is to investigate the literacy practices of three members of Alcoholics Anonymous (A.A.) and to explore how they use these practices to support and maintain their recovery in their lives. This study also aims to examine how each participant used specialist language, enacted certain identities and acquired the secondary Discourse in A.A. through literacy use. This dissertation study is the result of in-depth interviewing in which each participant was interviewed three times for 90-minutes. These interviews were then transcribed and analyzed using discourse analysis. Study results are presented in three chapters, each one designated to one of the participants. Within these chapters is a life history (chronology) of the participant leading up to the point in which they got sober. The chapters also include a thematic discourse analysis of the interview transcripts across themes of literacy practice and topics in A.A. A conclusion is then presented to investigate how literacy was used from a sociocultural perspective in the study. Due to the emotionally charged nature of this dissertation, it has been formatted to present the stories of the participants first, leaving the theoretical framework, literature review and research methods to be included as appendices to the main text. / Dissertation/Thesis / Ph.D. Curriculum and Instruction 2013

Este trabalho foi realizado com a finalidade de demonstrar a utilização de nitrogênio de dietas enterais quimicamente definidas ( DE) comparadas com dieta geral via oral em um grupo de pacientes alcoólatras crônicos. Além de verificar o efeito das DE na recuperação do estado nutricional destes pacientes. Para SG atingir este objetivo foram realizado:. basicamente balanços rnctabólicos nitrogenados ( BN) e aminoacidogramas venosos na internação e alta dos pacientes. Foram estudados 20 indivíduos do sexo masculino, com idade variando entre 25 e 64 anos ( média = 39,5), 15 brancos e 5 não brancos, divididos ao acaso em 3 grupos de 7, 7 e 6 pacientes respectivamente. Todos eram alcoólatras crônicos e ingeriam em media 1 litro de aguardente por dia. Em 7 pacientes foi feito clinicamente o diagnóstico de pelagra, em 5 de neuropatia periférica e em 1 de cirrose hepática, Um outro tinha ascite. Em 2 pacientes houve retenção de bromosulfaleina entre 20 e 30 % e em outros 2 entre 10 e 20 %, sondo nos demais pacientes inferior a 10%. Do ponto de vista nutricional estes indivíduos foram classificados como soado de baixo risco, segundo Sauberlich e cols., 1974. Aos 2 primeiros grupos de pacientes foram oferecidas dietas enterais quimicamente definidas e ao terceiro grupo uma dieta geral habitual, A oferta nitrogenada ± 16 g/dia) E calórica ( ± 3000 calorias/dia) foi mantida constante nos 3 grupos. No primeiro . grupo toda oferta calórica foi proveniente de hidratos de carbono e proteínas, portanto sem lápides. Nós 2 outros Grupos a oferta calórica foi balanceada entre 10% de proteínas, 65% de hidratos de carbono e, 25% de gorduras. As DE Foram constituídas basicamente de uma solução de L-aminoácidos, sacarose, vitaminas c minerais, com ou sem lápides. A dieta geral incluia arroz, feijão, carne e legumes ou verduras. Os pacientes foram internadas na Unidade Metabólica da Disciplina de Nutrologia, Departamento de Clínica Médica da Faculdade de Medicina de Ribeirão Preto, durante aproximadamente 15 dias, sendo 12 para o estudo. O período inicial de adaptação ao ambiente e à dieta foi de 6 dias. Nos 6 dias finais todo nitrogênio ingerido, fecal e urinário foi dosado e calculado o balanço metabólico nitrogenado aparente. De cada paciente na internação e alta foram dosados os níveis de aminoácidos venosos. Também foi calculado quantide de de nitrogênio absorvido em relação ao ingerido e a digestibilidade verdadeira das 3 dietas. Os principais ratos observados foram: 1. A ingestão de nutrientes foi mantida constante nos pacientes submetidos às 2 dietas enterais o que não foi possível nó terceiro grupo, que recebia dieta geral. 2. A absorção das dietas enterais foi significativamente superior à da dieta Geral. 3. O peso e\' quantidade de nitrogênio focal foram significativamente inferiores nos indivíduos submetidos a dietas enterais. 4. A digestibilidade verdadeira mostrou valores estatisticamente superiores para as dietas enterais. 5. A analise dos resultados das 2 dietas enterais não mostrou diferenças entre elas. 6. Ao final do estudo observou-se uma tendência de melhoria de todos os parâmetros antropométricos e laboratoriais utilizados na avaliação do estado nutricional. Não houve diferenças entre ás pacientes que receberem as 3 dietas. 7. Os níveis de aminoácidos plasmáticos na admissão e na alta não apresentaram diferenças nos 3 grupos de pacientes. 8. As dietas enterais utilizadas são facilmente administradas e controladas, não tendo sido encontrados problemas com efeitos colaterais indesejáveis. / The objective of this research was to determine the utilization of nitrogen from chemically defined enteral diets ( ED), compared with oral diets, by groups of chronic alcoholic patients. The effect of ED on the recovery of nutritional status by the patients was also determined. The methods used were metabolic nitrogen balance ( WE ) and amino acid analysis of venous blood. The study was done on 20 males, If range 25-64 years ( mean age = 39,5). The subjects ( 15 White and 5 non-White individuals) ware divided at into 3 croups of 7, 7 and 6 patients, respectively. All were chronic al coholics, whose mean daily intake was 1 liter of sugar cane liquor. Seven of the patients were diagnosed as having pellagra, 5 as having peripheral neuropathy, and 1 cirrhosis of the liver. Another patient had ascites. Two patients showed 20 to 30 %. bromosulfalein retention, and 2 more showed 10 to 20 %, while the -remainder had less than MID retention. Nutritionally , these individuals were classified as low risk accoreiiny to Sauberlich .et al., 1974. The first 2 groups were offered chemically defined cntcral diets, while the third group received a usual general diet. The amount of nitrogen ( ± 16 g/day) and of calories ( 3000 cal/day) was kept constant for all groups. The calories offered to the first group consisted solely of carbohydrate and protein, without lipids. The two remaining groups received a balanced diet, with calories distribute as approximately follows: 10% protein, 65% carbohydrate and 25% fat. The .EDs consisted basically of a solution of L-amino acids, sucrose, vitamins and rninerals, with without lipide.The general diet include rice, beans meat and legumes or vegetables. The patients were admitte to the Metabolic unit of the Discipline of Nutroloyy, Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto, where they remained far 15 days, 12 of which devoted to the study, The initial period of adaptation to the environment and diet lasted 6 days. During the final 6 days, all ingested nitrogen as well as fecal and urinary nitrogen were measured and the metabolic nitrogen balance was calculated. The levels of peripheral venous amino acids were measured for each patient upon admission and at discharge. The amount of absorbed nitrogen in relation to ingested nitrogen and the true gestibility of the three diets were also calculated. The following main observations were made: 1. Nutrient intake was kept constant for the patients submitted to the two enteral diets, whereas this was not possible for the third group which received the oral diet. 2. Absorption of the enteral diets WQS significantly higher than that of the oral diet. 3. The weight and amount of fecal nitrogen were significantly 6 lower for the individuals submitted to the enteral diets. 4. True digestibility was statistically higher for the enteral diets. 5. The two enteral diets gave equal results. 6. At the end of the study, a tendency towards improvement was observed for all anthropometric and laboratory parameters used to evaluate nutritional status. No differences were observed axons the patients who received the three diets. 7. No differences in plasma amino acids upon admission and at discharge were found among the three groups. 8. The enteral diets used are easy to administer and to control, and produced no problems or undesirable side effects..

D.Litt. et Phil. / Please refer to full text to view abstract

D.Phil. (Social Work) / The treatment of out-patient alcoholics has thus far commanded little research attention in South Africa. The present investigation alms to provide a profile of the characteristics both of clients who approach out-patient clinics for help and of those who render service in this field. Additionally, an attempt is made to delineate the nature of treatment received by outpatient alcoholics and to link any subsequent relapse to aspects of such treatment and to characteristics which they evidence. In this way characteristics of clients which may be indicative of favourable prognosis as well as specific components of treatment which may promote rehabilitation are identified. All 390 alcoholic clients who approached the 26 out-patient clinics in South Africa for help during 1st April to 30th June 1981 inclusive, comprise the research universe. To each of these clients an interview schedule was administered by professional staff members at the various clinics in order to obtain i~formation pertaining to major client characteristics. Such staff members, by means of a standardised check list, also monitored the nature of treatment received by each client in the investigation. The relapse of clients was ascertained by the researcher personally tracing their readmission at any in- or out-patient clinic in South Africa within one year of their individual dates of discharge from clinics where they were drawn for inclusion in the investigation. In order to identify the major characteristics of staff members, especially those pertaining to their employment at the various clinics, the researcher personally administered an interview schedule to each of the 84 professionals who comprise the staff research universe. These staff members were directly involved in rendering service to the 390 out-patient clients during the course of their formal treatment periods.

M.Tech. / Alcohol intoxication is often linked to crime, motor vehicle accidents, violence and acts of aggression. There is currently no reversal agent or antidote available for alcohol intoxication. A study conducted by the University of Johannesburg, reports positive results when using Chelidonium 3cH and 30cH to reduce breath alcohol levels. Homeopathy is a therapeutic system based primarily on the Law of Similars. The drug picture of Chelidonium majus is well matched to the symptom picture of acute alcohol intoxication and is thus a well-indicated remedy to treat the symptoms of this condition. The aim of this study was to determine the efficacy of the homeopathic preparations Chelidonium majus 3cH and 30cH to reduce breath alcohol levels when compared to a placebo. This was a double blind, placebo controlled study. The sample groups were recruited using advertisements at the University of Johannesburg Doornfontein Campus and surrounding areas and consisted of thirty male participants between 20 and 45 years of age. Participants were required to attend three experimental sessions. The researcher completed a selection form to exclude interested parties with abnormal vital sign readings, diabetes, drug or alcohol addiction, history of cerebrovascular accident (stroke), diagnosed hypotension or hypertension, diagnosed hyperlipidaemia, liver or gallbladder disease, recent head trauma, taking any medication contra-indicating alcohol ingestion or history of chronic cardiac or renal disease. The Widmark formula was used to determine the exact amount of 43% brandy, diluted with cola drink to obtain a 20% volume-to-volume dilution. These calculations were done according to the weight of each participant to ensure that their breath alcohol concentrations were increased to the legal limit of 0.08 mg/dL. In the first session, the participants only consumed the alcohol to establish a baseline reading for their breath alcohol levels. During session two participants in the experimental group received a single powder medicated with Chelidonium majus 3cH. Participants in the placebo group received an unmedicated powder. During session three participants in the experimental group received a single powder medicated with Chelidonium majus 30cH. Participants in the placebo group received an unmedicated powder. During each session breath alcohol measurements were taken and recorded at twenty minutes, forty minutes, sixty minutes and eighty minutes after the initial alcoholic beverage has been ingested. The breath alcohol readings were statistically analysed and compared by Ms. Riette Eiselen, Head: Statistical Consultation Services (STATKOM), University of Johannesburg. Independent sample t-tests and a Mann-Whitney test were used to determine if there was any significant difference between the median breath alcohol reductions of the experimental and the control group. These tests indicated that there was no significant difference between the median breath alcohol reductions of the experimental and the control group on any variable at any point in time for any one of the sessions. A One Way Analysis of Variance (ANOVA) test was utilised to determine if there was any significant reduction in breath alcohol levels during the 3 sessions in both the experimental and control groups. The test revealed that both groups showed a significant decrease in breath alcohol concentrations but that there was no significant difference between the breath alcohol reductions between groups. Participation in the study was voluntary and withdrawal or refusal to continue was allowed at any time. Participants had the option to remain anonymous. Since Chelidonium majus 3cH and 30cH are rarely associated with side effects, the risk factors for participants in the study were minimal and no adverse effects were anticipated. In the event of an emergency, medical personnel were on standby. Participants were requested not to leave the venue until breathalyzer tests revealed a breath alcohol concentration of 0.01 g/dL. The results of the study were made available to the participants on request.

Master of Public Health - MPH / Since the anecdotal assumption is that GPs do not effectively diagnose and manage problem drinking amongst their patients, this study investigated the role of GPs in addressing problem drinking in Cape Town as well as the prevalence of problem drinking amongst their patients. / South Africa

The purpose of this study was to examine the effectiveness of psychoeducational group techniques in reducing an individuals' level of alcohol intake. It was hypothesized that when one is more educated about alcoholism, and how the addictive behavior began, their level of alcohol intake will decrease. To test this hypothesis, the researcher monitored changes in the alcohol involvement of a middle-aged African American woman engaged in psychoeducational group treatment. The researcher monitored these changes by administering the subject a standardized questionnaire developed by Hudson, before intervention, during intervention, and after completion of intervention. The results of the study show that by involvement in psycho-educational groups and cognitive therapy, the subject was able to reduce her overall level of alcohol intake.

Alcoholics Anonymous (AA) is the world’s largest and most recognisable recovery ‘program’, and central to its philosophy is the 12 Step Program. AA is a global organisation of 2.2 million members worldwide (AAWS, 2001), with a reported 3,600 weekly meetings in the United Kingdom (AAWS, 2011). AA has made many claims in their literature about the program’s effectiveness (AAWS, 2001: 84). Alcoholism is associated with a number of very serious health and social problems, including involvement in crime (Finney 2004; Fitzpatrick, 2010; Alcohol Reduction Strategy 2003). As fiscal pressure mounts, groups such as AA will be of interest to policy makers. Through an analysis of interviews with twenty long-term abstinent members of Alcoholics Anonymous, the thesis seeks to explain the effects of participation in AA’s therapeutic practices. Evidence from the literature on AA, revealed three concepts key to understanding participation in AA: Motivation to Engage (MtE), Structured Social Engagement (SSE), and Personal Agency (PA). A hypothetical model of AA-mediated behavioural change, constituted by these elements, was constructed and the findings supported this putative model. Further analysis revealed the coping strategies members of AA employed that ensured engagement with AA during stressful life events that threatened abstinence. The model was adapted to incorporate the temporal effects of long-term engagement with AA. Elements of Maruna’s (2001: 73) Condemnation Script resonated in the narratives of AA members. Contra Maruna’s analysis, AA members accepted ‘condemnation script’, but these were not negative, limiting beliefs. AA’s therapeutic practices structure, a coherent sense of self, one that supports cessation from negative patterns of drinking. The data exposed the sustained usage of AA’s discourse in the narrative accounts given. This finding extends Borkman’s (1976) Experiential Knowledge thesis, a language of ‘truth’ based on personal experience. The ‘linguistic echoes’ embedded in each narrative, suggests that a person uses AA’s discourse to ‘scaffold’ their recovery. This thesis provides an explanation of AA’s therapeutic practices of how adherence to AA’s principles, cognitively restructures the individual towards mastering self-control. AA’s philosophy and the following empirical evidence asserts abstinence as pre-requisite for recovery from alcohol dependence.