Backgroud: Drinking to a level that causes harm to oneself or others is characterized by several terms in the alcohol literature. These include: alcohol abuse, alcoholism, excessive drinking, heavy drinking, and problem drinking. The latter is the term used throughout the dissertation. Findings across various alcohol measures and across time show that Blacks have lower prevalence rates of problem drinking than Whites. These results appear paradoxical. First Blacks have poorer health status than Whites for many health outcomes such as diabetes, hypertension, and cirrhosis of the liver--a chronic condition attributed to heavy alcohol use. Blacks lower problem drinking than Whites seem contrary to the way social determinants and tension-reduction theories are thought to influence health. According those theories and frameworks, exposure to poor economic and social circumstances are considered socioeconomic status-related stressors, which are risk factors for problem drinking. Blacks therefore would be expected to have higher prevalence rates of problem drinking because they are exposed to a greater number and frequency of poor socioeconomic status conditions, and greater frequency of stressors relative to Whites. Quite often, the typical investigation of Black-White differences in health aims to understand why Blacks have poorer health than Whites. I investigated problem drinking for my dissertation because I thought it was equally important to understand health and behavioral outcomes for which Blacks do better than Whites and to learn about what contributes to that better health. Levels of religious involvement, the salience of religion among groups, and the potential strength of religion to regulate the lives of individuals differ across social statuses such as race/ethnicity and socioeconomic status. That rationale is discussed through historical evolution of religion among Blacks, beginning slavery, through theories attributed to Max Weber and Karl Marx, and through analysis of a passage within the Holy Bible. Given that measures of religion differ across social status, it is plausible then that religion's protective effect on health too is expected to be different across social statuses. My second hypothesis is that the protective benefits of religion on problem drinking will be stronger among Blacks than Whites. My third hypothesis is that lower socioeconomic status is associated with higher levels of religious involvement. My fourth hypothesis is that the protective benefits of religion on problem drinking are stronger among persons with low compared to high socioeconomic status. Finally, I argue that the dual social location of low socioeconomic status and Black race creates an opportunity where the protective effects of religious involvement on problem drinking become compounded. My fifth hypothesis is that the protective effects of religious involvement on problem drinking among Black low socioeconomic status would explain their lower prevalence rates of drinking compared to Whites. Methods: A secondary data analysis was conducted using Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) among a sample of Non-Hispanic Blacks (n=6, 587) and Non-Hispanic Whites (n=20,161). The main dependent variable was DSM-IV alcohol abuse. A second variable, heavy drinking, which was used for sensitivity analyses, was derived from two variables (1) frequency of consuming 5+ drinks in a single day and (2) largest number of drinks in a single day. The exposure variables were four measures of religious involvement: (1) currently attending religious services, (2) frequency of religious service attendance, (3) count of the number of religious members one interacted with on a social basis, and (4) importance of spirituality in one's daily life. Education and income were the socioeconomic status (SES) variables. Race/ethnicity was a binary variable indicating Non-Hispanic Blacks versus Non-Hispanic Whites. Results: Detailed results of this analysis are presented in this dissertation. Conclusions: Overall, religion measures had a protective effect on problem drinking, but service attendance had the most robust association. It appears that religion and socioeconomic status are not competing factors that potentially explain race-differences, in fact, they work together. There appears to be some support for the perspective that Black-White differences are explained, or at least better understood, when socioeconomic status and religion operate in an interaction model framework. The lack of finding of Black-White differences across all combinations of religion and socioeconomic status, and those differences being dependent on the type of problem drinking measure used limits the ability to generalize to an overall hypothesis. There are some noteworthy contributions this dissertation that advances the state of knowledge on this topic. It appears that the effect of religion on DSM-IV alcohol abuse for Blacks operates under different model assumptions than for Whites. Therefore, statistical comparisons may not tell the full story of Black-White differences and I recommend a renewed focus on race-specific analyses. Two main theoretical contributions emerge from this study. First, these findings suggest that individual religiosity plays an important protective role on problem drinking for equally for Blacks and Whites. The study adds more evidence as to which dimensions of religiosity most salient for protecting against problem are drinking, which is lacking in the research literature. Second, sensitivity analyses showed that the type of alcohol measure one uses to characterize problem drinking has potential implications racial disparities in alcohol research.

Made available in DSpace on 2014-06-11T19:30:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-23Bitstream added on 2014-06-13T20:01:17Z : No. of bitstreams: 1 alonso_jmsl_dr_sjc.pdf: 1064371 bytes, checksum: 4b5574d1963cb808bb8dd39cc9e27047 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Condições sistêmicas do hospedeiro podem modular a resposta inflamatória periodontal, determinando variação em relação à susceptibilidade individual e velocidade de progressão da doença periodontal. Dentre os fatores sistêmicos adquiridos, a osteoporose e o alcoolismo são descritos na literatura, como indicadores de risco para a perda óssea associada à doença periodontal. Este estudo objetivou analisar, para ratas Wistar, a influência do consumo crônico do etanol 20% associado à deficiência estrogênica considerando aspectos histológicos e histomorfométricos. Foram utilizadas sessenta ratas, com aproximadamente noventa dias, divididas em dois grupos correlacionados à cirurgia (OVZ) ou simulação cirúrgica de ovariectomia (SHAM). Cada grupo foi dividido em três subgrupos: (C) dieta controle, (A) dieta alcoólica 20% e (I) solução isocalórica ao etanol 20%. Após trinta dias da castração, iniciou-se a dieta e indução de periodontite experimental no primeiro molar inferior esquerdo, as quais foram mantidas por 56 dias. As regiões interproximais entre primeiro e segundo molar inferior esquerdo e o sítio contralateral sem indução da doença periodontal foram avaliadas quanto ao nível ósseo, perda de inserção e características inflamatórias. Os resultados demonstraram que em relação à significância para SHAMC e OVZ-C, a deficiência hormonal não foi capaz de induzir ou agravar a perda óssea na doença periodontal, mas acarretou alterações inflamatórias importantes. Considerando os grupos SHAM e OVZ e a ausência de doença periodontal, o etanol acarretou perda óssea e alterações inflamatórias para ambos os grupos, sendo observada maior severidade quando combinado à ovariectomia. Nas ratas com periodontite induzida, OVZ ou SHAM... / The immune system has an important paper in pathogenesis of the periodontal disease, being the host can modulate periodontal inflammatory reaction, determining variance to individual susceptibility and speed of progression of the periodontal disease. Amongst systemic acquired factors, osteoporosis and alcoholism are described in the literature, as risk indicators for bone loss associated with periodontal disease. The purpose of this study was evaluate histological and histomorfometrics aspects on influence of the chronic alcohol consumption in the ligature-induced periodontitis in rats with estrogen deficiency for. Sixty rats were used, with approximately 90 days-old, divided into two groups correlated surgery (OVZ) or surgical simulation of ovariectomy (SHAM). Each group was divided into three subgroups groups (C) control diet, (A) ethanol 20% containing liquid diet and (I) par-fed control diet. After thirty days of castration, diet and experimental periodontitis induction, which were maintained by 56 days. Interproximal regions between first and second molar lower left and the respective contralateral site without induction of periodontal disease were assessed as to the level osseous insertion loss and inflammatory characteristics. The results showed that in relation to the significance to SHAM-C and OVZ-C, hormone deficiency was not able to induce or aggravate the bone loss, but periodontitis has resulted in important inflammatory changes. Whereas the groups SHAM and OVZ and the absence of periodontitis, ethanol has resulted in bone loss and inflammatory changes to both groups, and also greater severity when combined with ovariectomy. In rats periodontitis induction, OVZ or SHAM, the 20% ethanol consumption doesn’t affect exacerbate bone... (Complete abstract click electronic access below)

FundaÃÃo de Amparo a CiÃncia e Tecnologia de Pernambuco / O estudo tem como objeto a revisÃo do diagnÃstico de enfermagem Processos familiares disfuncionais relacionados a abuso de Ãlcool. Estudo metodolÃgico, desenvolvido em trÃs etapas: anÃlise de conceito, anÃlise de conteÃdo por especialistas e anÃlise da acurÃcia de indicadores clÃnicos. Para a realizaÃÃo da anÃlise de conceito, utilizou-se como referÃncia o modelo de anÃlise de conceito proposto por Walker e Avant e os passos da revisÃo integrativa da literatura. Procedeu-se à busca na literatura em trÃs bases de dados: SCOPUS, PubMed e CINAHL, com os descritores alcoolismo e famÃlia disfuncional e suas sinonÃmias nas lÃnguas inglesa e espanhola. ApÃs a aplicaÃÃo dos critÃrios de inclusÃo e exclusÃo, restaram 11 estudos de um total de 113 que subsidiaram a anÃlise do conceito. A partir da revisÃo do conceito famÃlia disfuncional e sua correlaÃÃo com o diagnÃstico de enfermagem Processos familiares disfuncionais, foi possÃvel reduzir o quantitativo de 115 caracterÃsticas definidoras para 91, por meio da exclusÃo de 24 caracterÃsticas que apresentaram significado semelhante a outros indicadores ou por nÃo se aplicarem a alcoolistas adultos. TrÃs caracterÃsticas foram condensadas em uma e foram incorporadas duas novas caracterÃsticas definidoras: abuso fÃsico e abuso sexual. Foram utilizados artigos, livros e dicionÃrios para a construÃÃo das definiÃÃes conceituais e operacionais das 91 caracterÃsticas definidoras. A segunda etapa do estudo, anÃlise de conteÃdo por especialistas, consistiu no julgamento por 23 especialistas quanto à relevÃncia, clareza e precisÃo das definiÃÃes construÃdas na etapa anterior. Dois itens foram julgados como inadequados no critÃrio relevÃncia e, portanto, excluÃdos do estudo. Dezessete itens tiveram suas definiÃÃes julgadas como inadequadas nos critÃrios clareza e/ou precisÃo e foram reformuladas. Duas caracterÃsticas tiveram seu rÃtulo modificado segundo sugestÃes dos especialistas. Para esta etapa, considerou-se o nÃvel de concordÃncia de 85%. A partir das definiÃÃes operacionais das 89 caracterÃsticas definidoras julgadas como relevantes pelos especialistas, foi construÃdo o instrumento de coleta de dados aplicado com 110 alcoolistas internados em uma unidade de cuidados prolongados para tratamento de alcoolismo crÃnico. Para a delimitaÃÃo da amostra, foi realizado cÃlculo amostral e estabelecidos critÃrios de inclusÃo e exclusÃo. Os dados foram coletados por meio de entrevista e analisou-se a presenÃa ou ausÃncia de cada indicador clinico. Os dados foram submetidos à anÃlise de classe latente, que permitiu encontrar um conjunto de vinte e quatro caracterÃsticas que apresentaram bom ajuste para a correta identificaÃÃo do diagnÃstico Processos familiares disfuncionais. As caracterÃsticas definidoras Papeis familiares interrompidos, Problemas econÃmicos e Rituais familiares interrompidos apresentaram boa sensibilidade e especificidade. As caracterÃsticas definidoras Abuso sexual, DistÃrbio no desempenho escolar em crianÃas, ManipulaÃÃo, Falta de coesÃo e Baixa autoestima crÃnica apresentaram valor de especificidade significativo. As demais mostraram valor de sensibilidade significativo: Mentiras, AngÃstia, Ansiedade, ConfusÃo, Constrangimento, Perda, Raiva, ComunicaÃÃo contraditÃria, Dificuldade com relacionamentos Ãntimos, Imaturidade, Tristeza nÃo resolvida, DeterioraÃÃo nos relacionamentos familiares, DinÃmicas familiares perturbadas, Problemas conjugais, InseguranÃa e SolidÃo. A revisÃo do diagnÃstico Processos familiares disfuncionais relacionados a abuso de Ãlcool possibilitou uma reflexÃo crÃtica acerca das caracterÃsticas definidoras constantes na NANDA-I, com vistas ao seu refinamento. Espera-se que este estudo possa auxiliar o enfermeiro na sua prÃtica assistencial a identificar o referido diagnÃstico de modo mais acurado. / The study focuses the review of the nursing diagnosis Dysfunctional family processes related to alcohol abuse. Methodological study, developed in three stages: concept analysis, content analysis by experts and analysis of the accuracy of clinical indicators. For the realization concept analysis, was used as reference the concept analysis model proposed by Walker and Avant and steps of the integrative literature review. Proceeded the literature search in three databases: SCOPUS, PubMed and CINAHL, with descriptors alcoholism and dysfunctional family and their synonyms in English and Spanish. After applying the inclusion and exclusion criteria, 11 studies remained from a total of 113 that supported the concept analysis. From the review of the concept dysfunctional family and its correlation with the nursing diagnosis of Dysfunctional family processes, it was possible to reduce the quantitative defining characteristics from 115 to 91, by deleting the 24 characteristics that were similar to other indicators or meaning is not apply to adult alcoholics. Three characteristics were condensed into one and were incorporated two new defining characteristics: Physical abuse and Sexual abuse. Articles, books and dictionaries were used to build the conceptual and operational definitions of the 91 defining characteristics. The second stage of the study, content analysis by experts consisted at trial of 23 experts for relevance, clarity and accuracy of definitions constructed in the previous step. Two items were judged as inappropriate in relevance criteria and therefore excluded from the study. 17 items had their definitions judged as inadequate on the clarity and/or precision criteria and have been reformulated. Two had their labels modified second suggestions from experts. For this step, was considered the level of agreement of 85 %. From the operational definitions of the 89 defining characteristics judged as relevant by experts, was built the instrument of data collection applied with 110 alcoholics admitted to a unit for extended care treatment of chronic alcoholism. For the delimitation of the sample, sample size calculation was performed and established criteria for inclusion and exclusion. Data were collected through interviews and analyzed for the presence or absence of each clinical indicator. The data were subjected to latent class analysis, which allowed to find a set of twenty-four characteristics that showed good fit for the correct identification of diagnostic Dysfunctional family processes. The defining characteristics Disrupted family roles, Economic problems and Disrupted family rituals showed good sensitivity and specificity. The defining characteristics Sexual abuse, Disturbances in academic performance in children, Manipulation, Lack of cohesiveness and Chronic low self-esteem showed the mean value of specificity. The other showed the mean value of sensitivity: Lying, Distress, Anxiety, Confusion, Embarrassment, Loss, Anger, Contradictory communication, Difficulty with intimate relationships, Immaturity, Complicated grieving, Deterioration in family relationships, Disturbed family dynamics, Marital problems, Insecurity and Loneliness.. A review of the diagnosis Dysfunctional family processes related to alcohol abuse provided a critical analysis of the defining characteristics listed in the NANDA-I, with a view to its refinement. It is hoped that this study can help nurses in healthcare practice to identify the diagnosis more accurately.

O uso indevido de drogas tem sido objeto de diversos estudos no Brasil, devido à crescente preocupação com os hábitos de consumo de drogas lícitas e ilícitas e seus impactos sociais, econômicos e, sobretudo, suas implicações na saúde da população. O objetivo desta pesquisa é estimar a prevalência do tabagismo e o uso de outras drogas e descrever o perfil epidemiológico, dos pacientes que frequentam o Centro de Fisioterapia Oscar Pires de Andrade do SUS de Itapira-SP. Trata-se de um estudo epidemiológico, descritivo, modelo inquérito, com uma abordagem metodológica quantitativa. Dos 399 pacientes agendados, foram entrevistados 217 (54,38%) pacientes, nos meses de julho e agosto de 2010. Os pacientes foram entrevistados pelo pesquisador deste trabalho conforme o Questionário Sócio Demográfico e sobre Prevalência do Tabagismo no Centro de Fisioterapia de Itapira - SP (SUS) e Teste de Fagerstrom para a Dependência a Nicotina (FTND) e Questionário ASSIST V. 3.0. A média de idade, dos pacientes entrevistados foi 50 anos, maioria é do sexo feminino (63, 13%), a moda de anos de escolaridade foi 11 anos e a mediana foi cinco. Lombalgia, cervicalgia e tendinite representaram juntos 50% dos encaminhamentos para fisioterapia com diagnóstico médico por explicitos. Mais da metade dos pacientes relataram ter outras doenças além daquela que foi motivo do encaminhamento para a fisioterapia, as doenças mais citadas pelos pacientes foi hipetensão e diabetes. Mais da metade dos pacientes relataram apenas uma queixa principal sendo a dor a queixa mais frequente. A prevalência de fumantes foi 17%, a média de idade dos pacientes fumantes foi 48 anos e 51% eram do sexo feminino, a maioria (89%) relatou fumar apenas cigarros comercializados, a mediana do número de cigarros fumados por dia foi 10 e a mediana de tempo que o indivíduo usou o tabaco foi 30 anos. A metade dos tabagistas foram classificados, de acordo com o FTND, como muito baixa e baixa dependência à nicotina, a média do escore de Fagerström foi de 4,1. Sobre o uso de substâncias psicoativas na vida, 70% dos pacientes relataram ter usado tabaco na vida; 91% bebidas alcoólicas; 14% maconha; 6% cocaína, crack; 11% inalantes; 10% hipnóticos, sedativos; somente um indivíduo relatou ter usado em sua vida inalante, e nenhum experimentou alucinógenos, opióides e outras drogas a especificar. Em relação à classificação do Questionário ASSIST, o tabaco (31%) e o álcool (31%) foram as drogas mais citadas para receber intervenção breve, seguido da maconha (3%), cocaína, crack (1%), anfetaminas (1%). As drogas legais como o álcool e o tabaco são os problemas de saúde pública mais proeminente no Brasil. Essa é uma situação preocupante e aponta a importância de trabalhar a prevenção de drogas psicoativas, nos serviços de atenção primária. / The misuse of drugs has been the subject of several studies in Brazil, due to growing concern about the consumption patterns of licit and illicit drugs and their negative social, economic, and especially its implications for population health. The objective of this research is to estimate the prevalence of smoking and the use of other drugs and describe the epidemiological profile of the patients attending the Physiotherapy Centre Oscar Pires de Andrade Itapira SUS-SP. This is an epidemiological study, descriptive model survey is a quantitative approach. Of the 399 patients scheduled were interviewed, 217 (54.38%) patients in the months of July and August 2010. Patients were interviewed by the researcher in this study as the Socio - Demographic Questionnaire on Smoking Prevalence and Fitness Center in Itapira - SP (SUS) and the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire and ASSIST V. 3.0. The mean age of patients interviewed was 50 years, most are female (63, 13%), the fashion of years of education was 11 years and the median was five. Low back pain, neck pain and tendinitis together accounted for 50% of referrals for physical therapy with medical diagnostic explicit. More than half of patients reported having other diseases beyond what was reason for referral for physical therapy, the disease most often cited by patients was hipetensão and diabetes. More than half of patients reported only one major complaint is the pain the most frequent complaint. The prevalence of smokers was 17%, the average age of smokers was 48 years and 51% were female, most (89%) reported smoking only cigarettes sold, the median of cigarettes smoked per day was 10 and median time that the person has used tobacco was 30 years. Half the smokers were classified according to the FTND, as very low and low nicotine dependence, the average Fagerström score was 4.1. On the use of psychoactive substances in life, 70% of patients reported having used tobacco in their lives, 91% alcohol, 14% marijuana, 6% cocaine, crack, inhalants 11%, 10% hypnotics, sedatives, only one person reported having used inhalants in their lifetime, and none experienced hallucinogens, opioids and other drugs to specify. Regarding the classification of the Questionnaire Assist, tobacco (31%) and alcohol (31%) were the most commonly cited to receive brief intervention, followed by marijuana (3%), cocaine, crack cocaine (1%), amphetamines (1% ). Legal drugs like alcohol and tobacco are the health problems more prominent in Brazil. This situation is worrisome and highlights the importance of working prevention of psychoactive drugs in primary care services.

O tema desta dissertação é o impacto do alcoolismo nas relações sociais, em especial, na família e no trabalho. No mundo existem 500 milhões de dependentes, 10 a 15% da população têm propensão à dependência. O consumo de álcool e outras drogas em ambiente de trabalho atinge 10 a 14% dos trabalhadores, eleva os atendimentos médicos e diminui a produtividade. O trabalho tem como ponto de partida a freqüência a reuniões de Alcoólicos Anônimos (AA) em regiões centrais e periféricas da cidade de São Paulo. A análise teórica é baseada nos conceitos de identidade e socialização. Segundo Habermas (1983) a identidade é gerada pela socialização, isto é, pela integração do sujeito ao sistema social, por meio da apropriação dos universais simbólicos. Contudo, em fase posterior, ela é garantida e desenvolvida pela individualização, ou seja, pela independência em relação aos sistemas sociais. O álcool, em princípio, exerce a função de \"modelador social\", favorecendo o relacionamento social, mas, a partir do avanço do processo de alcoolização, domina e destrói o cotidiano pessoal. Conforme avança o processo de alcoolização, maior o prejuízo das relações sociais. Conclui-se que o discurso médico influencia o AA e seus freqüentadores. Existem importantes diferenças entre os membros de AA, tais como, o período de desenvolvimento da dependência alcoólica, os tipos de profissão e os níveis educacionais e de rendimento. / This research presents an investigation on the impact of alcoholism in social relations, mainly in family and work ones. There are 500 million alcohol addicts in the world and 10 to 15% of the population is likely to be dependent one day. The consumption of alcohol and other drugs in work environments has impact on 10 to 14% of workers, which increases hospital assistance and decreases work productivity. The analysis in this investigation starts from AA meetings\' attendance in downtown and surrounding areas in São Paulo city. The theoretical analysis is underpinned by the concepts of identity and socialization. According to Habermas (1983), identity is created by socialization; i.e, by the acquisition of symbolic universals. However, later on, it is sustained and developed by the process of individualization; i.e., by getting independent in relation to social systems. At the beginning, alcohol has the function of social \"modeler\" and it favors social relationship. However, as the process of addiction advances, it dominates and destroys everyday life. As a conclusion, medical discourse influences AA and its participants. There are important differences among AA members, such as, development period of alcohol dependence, kind of occupation, educational and income levels.

Identificar e analisar a representação social dos enfermeiros de Hospital Geral frente ao paciente alcoolista e à etiologia para o alcoolismo. Os sujeitos do estudo foram 20 enfermeiros de três Hospitais Gerais de uma cidade do interior de São Paulo (Brasil). Os dados foram coletados por meio de entrevistas autogravadas que foram transcritas e analisadas pelo método da Análise de Conteúdo, tendo como categoria para análise o referencial teórico da representação social. Da análise dos dados, emergiram duas categorias empíricas: 1-Representação social dos enfermeiros frente ao paciente alcoolista e 2- Representação da etiologia para o alcoolismo Os resultados apontaram que os enfermeiros concebem o paciente alcoolista como uma pessoa doente, portanto, o alcoolismo como uma doença. Em relação ao trabalhar com esse tipo de paciente, alegaram que é de difícil manejo, tendo em vista que os profissionais não estão preparados para atuar com este tipo de paciente e que sua assistência é permeada pelo estigma e preconceito. Na representação desses enfermeiros, a etiologia do alcoolismo está relacionada às questões sociais, psicológicas, emocionais e biológicas. Concluiu-se que a representação dos sujeitos do estudo frente ao paciente alcoolista e a etiologia para o alcoolismo estão atreladas mais ao senso comum do que ao conhecimento técnico-científico, o que em última análise remete à necessidade de melhor preparo e capacitação dos profissionais enfermeiros sobre a temática álcool e alcoolismo, uma vez que o pouco conhecimento da temática pode contribuir para uma assistência fragmentada e pautada nas questões de ordem moral que permeiam o senso comum. / Identify and analyzed the social representation of General Hospital nurses front of the alcoholic patient and the etiology in order to alcoholism. The subjects of the study were 20 nurses from three General Hospital in a country town of São Paulo (Brazil).The data were collected through interviews self recorded that were transcribed and analyzed by The content Analysis Method, having as category for analysis the theoretical reference of social representation. From analysis of empirical data emerged two categories: 1 - Social representation of nurses front of alcoholic patient. 2- Representation of the etiology in order to alcoholism. The results pointed out that the nurses conceive the alcoholic patient as a sick person, therefore, the alcoholism as a disease. In relation to working with this type of patient, claimed that it is unwieldy, in order that professionals are not prepared to work with this type of patient and that its assistance is permeated by the stigma and prejudice. In the representation of these nurses, the etiology of alcoholism is related to social, psychological, emotional and biological issues. It was concluded that the representation of subjects of the study front of the alcoholic patient and the etiology in order to alcoholism are more tied to common sense than to scientific-technical knowledge, wich ultimately refers to the needs for better preparation and professional training of nurses on the thematic alcoholism, in that the few knowledge about the theme can contribute to a fragmented assistance and guided in matters of moral order that pervade common sense.

Desenvolveu-se uma escala para medir atitudes de enfermeiros frente ao álcool, ao alcoolismo e ao alcoolista (EAFAAA). Trata-se de uma escala do tipo likert que teve como fundamentação teórica os pressupostos de Pasqualli (1999). Para a elaboração dos itens da escala numa etapa inicial, realizou-se entrevista semi-estruturada com 30 enfermeiros, e da análise destas entrevistas foi extraído um total de 225 itens. O total dos itens foi submetido a análise de seis juízes especialistas no assunto. Após a análise somente 165 permaneceram. A escala composta por 165 itens foi submetida a um estudo-piloto com o objetivo de verificar as características estatísticas da mesma, para isso o instrumento foi testado numa população de 144 estudantes de enfermagem do último ano, de duas faculdades privadas. De posse dos instrumentos respondidos pelos 144 sujeitos, criou-se um banco de dados no programa SPSS (Satatistical Package for the Social Sciences v.8 for Windows), através do qual procedeu-se à análise estatística do instrumento. A análise fatorial originou uma escala composta por 96 itens divididos em cinco fatores: Fator 1: O Alcoolista, o trabalhar e o relacionar-se com o mesmo; Fator 2: Etiologia; Fator 3: Doença; Fator 4: Repercussões decorrentes do uso/abuso do álcool e Fator 5: A Bebida alcoólica. A consistência interna foi de 0,9068 (alfa). As correlações item-escore total variaram entre 0,35 e 0,65 com média de 0,50. Os dados de confiabilidade acima citados permitem concluir que se obteve um instrumento adequado para a finalidade e que pode ser útil para o conhecimento das atitudes de enfermeiros frente às questões referentes ao álcool, ao alcoolismo e ao alcoolista. Uma vez confirmada a confiabilidade da EAFAAA, a mesma foi testado numa população de 148 enfermeiros. A análise dos dados revelou que tanto enfermeiros quanto estudantes de enfermagem aceitam o alcoolismo enquanto doença, demonstrando atitudes positivas frente à mesma, porém encontrou-se uma parcela significativa de sujeitos com atitudes moralistas e condenatórias no que se refere a pessoa do alcoolista, concebendo-o inclusive como culpado por seus problemas de saúde. Sugere-se que outros estudos envolvendo a escala construída sejam realizados, no sentido de aprimorar sua qualidade estatística. Aponta-se ainda a necessidade de maior atenção à temática nos currículos de enfermagem, bem como a necessidade de novos métodos para a mudança de atitudes profissionais frente ao álcool, ao alcoolismo e ao alcoolista. / A scale of nurses’ attitudes towards alcohol, alcoholism and the alcoholic (EAFAAA) was developed. It is a Likert type scale based on Pasqualli’s (1999) theoretical framework. In order to elaborate the scale items, the author used a semi-structured interview with 30 nurses and these interviews’ analysis resulted in a total of 225 items. The items were evaluated by six peer reviewers specialized on the subject. After the analysis, 165 items were maintained. The scale with the 165 items was submitted to a pilot study with the purpose to verify some statistical characteristics. Thus, the instrument was tested in a population of 144 nursing students from two private Universities enrolled in the last year of their program. With the 144 instruments responded, the author created a data bank using SPSS (Statistical Package for the Social Sciences v.8 for Windows), and began the statistical analysis. The factorial analysis originated a scale with 96 items divided in five factors: Factor 1: The Alcoholic, the work and the relationship between them; Factor 2: Etiology; Factor 3: Disease; Factor 4: Repercussions of alcohol use and abuse and Factor 5: The Alcohol. The internal consistency was of 0.9068 (alpha). The item-score correlations varied from 0.35 and 0.65 with an average of 0.50. Data regarding reliability enabled the conclusion that the instrument is adequate to its aim and can be useful to learn more about nurses’ attitudes towards alcohol, alcoholism and the alcoholic. After the reliability confirmation, the scale was tested in a population of 148 nurses. Data analysis showed that nurses and nursing students accept alcoholism as a disease, demonstrating positive attitudes towards it. However, there was a significant number of subjects with moral and condemning attitudes regarding the alcoholic, considering them guilty in respect to their health problems. The author suggests the development of other studies involving the constructed scale with the aim of improving its statistical quality. He also points out the need for greater attention to the theme in the curriculum of the nursing undergraduate programs as well as the need for new methods to change the professional attitudes towards alcohol, the alcoholism and the alcoholic.

Objetivo: Analisar e descrever o perfil de expressão das proteínas relacionadas ao mecanismo de apoptose (PARP e AIF), e o perfil de expressão gênica sérica do microRNA-9 relacionado ao mecanismo de apoptose, em ratos submetidos à isquemia cerebral focal por oclusão da ACM por 90 minutos, seguida de reperfusão de 48horas, associado ou não com modelo de alcoolismo crônico. Métodos: Foram utilizados 20 ratos Wistar adultos, subdivididos em 4 grupos experimentais: grupo controle (C): animais submetidos apenas à anestesia; grupo isquêmico (I): animais submetidos à isquemia cerebral focal por 90 minutos seguido por reperfusão de 48 horas; grupo alcoolizado (A): animais que receberam diariamente álcool etílico absoluto diluído a 20% em água durante quatro semanas; e, grupo isquêmico e alcoolizado (IA): animais submetidos ao mesmo tratamento do grupo A e que, após quatro semanas foram submetidos à isquemia cerebral focal durante 90 minutos, seguido por reperfusão de 48 horas. As amostras do encéfalo coletadas foram processadas para a análise imunohistoquímica (para a expressão protéica de PARP-1 e AIF); e o sangue da artéria ventral da cauda foi coletado para a análise da expressão gênica do miRNA-9, relacionada ao mecanismo de apoptose, pela técnica de PCR em tempo real. Resultados: A comparação entre os grupos identificou uma redução da expressão proteica de PARP-1 nos animais do grupo AI quando comparado com os demais. Foi observada marcação positiva nuclear para a proteína AIF somente no grupo IA. Não houve diferença estatisticamente significante da expressão sérica do miRNA-9 entre os grupos. Conclusão: O modelo proposto, pode não ter sido suficiente para promover a ativação de AIF nos grupos C, A e I e desta forma, a apoptose celular por essa via analisada. A expressão proteica de PARP-1 no grupo A, associado com a expressão nula de AIF, indica um efeito neuroprotetor do etanol neste grupo. A redução da expressão proteica de PARP-1 não afetou sua atividade enzimática, proporcionando, mesmo em baixas concentrações, ativação de AIF no grupo IA. A expressão de PARP- 1 no grupo I, associada a expressão nula de AIF indica que o modelo de isquemia possivelmente gerou leves danos no DNA o que estimulou a ativação de PARP-1 somente em níveis suficientes para promover a reparação do DNA e não a ativação do processo de apoptose pela translocação de AIF. A expressão gênica sérica do miRNA- 9 observada indicou que a mesma foi suprimida quando exposta a mecanismos de estresse (alcoolismo, isquemia e a associação dos mesmos). A correlação do miRNA-9 com a expressão proteica de PARP-1 e AIF, indicou um aspecto protetor da baixa regulação do miRNA-9 tanto em animais alcoolizados como em animais isquêmicos. O grupo IA apresentou uma tendência a baixa expressão do miRNA-9, baixa expressão de PARP-1 e alta expressão de AIF, indicando que a associação álcool e isquemia tenha interferido no efeito protetor do miRNA-9 visto nos demais grupos / Aim: To analyze and describe the expression profile of proteins related to apoptosis mechanism (PARP and AIF), and profile of gene expression of miRNA-9 related to apoptosis mechanism in rats submitted to focal cerebral ischemia by occlusion of the CMA for 90 minutes, followed by 48 hours of reperfusion, associated or without associated to chronic alcoholism model. Methods: 20 adult Wistar rats were used, divided into 4 groups: control group (C): animals submitted only to anesthesia; Ischemic group (I): animals subjected to focal cerebral ischemia for 90 minutes followed by 48 hours of reperfusion; alcoholic group (A): animals that received daily solution of 20% of absolute ethyl alcohol diluted in water during four weeks; and ischemic group and alcoholized (IA): Animals subjected to the same treatment group A and after four weeks were subjected to focal cerebral ischemia for 90 minutes followed by 48 hours of reperfusion. The brain samples were collected and processed for immunohistochemical analysis (for protein expression - PARP-1 and AIF); and the blood from ventral artery of tail was collected for the analysis, by PCR in real time, of gene expression of miRNA-9 related to the mechanism of apoptosis. Results: The comparison between the groups identified a decrease in protein expression (PARP-1) in animals from IA group compared to others groups. Nuclear positive staining was observed for the AIF protein only in the IA group. There was no significant difference in serum expression of miRNA-9 between the groups. Conclusion: The proposed model may not have been sufficient to promote the activation of AIF in groups C, A and I, and thus the apoptosis analyzed in this way. Protein expression of PARP-1 in group A associated with a null expression of AIF, indicate a neuroprotective effect of ethanol in this group. The reduction of protein expression PARP-1 did not affect its enzymatic activity, providing even at low concentrations, activation AIF in IA group. The expression of PARP-1 in group I associated with null expression of AIF showed that model of ischemia, possibly, promoted light damage in DNA which stimulated PARP-1 activation just in sufficient levels to promote DNA repair, and without activation of apoptosis by translocation of AIF. The gene expression of miRNA-9 indicated that it was suppressed when exposed to mechanical stress (alcoholism, ischemia and combination thereof). The correlation of miRNA-9 with the protein expression (PARP-1 and AIF), indicated a protective aspect of downregulation of the miRNA-9 in both animals drunk as ischemic animals. IA group showed a trend to low expression of miRNA-9 and PARP- 1, in other hand an overexpression of AIF, indicating that the association between alcohol and ischemia interfered in protective effect of miRNA-9 seen in the other groups

Thesis (M.A. (Social Work)) -- University of Limpopo, 2018 / Refer to the document

Teen problem-d1inking is a pervasive problem in our society. Teens with drinking problems utilize treatment centers and then return to school attempting to stay sober. However, many return to affiliate with problem drinkers instead of with non-drinkers, and risk for relapse is high. One explanation may be that teens without drinking problems do not accept teen problem drinkers into their peer group due to negative reactions toward problem drinkers. One way to examine their attitudes is to examine differences between teen problem drinkers and non-drinkers regarding causal attributions. Attribution theory proposes that various attributions will elicit different emotional reactions and will motivate teens to behave in certain ways. The purpose of this study was to determine if teens with prior experience in treatment (problem drinkers) and teens without that experience (non-problem drinkers) make different causal attributions for teen problem drinking. Furthermore, group differences in emotional reactions, beliefs about how to offset the problem, and help-giving behaviors were also examined. This study also sought to determine whether there was a predictable link between attributions and emotional reactions, and between emotional reactions and helpgiving behaviors. One hundred twenty-one teenagers aged 13 to 20 were recruited as subjects, 79 from Portland area schools and 42 from treatment centers. Subjects completed a written survey measuring causal attributions for teen problem drinking, emotional reactions toward teen problem drinkers, beliefs regarding how to offset the problem, and help-giving behaviors. Four MANOYAs were used to determine group differences. Results revealed group differences on causal attributions, emotional reactions, and offset controllability, but not on help-giving behaviors. Two multiple regressions were used to determine whether attributions predicted emotional reactions and whether emotional reactions predicted help-giving behaviors; results revealed no link. Although results revealed group differences, these were found not to be consistent with the hypothesis based on attribution theory. Results did reveal positive outcomes regarding attitudes toward teen problem drinkers by nonproblem drinkers, which is important as it suggests that teens without prior experience in treatment may be more accepting of teen problem drinkers than was expected.