[pt] Esta dissertação propõe um estudo acerca da acentuação do controle dos corpos efetuado pelo regime farmacopornográfico (Paul B. Preciado) e sua produção de subjetividade, levando em conta a tensão entre as técnicas que compõem o que se habituou a chamar de humano e as invenções técnicas que se afastam do mesmo, das quais o bio-hackeamento e a intoxicação voluntária serão os exemplos analisados. Para isso, faz-se aqui um duplo movimento de investigação e experimentação dos conceitos de aliança intensiva (Deleuze e Guattari), ou alianças demoníacas (Viveiros de Castro), a partir de laços estratégicos possíveis entre os desumanizados pelo humanismo. Há também a proposição de uma alternativa ao humanismo levando adiante a provocação conceitual de Preciado de um animalismo por vir, em uma escrita especulativa que atravessa as obras de Eduardo Viveiros de Castro (Metafísicas Canibais) e Paul B. Preciado (Testo Yonqui). / [en] This dissertation proposes a study on the accentuation of the control of the bodies effected by the pharmacopornographic regime (Paul B. Preciado) and its production of subjectivity taking into account the tension between the techniques that compound what we are accustomed to call human and the technical inventions that deviate from it, of which the biohacking and the voluntary intoxication will be the examples analyzed. For this, a double movement of investigation and experimentation of the concepts of intensive alliance (Deleuze and Guattari), or demonic alliance (Viveiros de Castro), possible strategic ties between the dehumanized by humanism, is necessary. There is also the proposition of an alternative to humanism taking forward the conceptual provocation of Preciado of an animalism to come, in a speculative writing that runs through the works of Eduardo Viveiros de Castro (Cannibal Metaphysics) and Paul B. Preciado (Testo Junkie).

Made available in DSpace on 2016-06-02T19:46:21Z (GMT). No. of bitstreams: 1 4920.pdf: 489498 bytes, checksum: 9e4b0d1ab8d50b5b6eaedfc2626327aa (MD5) Previous issue date: 2007-02-26 / Financiadora de Estudos e Projetos / Lead is a toxic metal that affects all the organs and systems of the human body, being its absorption bigger in children and pregnant women. Although the harmful effect of lead in infantile development (e.g., hyperactivity, cognitive deficit, low efficiency at school, etc) there are no studies on the effect of intervention programs for this population. The objectives of this work were: 1. to compare, the acquisition of abilities (foreseen in the Portage Guide) for children of 3 to 5 years old, with average level of lead equal to 21 g/dl at four moments and 2. to verify the effect of two domiciliary interventions (A: individual training of the mother according to procedures of the Portage Guide, and the other, B: toys and models of tricks available to the child - environmental enrichment) in its performance. Two groups of 4 children were analyzed, being two groups of intervention and one of waiting control. The delineation counts on: evaluation retrospect (2002/03), a pre-test evaluation of all children in Portage Guide and HOME; implementation of the intervention programs with groups A and B (23 sessions); sounding the trained and emergent behaviors (application of the Portage Guide); retaken of the intervention program (9 weeks); post-test 1 (Portage Guide and HOME); post-test 2 (Portage Guide); post-test 3 with only one child of each group; besides the weekly evaluation of the children s performance through observation and record and posterior intervention with the controlled group. The results pointed to a decay of performance in the Portage Guide of evaluation 2002/03 for the pre-test, in the three groups, being the greater deficits in the cognition and language areas. After the period of intervention, children from group A got greater addition of behaviors, followed by group B and finally group C. The environment quality and care of these children came to be insufficient, but with improvements to the intervention for the submitted groups. It can be concluded that the two interventions speed up the development, but with better results for the intervention with parents guiding. The results indicate, also, that deficits of behavior tend to extend themselves throughout the time when it comes to this population. / O chumbo é um metal tóxico que afeta todos os órgãos e sistemas do corpo humano, sendo sua absorção maior em crianças e gestante. Apesar dos efeitos nocivos do chumbo no desenvolvimento infantil (ex., hiperatividade, déficit cognitivo, baixo rendimento escolar, etc) não existem estudos sobre o efeito de programas de intervenção para esta população. Os objetivos deste trabalho foram: 1.comparar, a aquisição de habilidades (previstas no Inventário Portage Operacionalizado - IPO) por crianças de 3 a 5 anos com nível médio de chumbo igual a 21 g/dl em quatro momentos e 2. verificar o efeito de duas intervenções domiciliares (A: treino individual da mãe segundo os procedimentos do IPO, e a outra B: disponibilização de brinquedos e modelos de brincadeiras à criança enriquecimento ambiental) no seu desempenho. Foram analisados três grupos de 4 crianças sendo dois grupos de intervenção e um de controle de espera. O delineamento conta com: avaliação retrospectiva (2002/03), uma avaliação pré-teste de todas as crianças no IPO e HOME; implementação dos programas de intervenção com os grupos A e B (23 sessões); sonda dos comportamentos treinados e emergentes (aplicação do IPO); retomada do programa de intervenção (9 semanas); pós-teste 1 (IPO e HOME); pós-teste 2 (IPO); pós-teste 3 com apenas 1 criança de cada grupo; além da avaliação semanal do desempenho das crianças via observação e registro e intervenção posterior com grupo controle. Os resultados apontam para queda de desempenho no IPO da avaliação 2002/03 para o pré-teste, nos 3 grupos, sendo os maiores deficits nas áreas de cognição e linguagem. Após o período de intervenção as crianças do grupo A obtiveram maior acréscimo de comportamentos, seguidas do grupo B e por último o grupo C. A qualidade do ambiente e cuidado destas crianças mostrou-se insuficiente, mas com melhoras para os grupos submetidos a intervenção. Pode-se concluir que as duas intervenções aceleram o desenvolvimento, mas com melhor resultado para a intervenção com orientação de pais. Os resultados indicam, também, que os deficits comportamentais tendem a se ampliar ao longo do tempo quando se trata desta população.

O presente trabalho consiste em um estudo epidemiológico, de corte transversal, sobre comportamentos de risco à saúde e sua associação com padrões de consumo de álcool, realizado entre a população de estudantes de graduação da Pontifícia Universidade Católica do Paraná. A pesquisa tem como objetivo descrever a prevalência de comportamentos de risco à saúde desses alunos e estudar a associação entre uso intenso de álcool e outros comportamentos de risco à saúde praticados por eles. O consumo intenso de álcool é definido neste trabalho como \"ter bebido cinco ou mais doses de álcool em, pelo menos, uma ocasião, nos últimos 30 dias\" e os comportamentos de risco considerados são aqueles monitorados pelo Centro de Controle e Prevenção de Doenças (CDC) dos EUA e com maior impacto na morbi-mortalidade do jovem contemporâneo. O recorte temporal (últimos 12 meses ou 30 dias) e de freqüência (1 vez, várias vezes, outros) variou dependendo do comportamento analisado. Os dados, obtidos por meio da aplicação de um questionário de autopreenchimento, anônimo, em uma amostra de estudantes sorteados (n= 1201), apontam que uma proporção elevada de estudantes se envolve em comportamentos de risco e a associação positiva entre consumo intenso de álcool e diversos desses comportamentos, apresentando variações de acordo com sexo e faixa etária. Os resultados permitem a constatação de que a ampla maioria dos bebedores intensos (77,7%) admite que seu padrão de consumo de álcool resultou em, pelo menos, 3 problemas, nos últimos 3 anos. Apesar das limitações próprias do estudo, seus resultados indicam a procedência do desenvolvimento de programas de promoção à saúde integral de universitários. / This paper presents a cross sectional study on health risk behaviors and their association with drinking patterns, among College students of the Catholic University of Paraná (Pontifícia Universidade Católica do Paraná) - PUCPR. Students were divided into 3 groups, according to their drinking patterns: binge drinkers, defined as having five or more drinks in at least, one single occasion during the last 30 days\", current drinkers (had some alcohol in the last 30 days but not reported a binge episode), and non drinkers (did not report alcohol use in the last 30 days). Risk behaviors considered in the study are those monitored by the Centers for Disease Control and Prevention (CDC) of USA and with greatest impact on the morbidity and mortality of the contemporary youth. The time periods (last 12 months or 30 days) and frequencies (once, many times, others) measured varied according to the behavior analyzed. Data obtained by means of an anonymous self completing questionnaire in a sample of randomized students (n=1201), documents that a great proportion of students get involved on risk behaviors and several of these behavior are positivetly associated with binge drinking. Results also lead to the conclusion that the majority of the binge drinkers (77,7%) admitted that their alcohol use behavior has resulted in, at least 3 problems during the last 3 years. Despite of study limitations, its results indicate the suitability of the development of programs for comprehensive student\'s health promotion.

Love Song is an essay about romance, passion, obsession, attraction, Eros, intoxication, infatuation, to fall in love and love. Love songs, as artworks, are almost always directed towards a nameless “you” and this essay wants to talk to you. The text might be seen as a way to create and rewrite something, a performance to understand other performances, a dwelling on past relationships, a love letter, or just a text for me to vent you with others that have been thinking about you. I would love to hear Elsa von Freytag-Loringhoven, Chris Kraus, Beyoncé, Bell Hooks, Anaïs Nin and Taylor Swift talk to each other about art and romances, but because that is an impossible dream I try to connect them and many other thinkers, artists and singers through language. One of them, Roland Barthes once wrote: "Language is a skin: I rub my language against the other. It is as if I had worlds instead of fingers, or fingers at the tip of my worlds."[1] Love Song is, more than anything else an attempted to touch you, a strategy to better understand the way you made and make me feel.   [1] Roland Barthes, A Lover’s Discourse – Fragments, original: Fragments d’un discours amoureux, 1977, translation from French: Richard Howard, Edition du Seuil, 1978, p. 73.

« Pour respecter les droits d’auteur, la version électronique de ce mémoire [de cette thèse] a été dépouillée de certains documents visuels et audio‐visuels. La version intégrale du mémoire [de la thèse] a été déposée à la Division de la gestion des documents et des archives » / Cette thèse s’intéresse à la présence opérante, dans plusieurs discours fondateurs du modernisme et dans certaines de ses pratiques, de l’ivresse comme concept, c’est-à-dire comme façon de penser la création artistique, ou comme méthode concrète d’intoxication permettant d’y accéder. Dans la première partie de la thèse, nous observons comment, au 19e siècle, les spéculations sur les états de conscience modifiés (alcool, opium, haschich, etc.) ont croisé les considérations poïétiques et esthétiques. Pour ce faire, nous mettons en rapport le développement d’un imaginaire de l’ivresse nourri de références à la peinture et des écrits sur la création artistique faisant bon accueil aux dérèglements psychophysiologiques. Afin de problématiser ce rapport de l’art et de l’ivresse qui est pour nous constitutif de l’esprit du modernisme, nous sollicitons les points de vue de quatre auteurs qui ont adopté une perspective physiologique sur l’art : Stendhal, Balzac, Baudelaire et Nietzsche. Notre traitement vise à préciser le développement d’une pensée de l’ivresse spécifique à chacun sans perdre de vue le contexte sociohistorique élargi dans lequel ils ont respectivement évolué. Il nous est ainsi possible de retracer l’émergence de la figure de l’artiste intoxiqué et d’en déterminer les résonances idéologiques. Dans la seconde partie de la thèse, nous observons les incidences de cette construction sur les pratiques artistiques elles-mêmes au cours du 20e siècle. En premier lieu, nous constatons les défis et les problèmes concrets qu’ont pu poser les états d’intoxication dans l’exercice du métier de peintre. Nous mettons ainsi à jour les raisons qui ont conduit les artistes des premières avant-gardes à tenir l’ivresse à distance. Nous nous intéressons ensuite à des peintres qui, à partir de l’entre-deux-guerres, ont plutôt recherché les états d’ivresse et développé des stratégies pour les exploiter à des fins créatrices : S.I. Witkiewicz, Josef Sima, André Masson, Jackson Pollock et Kazuo Shiraga. Nous remarquons d’abord que ces démarches tendent à se détacher d’un formalisme pictural rigoriste en accordant plutôt une fonction déterminante à l’empathie dans la création et dans la réception de l’œuvre d’art. Nous proposons ensuite de distinguer deux types d’expressions picturales de l’ivresse : l’une qui nécessite encore l’expédient de la figuration, l’autre qui s’appuie sur une mise en mouvement spontanée du corps de l’artiste. Les notions de trace et d’aura théorisées par Walter Benjamin nous permettent de rattacher ces deux façons de pratiquer l’ivresse à des manières d’envisager la création artistique à une époque marquée par le taylorisme ainsi que par les technologies de reproduction de l’image. / This thesis examines the operating presence of intoxication as a concept in many of modernism’s founding discourses as well as in some of its practices. Intoxication is considered both as a way to understand artistic creation and as a chemically-induced state allowing artists to access a specific kind of creativity. The first part of the thesis shows how, in the 19th century, speculations about altered states of consciousness (alcohol, opium, hashish, etc.) intersected with poietic and aesthetic considerations. To demonstrate this, we link the development of an imaginary construct of intoxication that is filled with references to painting with writings on artistic creation that celebrate psychophysiological disorders. To support our hypothesis that the relationship linking art and intoxication is constitutive of the spirit of modernism we solicit the points of view of four writers who have adopted a physiological perspective on art: Stendhal, Balzac, Baudelaire and Nietzsche. Our aim is to elaborate notions of intoxication that are specific to each without losing sight of their respective sociohistorical contexts. By doing so, it becomes possible to delineate the emergence of the figure of the intoxicated artist and to analyze its ideological character. In the second part of the thesis, we observe the implications of this construct on artistic practices during the 20th century. We begin by attesting to the challenges and material difficulties which states of intoxication can pose to painters. We thereby identity reasons why artists from the early avant-gardes kept their distance from intoxication. We then turn to painters who, from the inter-war period on, instead sought states of intoxication and developed strategies to exploit them to creative ends: S.I. Witkiewicz, Josef Sima, André Masson, Jackson Pollock and Kazuo Shiraga. First, we observe how these processes tend to detach themselves from a rigorist pictorial formalism, granting instead a determining function to empathy in the creation as well as the reception of the artwork. We go on suggest two distinct types of pictorial expression of intoxication: one which still requires the expedient of figuration, the other which is grounded in a spontaneous involvement of the artist's body. The notions of trace and aura theorized by Walter Benjamin allow us to tie these two modes of practicing intoxication to ways of conceiving artistic creation during a period distinguished by Taylorism as well as by image reproduction technologies.

Cette thèse est composée de deux parties. Dans la première partie, nous proposons une théorie pour l'interaction entre l'apprentissage par renforcement et les processus de régulation homéostatique. En fait, la régulation efficace de l'homéostasie interne et la défendre contre les perturbations a besoin des stratégies comportementales complexes pour obtenir des ressources physiologiquement épuisés. À cet égard, il est essentiel que les processus cérébraux de régulation homéostatique et les processus d'apprentissage associatifs travaillent de concert. Nous proposons une théorie computationnelle normative pour régulation homéostatique par l'apprentissage associatif, où la stabilité physiologique et l'acquisition de récompense s'avèrent les mêmes objectifs, réalisables simultanément. En théorie, le cadre résout la question de longue date de la façon dont le comportement manifeste est modulée par l'état interne, et comment les animaux apprennent à agir de manière prédictive pour empêcher des défis homéostasie potentiels (répondre par anticipation). Il fournit en outre une explication normative pour choix intertemporel, aversion au risque, la concurrence entre les systèmes de motivation, et le manque de motivation pour l'injection intraveineuse de produits alimentaires. Neurobiologiquement, la théorie suggère une explication pour le rôle de l'interaction par orexine entre les circuits hypothalamiques et les noyaux dopaminergiques du mésencéphale, comme une interface entre les états internes et les comportements motivés. Dans la deuxième partie de la thèse, nous utilisons le modèle présenté dans la première partie, comme base du développement d'une théorie de la dépendance à la cocaïne. Nous soutenons que la dépendance à la cocaïne provient du système de régulation homéostatique être détourné par les effets pharmacologiques de la cocaïne sur le cerveau. Nous démontrons que le modèle réussit à expliquer une variété des aspects comportementaux et neurobiologiques de la dépendance à la cocaïne , à savoir la grandissant de l’administration de cocaine sous les conditions de long accès a cocaïne, fonction dose-réponse pour la cocaïne , rechute à l'addiction à la cocaïne provoquée par amorçage, et l'interaction entre la disponibilité du récepteur de la dopamine D2 et dépendance à la cocaïne. / This thesis is composed of two parts. In the first part, we propose a theory for interaction between reinforcement learning and homeostatic regulation processes. In fact, efficient regulation of internal homeostasis and defending it against perturbations requires complex behavioral strategies to obtain physiologically-depleted resources. In this respect, it is essential that brains homeostatic regulation and associative learning processes work in concert. We propose a normative computational theory for homeostatically-regulated reinforcement learning (HRL), where physiological stability and reward acquisition prove to be identical objectives achievable simultaneously. Theoretically, the framework resolves the long-standing question of how overt behavior is modulated by internal state, and how animals learn to predictively act to preclude prospective homeostatic challenges (anticipatory responding). It further provides a normative explanation for temporal discounting of reward, and accounts for risk-aversive behavior, competition between motivational systems, taste-induced overeating, and lack of motivation for intravenous injection of food. Neurobiologically, the theory suggests a computational explanation for the role of orexin-based interaction between the hypothalamic circuitry and the midbrain dopaminergic nuclei, as an interface between internal states and motivated behaviors. In the second part of the thesis, we use the HRL model presented in the first part, as the cornerstone for developing an Allostatic Reinforcement Learning (ARL) theory of cocaine addiction. We argue that cocaine addiction arises from the HRL system being hijacked by the pharmacological effects of cocaine on the brain. We demonstrate that the model can successfully capture a wide range of behavioral and neurobiological aspects of cocaine addiction, namely escalation of cocaine self-administration under long- but not short-access conditions, U-shaped dose-response function for cocaine, priming-induced reinstatement of cocaine seeking, and interaction between dopamine D2 receptor availability and cocaine seeking.

Background/Aims: Adolescent alcohol binge-induced hospital admissions (BIHAs) are an increasing problem in Europe. We investigated whether psychosocial factors (e.g., drinking situations, drinking occasions and neighborhood unemployment) are associated with particularly risky patterns of alcohol or substance use. Method: We performed a systematic retrospective chart review of all the respective cases in 2003–2008 (n = 586; age range: 12–17 years) from both pediatric hospitals in the city of Dresden, Germany. Results: The vast majority of adolescent BIHAs were associated with drinking together with peers at weekend parties. Compared to this ‘typical’ drinking pattern, adolescents drinking ‘atypically’ (i.e., drinking either alone, to cope or despite the fact that the next day was a school/work day) more often had already used alcohol and illegal substances before and were more often diagnosed with substance use disorders and other mental disorders prior to BIHA. The unemployment rate in the patients’ neighborhood was positively related to the incidence proportion of adolescent BIHAs in the respective subdistricts (r s = 0.61). Conclusion: Adolescent atypical drinking may indicate an increased risk for the development of alcohol and substance use disorders. This information is quickly accessible and can alert clinicians to initiate psychosocial aftercare; their infrastructure should address the strong relation between BIHA probability and neighborhood unemployment rates.

Introduction : Les populations autochtones du Canada ont une incidence élevée d'empoisonnements, lesquels sont associés à une morbidité et mortalité élevées. Des soins sous-optimaux prodigués aux populations autochtones ont d'ailleurs été énoncés pour expliquer ce fardeau. Malgré ces constats alarmants, notre connaissance des soins d'urgence offerts à ces populations est très limitée. Notre étude se propose donc d'évaluer si des différences existent dans le continuum de soins des patients victimes d'empoisonnement, vivant en milieu rural dans la province de Québec au Canada, en fonction de l'origine ethnique. Méthodologie : Nous avons réalisé une étude de cohorte rétrospective multicentrique à partir des données du Centre antipoison du Québec (CAPQ) entre 2016-2017. Les patients d'origine autochtone ont été comparés aux patients non-autochtone, tous vivant en région éloignée. Notre critère de jugement principal était la durée de prise en charge prodiguée par le CAPQ. Une méthode de régression linéaire généralisée a été utilisée pour évaluer les différences de durée de prise en charge entre les groupes. Une analyse différenciée selon le sexe a également été effectuée. Notre critère de jugement secondaire était la gravité des symptômes au terme du suivi. Résultats : Parmi 362 patients (184 autochtones/178 non-autochtones), nous n'avons pas observé de différence dans le délai de prise en charge entre les groupes (GMR ajusté=1,09 [IC 95% 0,87 ; 1,38]). L'association n'était pas différente en fonction du sexe. Les symptômes au terme du suivi étaient légers à modérés pour la majorité des patients (78%). Un seul cas de décès a été enregistré dans chaque groupe. Le CAPQ a reçu très peu de références des Premières Nations dites 'non-conventionnées'. Conclusion : Nous n'avons pas observé de disparités de prise en charge chez les patients vivant en région éloignée. La perception de soins sous-optimaux offerts aux populations autochtones semble liée à l'éloignement géographique et non à l'origine ethnique. / Background : Indigenous population have a high incidence of poisoning cases across Canada, which is associated with high morbidity and mortality. A suboptimal provision of health care was suggested to explain such burden. Unfortunately, very little information is available to describe the specific presentations of poisoning cases in Indigenous populations. There fore, our study aims to assess whether differences exist in the continuum of care of poisoned patients living in rural regions in Quebec, Canada, according to their ethnic origin. Methods : We conducted a multicenter retrospective cohort study using data from the Centre antipoison du Québec (CAPQ) between 2016 and 2017. Indigenous poisoned patients were compared to non Indigenous patients living in rural areas. Our main outcome was the duration of involvement by the CAPQ in case management, reflecting the time required to complete toxicological management. Generalized linear regression was used to evaluate differences in the duration of poison center involvement between the two populations. A sex-specific analysis was also conducted. Our secondary outcome was the symptom severity at the conclusion of management. Results : Among 362 identified poisoned patients (184 Indigenous and 178 non-Indigenous), we observed no differences in the duration of case management between groups (GMR adjusted = 1.09; [95% CI 0.87;1.38]). Moreover, the sex-specific analysis showed that the association was not significant in either male or female groups. High proportion of patients, in both Indigenous and non-Indigenous groups, showing mild to moderate symptoms at follow-up (78%). One death was registered in each group. The CAPQ received very few calls from the non-conventioned First Nations during the study period. Interpretation : We did not observe any difference on the duration in case management of cases between patients living in rural areas. Perceptions of suboptimal care provided to rural Indigenous population are likely to be related to geographical remoteness rather than ethnicity.

Introduction : Les populations autochtones du Canada ont une incidence élevée d'empoisonnements, lesquels sont associés à une morbidité et mortalité élevées. Des soins sous-optimaux prodigués aux populations autochtones ont d'ailleurs été énoncés pour expliquer ce fardeau. Malgré ces constats alarmants, notre connaissance des soins d'urgence offerts à ces populations est très limitée. Notre étude se propose donc d'évaluer si des différences existent dans le continuum de soins des patients victimes d'empoisonnement, vivant en milieu rural dans la province de Québec au Canada, en fonction de l'origine ethnique. Méthodologie : Nous avons réalisé une étude de cohorte rétrospective multicentrique à partir des données du Centre antipoison du Québec (CAPQ) entre 2016-2017. Les patients d'origine autochtone ont été comparés aux patients non-autochtone, tous vivant en région éloignée. Notre critère de jugement principal était la durée de prise en charge prodiguée par le CAPQ. Une méthode de régression linéaire généralisée a été utilisée pour évaluer les différences de durée de prise en charge entre les groupes. Une analyse différenciée selon le sexe a également été effectuée. Notre critère de jugement secondaire était la gravité des symptômes au terme du suivi. Résultats : Parmi 362 patients (184 autochtones/178 non-autochtones), nous n'avons pas observé de différence dans le délai de prise en charge entre les groupes (GMR ajusté=1,09 [IC 95% 0,87 ; 1,38]). L'association n'était pas différente en fonction du sexe. Les symptômes au terme du suivi étaient légers à modérés pour la majorité des patients (78%). Un seul cas de décès a été enregistré dans chaque groupe. Le CAPQ a reçu très peu de références des Premières Nations dites 'non-conventionnées'. Conclusion : Nous n'avons pas observé de disparités de prise en charge chez les patients vivant en région éloignée. La perception de soins sous-optimaux offerts aux populations autochtones semble liée à l'éloignement géographique et non à l'origine ethnique. / Background : Indigenous population have a high incidence of poisoning cases across Canada, which is associated with high morbidity and mortality. A suboptimal provision of health care was suggested to explain such burden. Unfortunately, very little information is available to describe the specific presentations of poisoning cases in Indigenous populations. There fore, our study aims to assess whether differences exist in the continuum of care of poisoned patients living in rural regions in Quebec, Canada, according to their ethnic origin. Methods : We conducted a multicenter retrospective cohort study using data from the Centre antipoison du Québec (CAPQ) between 2016 and 2017. Indigenous poisoned patients were compared to non Indigenous patients living in rural areas. Our main outcome was the duration of involvement by the CAPQ in case management, reflecting the time required to complete toxicological management. Generalized linear regression was used to evaluate differences in the duration of poison center involvement between the two populations. A sex-specific analysis was also conducted. Our secondary outcome was the symptom severity at the conclusion of management. Results : Among 362 identified poisoned patients (184 Indigenous and 178 non-Indigenous), we observed no differences in the duration of case management between groups (GMR adjusted = 1.09; [95% CI 0.87;1.38]). Moreover, the sex-specific analysis showed that the association was not significant in either male or female groups. High proportion of patients, in both Indigenous and non-Indigenous groups, showing mild to moderate symptoms at follow-up (78%). One death was registered in each group. The CAPQ received very few calls from the non-conventioned First Nations during the study period. Interpretation : We did not observe any difference on the duration in case management of cases between patients living in rural areas. Perceptions of suboptimal care provided to rural Indigenous population are likely to be related to geographical remoteness rather than ethnicity.

Schätzungen über die Gesamtzahl der Vergiftungen in Deutschland belaufen sich auf 150 - 200.000 pro Jahr. In Deutschland machen Vergiftungsfälle 10% der in Notaufnahmen und auf Intensivstationen behandelten Patienten aus. Bis dato gibt es in Deutschland nur wenige strukturiert erfasste epidemiologische Daten von vergiftungsbedingten Todesfällen. In der vorliegenden Arbeit wurden die vergiftungsbedingten Todesfälle aus dem Giftinformationszentrum-Nord (GIZ-Nord) für den Zeitraum vom 01.01.1996 bis einschließlich 31.12.2009 retrospektiv analysiert. Insbesondere vor dem Hintergrund der Toxikovigilanz konnten folgende Fragen zu Risikokonstellationen für letale Vergiftungen durch diese Arbeit beantwortet werden: 1. Gibt es bei den vergiftungsbedingten Todesfällen jahreszeitliche Schwankungen? Ja, die vergiftungsbedingten bzw. suizidalen letalen Intoxikationen zeigen jahreszeitliche Schwankungen mit einem maximalen Anteil im Frühling von knapp 30% und dem geringsten Anteil im Herbst mit etwa 20%. 2. Bergen die iatrogen bedingten Vergiftungen ein besonderes Mortalitätsrisiko? Ja, die iatrogenen Vergiftungen weisen die höchste Mortalitätsrate mit knapp 5 ‰ aller iatrogenen Expositionen auf, vor allem bei parenteraler Arzneimittelapplikation. 3. Stellen Adoleszente (Heranwachsende und Jugendliche) und Senioren über 70 Jahre besonders gefährdete Altersgruppen für letale Intoxikationen dar? Ja, beide Populationen stellen besondere Risikogruppen für vergiftungsbedingte Todesfälle dar. Vor allem männliche Heranwachsende repräsentieren eine Risikogruppe für letale Intoxikationen durch Abusus. 30% aller vergiftungbedingten Todesfälle durch Abusus sind bei männlichen Jugendlichen aufgetreten. Senioren (Männer und Frauen) über 70 Jahre sind eine im hohen Maß gefährdete Altersgruppe für letale Vergiftungen. Einerseits ist die relative Mortalitätsrate bezogen auf alle Expositionen dieser Altersgruppe mit knapp 6 ‰ am höchsten. Andererseits zeigen die suizidalen Intoxikationen bei den Senioren eine zunehmende Tendenz. Außerdem bilden Senioren mit einem Anteil von 24% die Gruppe mit dem größten Anteil an den letalen nicht suizidalen Intoxikationen. Mehr als 70% der akzidentellen letalen Intoxikationen und 50% der letalen Vergiftungen durch Verwechslungen betreffen Senioren, dabei sind Frauen mehr als 3fach häufiger betroffen als Männer. Darüber hinaus sind Senioren durch Aspiration schäumender, prinzipiell niedrig toxischer Kosmetika und tensidhaltiger Chemikalien besonders gefährdet. 4. Gibt es bei den gewerblichen Expositionen besondere Risikokonstellationen? Ja, die gewerblichen Expositionen, die mit einer hohen Männerlastigkeit auftreten, bergen eine hohe letale Intoxikationsgefahr. Vor allem bei den gewerblichen inhalativen Expositionen von toxischen Reizgasen besteht eine Gefährdung für die betroffenen Beschäftigten, aber auch für die nicht selbstgeschützten Ersthelfer: 6% der inhalativen gewerblichen Intoxikationen durch Schwefelwasserstoff endeten letal.