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Patients with type 2 diabetes (T2D) are at risk for non-alcoholic fatty liver disease (NAFLD) and associated complications. This study evaluated the performance of international (EASL-EASD-EASO) and national (DGVS) guidelines for NAFLD risk stratification. Patients with T2D prospectively underwent ultrasound, liver stiffness measurement (LSM) and serum-based fibrosis markers. Guideline-based risk classification and referral rates for different screening approaches were compared and the diagnostic properties of simplified algorithms, genetic markers and a new NASH surrogate (FAST score) were evaluated. NAFLD risk was present in 184 of 204 screened patients (age 64.2 ± 10.7 years; BMI 32.6 ± 7.6 kg/m2). EASL-EASD-EASO recommended specialist referral for 60–77% depending on the fibrosis score used, only 6% were classified as low risk. The DGVS algorithm required LSM for 76%; 25% were referred for specialised care. The sensitivities of the diagnostic pathways were 47–96%. A simplified referral strategy revealed a sensitivity/specificity of 46/88% for fibrosis risk. Application of the FAST score reduced the referral rate to 35%. This study (a) underlines the high prevalence of fibrosis risk in T2D, (b) demonstrates very high referral rates for in-depth hepatological work-up, and (c) indicates that simpler referral algorithms may produce comparably good results and could facilitate NAFLD screening.

Thesis (MScAgric)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The WineScan FT120 is widely used in wine laboratories across South Africa. The WineScan FT120 uses Fourier transform infrared (FT-IR) spectroscopy with multivariate data analysis to correlate spectra with chemical compositional data. Ready-to-use, commercially available calibration models for a FT-IR spectroscopy instrument are an advantage for unskilled users and routine analysis. Introducing spirit products to this technology introduced new interferences, which necessitated vastly different calibrations models to compensate for the changes. Accuracy, precision and ruggedness of the reference methods validated during method validation, verified the suitability of the reference methods used to quantify the parameters in question before calibration model building was attempted. Various principal component analysis (PCA) were performed prior to the calibration step with the aim to identify outliers and inspect groupings. PCA models could identify samples with atypical spectra and differentiate between product types. Two tactics regarding data sets for calibration set-up was experimented with, all the products together and calibration models per product. Partial least squares (PLS) regression was used to establish the calibration models for ethanol, density, obscuration and colour. With all the calibration models, the calibration models based on the product specific data sets, achieved better predicting statistics. The best performing ethanol calibration models achieved Residual mean square error of prediction (RMSEP) = 0.038 to 0.106 %v/v and showed significant improvement on previously reported prediction errors by Lachenmeier (2007). The results for the density calibration showed a similar trend, with the product specific calibration models outperforming the calibration model when all samples were included into one calibration model. This study produced novel results for quantification of obscuration (RMSEP = 0.10 and 0.09 in blended brandies and potstill brandies, respectively) and colour (RMSEP < 2.286 gold units) of brandies and whiskies. The correlation coefficients (R²) between true and predicted values, for the four parameters tested, indicated good to excellent precision (0.8 < R² < 1.0). Minimising the variation between the samples of the data set, gave more accurate regression statistics, but this resulted in a lower residual predictive deviation (RPD) value (< 5) that indicated models were not suitable for quantification. Adding more samples per product will add more variability into a data set per product, increase the SD and result in an increase in the RPD. The results pave the way for the development of calibration models for the quantification of other parameters for specific products. Following the groupings of product types, further classifications of brandy brands were investigated. PCA plots showed clear separation between potstill brandies and blended brandies and some degree of clustering between some of the blended brands was observed. Classification of brandies were investigated using the Soft Independent Modeling of Class Analogy (SIMCA) approach resulting in a total correct classification rates between 81.25% and 100% for the various brandy brands. These preliminary results were very promising and highlight the potential of using FT-IR spectroscopy and multivariate classification techniques as a tool for rapid quality control and authentication of brandy brands. Using this work as base for further classification projects, this could be of great benefit to the alcoholic beverage industry of South Africa. Future work will involve the development of a database comprised of more products guaranteed authentic to expand the discriminating options. The results suggest FT-IR spectroscopy could be useful in authentication studies. / AFRIKAANSE OPSOMMING: Die WineScan FT120 is ‘n algemeen gebruikte instrument regoor Suid-Afrika. Die WineScan FT120 gebruik Fourier-transformasie-infrarooi (FT-IR) spektroskopie tesame met multiveranderlike statistiese metodes om spektra te korreleer met chemiese samestellingsdata. Die kommersieël beskikbare kalibrasiemodelle vir die FT-IR spektroskopie-instrument is ‘n voordeel vir onbedrewe gebruikers en roetine ontleding. Blootstelling van spiritusprodukte aan die tegnologie, het nuwe hindernisse bekend gestel en dus is verskillende kalibrasiemodelle genoodsaak om hiervoor te kompenseer. Akkuraatheid, presiesheid en ruheid van die verwysingsmetodes is geëvalueer tydens metodevalidasie. Die verwysingsmetodes is geskik verklaar vir die konstruksie van die kalibrasiemodel met geverifieërde akkurate verwysingsresultate. Verskeie multiveranderlike hoofkomponentanalise (MVK) was uitgevoer voor die kalibrasiestap met die doel om uitskieters te identifiseer en groeperings te inspekteer. MVK modelle kon monsters met atipiese spektra identifiseer en onderskei tussen verskillende produk tipes. Twee taktieke aangaande datastelsamestelling is getoets tydens kalibrasiemodel-opstelling, al die produkte saam en kalibrasiemodelle per produk soos met die MVK aangedui. Parsiële kleinste kwadraat (PKK)- regressie is gebruik vir die opstel van die kalibrasiemodelle vir etanol, digtheid, obskurasie en kleur. Met al die kalibrasiemodelle het die produk spesifieke kalibrasiemodelle beter regressiestatistiek gelewer. Die beste presterende etanol kalibrasiemodelle het ‘n standaardvoorspellingsfout (SVF) = 0.038 tot 0.106 %v/v bereik en het ‘n beduidende verbetering getoon op vorige gerapporteerde studies op spiritusprodukte (Lachenmeier, 2007). Die resultate vir die digtheidskalibrasiemodelle het ‘n eenderse tendens getoon soos die etanol, met die produk spesifieke kalibrasiemodelle wat beter presteer het. Hierdie studie was eerste in sy soort met die kalibrasiemodel vir obskurasie (SVF = 0.10 en 0.09 in gemengde brandewyne en potketel brandewyne, onderskeidelik) en kleur (SVF < 2.286 goud eenhede) van brandewyne en whiskies. Die bepalingskoëffisiënt (R²) vir die vier parameters, dui op goeie tot uitstekende presiesheid (0.8 < R² < 1.0). Vermindering van die variasie tussen die monsters in die datastel, het meer akkurate regressiestatistiek teweeg gebring, maar ‘n laer relatiewe voorspellingsafwyking (RVA) waarde (<5) tot gevolg gehad wat aan dui dat hierdie modelle nie geskik is vir sifting of kwantifisering nie. Die byvoeging van meer monsters per produk sal meer verskeidenheid in die datastel per produk bring, wat dan die standaardafwyking sal laat toeneem en uiteindelik die RVA laat toeneem. Die resultate het die fondasie gelê vir die ontwikkeling van kalibrasiemodelle vir die kwantifisering van ander parameters vir spesifieke produkte. As opvolg tot die groeperings van die produk tipe, waargeneem in die MVK modelle, was klassifikasie van brandewyn handelsmerke ondersoek. MVK modelle het duidelike skeiding gewys tussen potketel en gemengde brandewyne en tot ‘n sekere mate groepering tussen handelsmerke. Klassifikasie van brandewyne was ondersoek met behulp van the Soft Independent Modeling of Class Analogy (SIMCA) met die resultaat van ‘n totale korrekte klassifikasiekoers van tussen 81.25% en 100% vir die verskeie brandewyn handelsmerke. Hierdie voorlopige resultate toon belowend en beklemtoon die potensiaal van FT-IR spektroskopie en chemometrics tegnieke as toerusting vir die vinnige kwaliteitskontrole en egtheid van brandewyn handelsmerke studies. Met hierdie werk as basis vir verdere klassifikasie projekte, kan dit ‘n groot aanwins wees tot die alkoholiese drank industrie van Suid-Afrika. Toekomstige werk sal insluit die ontwikkeling van ‘n databasis saamgestel met meer gewaarborgde egte produkte om die klassifikasie uit te brei.

The problem of this study was to test the differences between adult children from alcoholic families with adult children from non-alcoholic families on levels of depression, self-esteem, and anxiety. The sample consisted of 203 volunteers, all from the Counselor Education Department, 150 females and 53 males, ages 19 and older. Volunteers who were noted as being adult children of alcoholic families numbered 60. Measures used were the Children of Alcoholics Screening Test (CAST), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Coopersmith Adult Self-Esteem Inventory (SEI). Multivariate Analysis of Variance was used to test for differences between groups. In addition, a secondary analysis using a one-way MANOVA was used to test for differences between dysfunctional and functional family of origin status on the dependent variables of depression, self-esteem, and anxiety.

by Sylvia Chun Mei Chan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 105-114). / Abstract also in Chinese. / Chapter I. --- CHAPTER ONE: INTRODUCTION --- p.1 / Chapter i) --- Research Problems / Chapter ii) --- Rationale of the Research / Chapter iii) --- Objectives / Chapter II. --- CHAPTER TWO: LITERATURE REVIEW --- p.11 / Chapter i) --- Generalized Female Vulnerability Thesis / Chapter ii) --- Biological Factor / Chapter iii) --- Cultural Factor / Chapter iv) --- Motivational Factor / Chapter v) --- Situational Factor / Chapter III. --- CHAPTER THREE: CONCEPTUAL FRAMEWORK --- p.33 / Chapter i) --- The First Model / Chapter ii) --- The Second Model / Chapter iii) --- The Third Model / Chapter IV. --- CHAPTER FOUR: DATA AND METHOD --- p.51 / Chapter i) --- Sample and Data Collection / Chapter ii) --- Measurements of Variables / Chapter iii) --- Profile of Respondents / Chapter ix) --- Analytical Strategy / Chapter V. --- CHAPTER FIVE: ANALYSIS AND INTERPRETATION --- p.65 / Chapter i) --- The Whole Sample / Chapter ii) --- The Current Drinkers Sample / Chapter VI. --- CHAPTER SIX: DISCUSSION AND CONCLUSION --- p.81 / Chapter i) --- Implications of the Results / Chapter ii) --- Limitations of the Study / Chapter iii) --- Suggestions for Future Research / Chapter iv) --- Social Reflection / Chapter VII. --- BIBLIOGRAPHY --- p.105 / Chapter VIII. --- FIGURES --- p.i-vi / Chapter IX. --- TABLES --- p.vii-xxiv

Made available in DSpace on 2016-04-29T14:16:30Z (GMT). No. of bitstreams: 1 Rosana Cristina Januario do Nascimento.pdf: 1185999 bytes, checksum: a6a5df2e66c78fd98450d9c7fa37b360 (MD5) Previous issue date: 2014-04-14 / This dissertation has the objective of analyzing the Program of Attention to the Family of an Alcoholic which is located in São Miguel township and indentify its comprisement of coverage of care, its efficiency and accessibility as well. The firsts investigation steps of this research occurred in the Núcleo de Prática Jurídica (NPJ) of the University Cruzeiro do Sul in São Paulo (Unicsul), from the observation of daily demand service of Social Service, when daily wives of alcoholics men seek social legal space to join with divorce actions , one of the reasons for marriage rupture: the alcolism. The methodology used in the research was Action Research . It was also utilized the following research tools: bibliographic research on thematic, documental research about anti drugs politics of National Secretary for Alcohol and Drugs (Senad), systematic review of articles in the database of Scielo, raising social assistance resources, semi-structured interview with the local resources responsible, Group Focus and woman attended testimony by Social Service on NPJ, with demand for advice to divorce of their alcoholic partner. The documental research presents through the legislation about alcohol and drugs, the importance about developing actions of alcoholic family attention. With the systematic review we identified the absence of productions in the area of social services about the thematic family and alcoholism . The social fundraising assistance allowed us to identify the services in the area where the research has been done and the semi-structured interview expanded our comprehension about the daily life of these services. The focus group and individual assistance approached us from experiences of alcoholics wives, revealing us a very contradictory universe. The research conducted us to deep our knowledge about alcoholism and its repercussion in the family / A presente dissertação de mestrado tem o objetivo de analisar os programas de atenção à família do alcoolista existentes no distrito de São Miguel, bem como identificar a abrangência da cobertura dos atendimentos, sua eficácia e acessibilidade. Os primeiros passos investigativos da pesquisa se deram no Núcleo de Prática Jurídica (NPJ) da Universidade Cruzeiro do Sul (Unicsul), em São Paulo, a partir da observação da demanda cotidiana nos atendimentos do Serviço Social, quando diariamente mulheres de alcoolistas procuram o espaço sociojurídico para ingressarem com ações de divórcio, indicando como um dos motivadores da ruptura conjugal o alcoolismo. A metodologia utilizada foi a Pesquisa Ação feita com os seguintes instrumentos: Pesquisa bibliográfica sobre a temática; pesquisa documental sobre a política antidrogas da Secretaria Nacional de Políticas sobre Drogas (Senad); revisão sistemática de artigos na base de dados do Scielo; levantamento de recursos socioassistenciais; entrevista semiestruturada com os responsáveis pelos recursos locais; formação de grupo focal; e depoimentos de mulheres atendidas pelo Serviço Social no NPJ, com demanda por assessoria para divórcio de seus parceiros alcoolistas. A pesquisa documental indicou, através da legislação sobre álcool e drogas, a importância do desenvolvimento de ações de atenção à família do alcoolista. Com a revisão sistemática identificou-se a ausência de produções na área do Serviço Social sobre a temática família e alcoolismo. O levantamento de recursos socioassistenciais permitiu identificar os serviços no território objeto da pesquisa e as entrevistas semiestruturadas ampliaram a compreensão acerca do cotidiano desses serviços. O grupo focal e os atendimentos individuais proporcionaram contato com a vivência das mulheres de alcoolistas, revelando um universo muito contraditório. A pesquisa nos conduziu a aprofundar o conhecimento sobre o alcoolismo e sua repercussão na família

published_or_final_version / Public Health / Master / Master of Public Health

The compatibility of on-site consumption alcohol outlets as land use is predicted by the acceptance level of the utility or disutility they enjoy amongst residents in a neighbourhood. The density of alcohol outlets is argued in literature as correlating to the significant positive rate of amenity effects that include property crime, alcohol related arrests, drunk-driving, fatal and severe alcohol-induced accidents, violence and assault amongst many others. The problems associated with on-site consumption alcohol outlets have been insistently brought to the attention of the Umjindi Local Municipality in the Ehlanzeni District area in Mpumalanga Province by the residents of the Emjindini neighbourhood. The study is based on the hypothesis that the high density of on-site consumption alcohol outlets contributes to the incompatibility of such outlets with residential areas. In addressing the research sub-questions and validating the research hypothesis, the study adopted various methods (including land use surveys, interviews, administration of questionnaires, literature review and document review) for the collection, analysis, interpretation and discussion of data. The study reveals that the higher density of alcohol consumption outlets is significant in areas of low socioeconomic status. The Emjindini Townships are located with the density of 1 on-site consumption alcohol outlet per 263 people. Liquor legislation in South Africa leaves a lot to be desired in its guidelines for alcohol outlet density, public participation, location radius and local authority involvement. In addition, our findings showed that the significantly unacceptable level of impact thereof is experienced especially in the night, in areas characterised by the high density of on-site consumption alcohol outlets. The on-site consumption alcohol outlets are seen as compatible land uses in residential areas for the reason that, the unacceptable level of impact is insignificant during the day. The adoption of preferred and practical guidelines related to the locality and density of on-site consumption alcohol outlets, compatibility performance standards and public participation are recommended for policy and practice. The amendment to the liquor law is subsequently proposed in this study. / M.U.R.D.P. University of KwaZulu-Natal, Durban 2014.

Thesis (Ph. D.)--University of Virginia, 1993. / Includes bibliographical references (p. 168-181) and index.

Background: Obesity has become one of our times most endemic disease on a global scale and changes to lifestyle is the most cost-effective way to treat patients, when the cost for healthcare related treatment is staggeringly high for obesity and sequela diseases NAFLD, diabetes typ 2, dyslipidaemia and metabolic syndrome.The problem with this remedy is that it requires work and dedication. But changes require hard work, and in this patient group- low compliance, weight gain after treatment, dropping out of programs and small desire to change are the most common problems. Motivational studies report that readiness in obese patients is low and the best way to help patients to move forward is by motivational conversations. The obesity sequela disease NAFLD is an asymptomatic disease it displays no symptoms until very late stages. Therefore it’s a problem to get patients make the patient understand his illness and the seriousness of it. Aim: This literature work was aimed at investigating compliance in lifestyle changes in obese subject and to see if close contact with healthcare staff affected the achieved results. Method: In this literature study, the databases Pubmed, Science Direct, Medline and Sportdiscus were used to find information. Article inclusion criteria were that the articles were not older than 10 years and were in English. Result: Frequent and regular contacts between participants and professional staff provided good results both with regard to weight loss, biochemical response, and the participants' willingness to change. Also it shows that return visits at least every three months will improve weight loss if the participant is motivated to implement a change to lifestyle. Conclusion: Overall, this literature study shows the difficulties with lifestyle changes in people with obesity and sequela NAFLD. Close contacts of the patients with healthcare staff has proven to have a positive impact on treatment compliance, but there are other lifestyle difficulties in these patient groups which hamper compliance.