The purpose of the study was to investigate the relationship, frequency, gender differences, situations and motivations of self-induced vomiting after drinking alcohol with disordered eating, alcohol use and psychopathology; with a nonclinical university sample of males and females in New Zealand. Participants were 102 male and 159 female university students ranging in age from 17-35 years who completed a survey designed for this study along with tests that measure eating disordered attitudes and behaviours, bulimia symptoms, depression and alcohol use. Overall, 90.04% of the sample reported that they drink alcohol and, of that subset, 57.58% of males and 42.26% of females reported having self-induced vomiting after drinking alcohol. The behaviour was related to eating pathology, depression and alcohol use with gender differences apparent. Specifically, on measures of disordered eating, females who self-induce vomiting after drinking alcohol scored higher than females who do not report the behaviour (no difference apparent for males), and overall, females scored higher than males. In terms of hazardous alcohol use, males who self-induce vomiting after drinking alcohol scored higher than males who do not with the same true for females, and overall males scored higher than females. In terms of drinking at the dependency level, individuals who reported self-induced vomiting after drinking alcohol drink at a more harmful level than those who do not (both males and females) and more males than females reported hazardous alcohol usage rates. When examining depressed symptoms, females who selfinduce vomiting after drinking alcohol reported more depressed symptoms than females who do not, with males who reported the behaviour endorsing less depressed symptoms than males who do not. Overall, females indicated more depressed symptoms than males. Persons who engaged in the behaviour were more likely to endorse it as being acceptable, with this trend being stronger for males. Females who self-induce vomiting after drinking were more likely to endorse symptoms of anorexia, bulimia and depression, whereas males who reported the behaviour were more likely to indicate harmful drinking levels, and perform the behaviour to carry on drinking. Thus, for males, self-induced vomiting after drinking alcohol was related to substance abuse whereas, for females, the behaviour may be more related to disordered eating.

Thesis (M Nursing (Advanced Practice))--University of South Australia, 1995

Thesis (M Nursing (Advanced Practice))--University of South Australia, 1995

The purpose of the study was to investigate the relationship, frequency, gender differences, situations and motivations of self-induced vomiting after drinking alcohol with disordered eating, alcohol use and psychopathology; with a nonclinical university sample of males and females in New Zealand. Participants were 102 male and 159 female university students ranging in age from 17-35 years who completed a survey designed for this study along with tests that measure eating disordered attitudes and behaviours, bulimia symptoms, depression and alcohol use. Overall, 90.04% of the sample reported that they drink alcohol and, of that subset, 57.58% of males and 42.26% of females reported having self-induced vomiting after drinking alcohol. The behaviour was related to eating pathology, depression and alcohol use with gender differences apparent. Specifically, on measures of disordered eating, females who self-induce vomiting after drinking alcohol scored higher than females who do not report the behaviour (no difference apparent for males), and overall, females scored higher than males. In terms of hazardous alcohol use, males who self-induce vomiting after drinking alcohol scored higher than males who do not with the same true for females, and overall males scored higher than females. In terms of drinking at the dependency level, individuals who reported self-induced vomiting after drinking alcohol drink at a more harmful level than those who do not (both males and females) and more males than females reported hazardous alcohol usage rates. When examining depressed symptoms, females who selfinduce vomiting after drinking alcohol reported more depressed symptoms than females who do not, with males who reported the behaviour endorsing less depressed symptoms than males who do not. Overall, females indicated more depressed symptoms than males. Persons who engaged in the behaviour were more likely to endorse it as being acceptable, with this trend being stronger for males. Females who self-induce vomiting after drinking were more likely to endorse symptoms of anorexia, bulimia and depression, whereas males who reported the behaviour were more likely to indicate harmful drinking levels, and perform the behaviour to carry on drinking. Thus, for males, self-induced vomiting after drinking alcohol was related to substance abuse whereas, for females, the behaviour may be more related to disordered eating.

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [101]-111).

Thesis (M.S.)--University of Wisconsin-Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 124-130).

Major advances in antiemetic therapy have been made over the past two decades. Despite these advances in antiemetic management, nausea and vomiting are still important problems in clinical practice, and approximately 50% of patients receiving chemotherapy still experience nausea and/or vomiting, highlighting the need for further developments in the field. Non-pharmacological interventions are suggested as possible adjuncts to standard anti-emetic therapy. A recently developed non-pharmacological intervention to alleviate nausea and vomiting is Nevasic, which may have potential to reduce CINV and improve management of these symptoms.This pilot trial was run to examine the feasibility of implementing and conducting a randomised controlled trial using Nevasic programme. In addition, the study aimed to evaluate the acceptability and potential effect of Nevasic on cancer patients undergoing chemotherapy. Ninety nine adult female breast cancer patients who had been prescribed a course of moderately high emetogenic chemotherapy were randomised to usual care (standard anti-emetics) plus one of (1) intervention group (using Nevasic), (2) attention group (listening to music), and (3) control group, receiving no additional intervention. Data were collected daily using the Rhodes Index of Nausea, Vomiting and Retching (INVR) and a structured diary questionnaire. The EORTC QLQ-C30 (and BR23) were used at baseline and day 6 post chemotherapy. Data were collected from cancer centres affiliated to Mashhad University of Medical Sciences in Mashhad, Iran.The findings from the trial highlight that conducting a non-pharmacological intervention using such an audio programme is feasible, although difficulties and limitations exist. This study did not detect any evidence for the effectiveness of Nevasic on CINV; however, the results show statistically significant less use of anti-emetics (post-chemotherapy) (p=0.03) and borderline non-significant (p=0.06) better global health status in Nevasic group. Further studies are required to investigate its implications from other perspectives such as use of anti-emetics - rather than looking only at the "level of nausea and/or vomiting" perspective.

No / Advances in antiemetic therapy for chemotherapy-induced emesis have resulted in improved protection against symptoms occurring within 24 h of chemotherapy. However, the vomiting which tends to occur beyond 24 h after chemotherapy (delayed-phase vomiting) is still relatively poorly controlled by the currently available drugs, suggesting that more than one mechanism may mediate these symptoms. The standard antiemetic regimen currently recommended for prevention of chemotherapy-induced emesis includes a serotonin (5-HT3) antagonist and a corticosteroid. The neurokinin-1 (NK1) antagonist aprepitant represents a new class of antiemetic currently in clinical development. Using data obtained in 2 Phase II clinical trials of aprepitant in patients receiving chemotherapy based on the highly emetogenic chemotherapeutic agent cisplatin, we compared the time course of antiemetic effect of aprepitant, a 5-HT3 antagonist, or a combination of both. Over the entire observation period (up to 7 days post-cisplatin), patients who received the NK1 antagonist had a superior prevention of emesis. However, in the first 24 h after cisplatin, emesis occurred in fewer patients who received the 5-HT3 antagonist than in patients who did not receive this class of drug. Furthermore, the majority of treatment failures in patients who received the NK1 antagonist occurred within the first 8¿12 h of chemotherapy, whereas the treatment failures in patients who received a 5-HT3 antagonist were more evenly distributed over time. Patients who received both drugs had superior control of symptoms compared with patients who received one or the other. The difference in the time course of emesis blockade observed with two different classes of receptor antagonists provides substantial evidence for involvement of separate pathophysiological mechanisms in chemotherapy-induced vomiting. Serotonin mediates the early vomiting process that occurs within 8¿12 h following cisplatin-based chemotherapy, after which time substance P acting at NK1 receptors becomes the dominant mediator of vomiting.

Introduction: Acute chemotherapy toxicity is common and can have negative effects for the patient and health economy and hospitalisation can be necessitated. Aims: To identify the incidence of toxicity and admission, and predictors of toxicity occurrence, severity, hospitalisation and length of stay. Method: Data was obtained from a proactive telephone assessment of acute toxicity 24 hours after administration of a first cycle of chemotherapy to patients in a large UK NHS teaching hospital. Results: 1539 patients were studied and the overall incidence of toxicity was 35.6% (530 patients). Disease site and number of chemotherapy agents given were shown to predict toxicity, with breast and upper gastrointestinal cancers having a higher likelihood of toxicity. Disease was predictive of toxicity grade, with urology, gynaecology and lung cancer patients experiencing higher grades of toxicity than other tumour sites. The rate of hospital admission due to toxicity was 13.1% (203 patients) and median length of stay 3 days (1-28). The risk of admission had some risk factors in common with toxicity. Disease and the number of drugs in the regimen affected the risk of admission, with gynaecology, head and neck and lung cancer patients and patients who received 3 drugs having a higher likelihood of admission. Predictors in the subgroups of breast, colorectal and lung cancer patients did not differ greatly from the whole population and the number of drugs was shown to be a predictor of nausea, vomiting and fatigue when explored as secondary outcomes. Conclusion: The research partly addressed the main aim and highlighted areas where further research is required. Keywords

Approximately 65% of all surgeries are conducted in the outpatient surgery setting involving more than 35 million patients. Thirty-five to fifty percent of these outpatients will experience post discharge nausea and vomiting (PDNV), nausea and vomiting that occurs after discharge from the health care facility after surgery. A dearth of literature details the problems associated with nausea and vomiting experienced by patients after discharge home from outpatient surgery. The purposes of this dissertation were to (1) review the current knowledge in the area of post discharge nausea and vomiting; (2) present results of an integrative review of the research literature to determine best evidence for prevention of PDNV in adults or rescue of patients who suffer from post discharge nausea and vomiting (PDNV); (3) present a critical review and analysis of measurement of nausea and vomiting after discharge from outpatient surgery, and (4) present findings of a prospective research study. The purposes of the research study were to: 1) describe the incidence and severity of PDNV over a 7-day period in a sample of adult surgical patients undergoing outpatient surgeries under general anesthesia, 2) describe the pharmacologic and nonpharmacologic modalities of care used by patients with PDNV to manage it, 3) compare the incidence and severity of PDNV between those who do and do not use pharmacologic and nonpharmacologic modalities, and 4) determine outcomes associated with PDNV. This study was part of a multi-site study that had as a primary objective development of a simplified risk model for predicting patients most likely to suffer PDNV. In this research study we described the incidence and severity of PDNV in adult outpatients after ambulatory surgery, described the pharmacologic and nonpharmacologic modalities of care used by patients with PDNV to manage it, compared the incidence and severity of PDNV between those who do and do not use pharmacologic and nonpharmacologic modalities, and determined outcomes associated with PDNV.