INTRODUÇÃO: O câncer vem apresentando um impacto cada vez maior nas populações em todo o mundo. Apesar de recente queda global na sua incidência, o câncer gástrico ainda é o quinto tipo mais comum. Sua patogênese é multifatorial, envolvendo a interação de fatores genéticos, ambientais e infecciosos. OBJETIVO: Avaliar a associação de tabagismo, consumo de álcool e nível de escolaridade com o desenvolvimento de câncer gástrico. MÉTODOS: Trata-se de um estudo caso-controle de base hospitalar em que foram incluídos pacientes com diagnóstico de adenocarcinoma de estômago confirmado por exame histopatológico sem tratamento prévio para a neoplasia. Posteriormente, os casos foram divididos em subtipos de acordo com a histologia (intestinal e difuso) e localização da lesão (proximal, distal e outras). Os indivíduos do grupo controle foram selecionados entre pacientes admitidos no mesmo hospital, sem história ou suspeita de câncer de estômago, emparelhados por frequência aos casos segundo sexo e idade. Tabagismo foi classificado em maços-ano e consumo de álcool em gramas-ano. RESULTADOS: Foram analisados 240 casos e 499 controles recrutados no período de junho de 2001 a dezembro de 2007. Não frequentaram a escola ou apresentavam ensino fundamental incompleto 94 indivíduos (39,2%) no grupo dos casos e 187 (37,5%) no grupo de controles. Ensino universitário foi atingido por 12 indivíduos (5%) no grupo de casos e por 45 indivíduos (9%) do grupo de controles. Não houve associação de nível de escolaridade com risco de desenvolvimento de câncer de estômago. Tabagismo esteve associado ao risco de câncer gástrico com odds ratio (OR) de 2,25 (IC95%: 1,53-3,31) para ex-tabagistas e de 2,67 (IC95%: 1,72-4,13) para tabagistas atuais. Com relação à localização e tipo histológico, tabagismo foi associado com todos os subtipos de tumores gástricos analisados, com destaque para os tumores proximais que apresentaram OR de 5,38 (IC95%: 2,15-13,45) para consumo superior a 38 maços-ano. Consumo de álcool também esteve associado a risco de desenvolvimento de câncer gástrico em todos os subtipos analisados. Entretanto, esta associação apresentou características distintas do tabagismo. Ex-consumidores de álcool apresentaram risco mais elevado (OR=3,81; IC95%: 2,45-5,91) que consumidores atuais (OR=2,06; IC95%: 1,31-3,26). A análise da interação mostrou que o efeito conjunto de tabagismo e consumo de álcool encontrado foi maior que o esperado, evidenciando interação positiva [?=1,51 (IC 95%: 1,05 - 1,96)]. CONCLUSÕES: Tabagismo e consumo de álcool apresentaram associação com o risco de desenvolvimento de câncer gástrico, com destaque para tabagistas atuais e maior consumo de maços-ano. O consumo associado do tabaco e do álcool aumenta esse risco / BACKGROUND: Cancer has an increasing impact on populations around the world. Despite a recent overall decline in incidence, gastric cancer stills the fifth most common type. Its pathogenesis is multifactorial involving the interaction of genetic, environmental and infectious factors. OBJECTIVES: To evaluate the association of smoking, alcohol consumption and education level with the development of gastric cancer. METHODS: This is a hospital-based case-control study that included patients with gastric adenocarcinoma confirmed by histopathological examination without prior treatment. Subsequently, patients were divided into subtypes according to histology (intestinal and diffuse) and location of the lesion (proximal, distal and others). Control subjects were selected among patients admitted to the same hospital with no history of gastric câncer, and were frequency-matched to cases for age and sex. Smoking was classified in pack-years and alcohol consumption in grams per year. RESULTS: We analyzed 240 cases and 499 controls recruited from June 2001 to December 2007. Not attended school or had incomplete elementary school 94 subjects (39.2%) in the group of cases and 187 (37.5%) in the control group. University education was achieved by 12 subjects (5%) in the case group and 45 subjects (9%) in the control group. There was no association of education level with increased risk of stomach cancer. Smoking was associated with increased risk of gastric cancer with an odds ratio (OR) of 2.25 (95%CI: 1.53-3.31) for former smokers and 2.67 (95%CI: 1.72-4.13) for current smokers. With respect to location and histological type, smoking was associated with all subtypes of gastric tumors analyzed with emphasis on the proximal tumors that had OR of 5.38 (95%CI: 2.15-13.45) for consumption over 38 packs-years. Alcohol consumption was also associated with increases risk of gastric cancer development in all analyzed subtypes. However, this association showed distinct characteristics of smoking. Former drinkers had higher risk (OR=3.81; 95%CI: 2.45-5.91) than current users (OR=2.06; 95%CI: 1.31-3.26). The analysis of the interaction showed that the combined effect of smoking and alcohol consumption was higher than expected, thus showing up a positive interaction [?= 1.51 (95%CI: 1.05-1.96)]. CONCLUSIONS: Smoking and alcohol consumption were associated with the risk of gastric cancer development, especially for current smokers and higher consumption of pack-years. Association of tobacco and alcohol consumption increases this risk

INTRODUÇÃO O consumo de álcool combinado com bebidas energéticas (AmED) tem se mostrado associado tanto a um padrão pesado de ingestão de bebidas alcoólicas, quanto a comportamentos de risco no trânsito (CRTs) entre jovens adultos. Devido ao grave impacto causado pelas incapacidades e mortes no trânsito serem decorrentes de comportamentos previsíveis e em grande parte evitáveis, o presente estudo procura investigar a influência do consumo de AmED sobre os comportamentos de risco no trânsito entre os motoristas de caminhão. MÉTODOS Dados de uma amostra de profissionais que trafegavam pelas rodovias do Estado de São Paulo entre junho de 2012 e setembro de 2013 (N=535) foram separados em três grupos: (a) os que afirmaram ingerir AmED (n=90), (b) que relataram consumir apenas bebidas alcoólicas (n=326) e (c) o restante da amostra (n=445). Análises bivariadas foram realizadas com os relatos positivos nos últimos 12 meses que antecederam a pesquisa. O nível de significância foi estipulado para um alfa de 5% e, posteriormente, a analise múltipla utilizou a regressão logística. RESULTADOS Comparando os condutores que ingeriram AmED com os que consumiram apenas bebidas alcoólicas, os primeiros tiveram mais chances de possuir idades entre 20 e 24 anos (OR=3,3), de trabalhar como profissional a menos de 5 anos (OR=2,5), apresentaram maiores riscos de dirigir sem cinto de segurança (OR=2,2), em alta velocidade (OR=1,9), ter brigado ou discutido no trânsito (OR=2,1), ter consumido bebidas alcoólicas em um padrão pesado (OR=3,4), bebendo mais doses alcoólicas por ocasião (mediana 5 vs 2 doses, p < 0,008); em maior frequência (OR=1,9), bebendo mais frequentemente no padrão binge drinking (OR=2,3) e consumindo drogas ilícitas em maior frequência (OR=2,3), além de maiores chances de apresentar uma qualidade de sono ruim (OR=1,7). Comparados ao restante da amostra, observou-se que os motoristas de caminhão que ingeriram AmED apresentaram maior risco de dirigir sem cinto de segurança (OR=2,2), em alta velocidade (OR=1,9), alcoolizado (OR=2,6), de brigar ou discutir no trânsito (OR=2,0), apresentaram maiores chances de ingerir mais doses alcoólicas por ocasião (medianas 5 vs 2 doses, p < 0,001), beber mais frequentemente (OR=2,6), inclusive no padrão binge drinking (OR=2,1), também em maior frequência em binge drinking (OR=3,2), consumir álcool em um padrão pesado (OR=3,4) e usar drogas ilícitas (OR=2,6). A regressão logística ajustada por idade indicou que os motoristas que brigaram ou discutiram no trânsito (OR=2,2), que dirigiram sem cinto de segurança (OR=1,9) e que relataram o uso de drogas ilícitas nos últimos 12 meses (OR=2,0) tiveram maiores chances de ter ingerido AmED. CONCLUSÃO O estudo indica uma associação entre a ingestão conjunta de álcool com bebidas energéticas e maiores chances de apresentar CRTs. São necessários investimentos em pesquisas e ações preventivas voltadas para essa população / INTRODUCTION: Consumption of alcohol mixed with energy drinks (AmED) has been shown associated with both a heavy pattern of alcohol intake as well as the traffic risk behaviors (TRB) among young adults. Due to the serious impact caused by disabilities and traffic deaths arising from predictable and largely preventable behaviors, the present study investigates the influence of AmED consumption on traffic risk behaviors among truck drivers. METHODS: Data from a sample of professional driving along the highways of the State of São Paulo (Brazil) between June 2012 and September 2013 (N=535) were divided into three groups: (a) those who reported drinking AmED (n=90), (b) who reported consuming alcohol only (n=326) and (c) the rest of the sample (n=445). Bivariate analyzes were performed with positive reports in the last 12 months preceding the survey. The level of significance was set for an alpha of 5% and, subsequently, it was made a multiple logistic regression analysis. RESULTS: Comparing the drivers who drink AmED with those who consumed only alcohol, the first were more likely to have between 20 and 24 years (OR=3.3), to work as a professional less than five years (OR=2.5), had higher risks of driving without a seat belt (OR=2.2), in high speed (OR=1.9), have a fight or discussion in traffic (OR=2.1), having consumed alcohol in a heavy pattern (OR=3.4), drinking more alcoholic drinks per occasion (median 5 vs 2 doses, p < 0.008); at higher frequency (OR=1.9), more often in binge drinking (OR=2.3), consuming illicit drugs more frequently (OR=2.3), as well as more likely to have a bad quality sleep (OR=1.7). Compared to the rest of the sample, it was found that truck drivers who drink AmED had higher risk of driving without a seat belt (OR=2.2), in high speed (OR=1.9), drunk (OR=2 , 6), to fight or discuss in traffic (OR=2.0), were more likely to consume more alcoholic drinks per occasion (median 5 vs 2 doses, p < 0.001), drinking more often (OR=2.6), including in binge drinking (OR=2.1), also in higher frequency in binge drinking (OR=3.2), consuming alcohol in a heavy pattern (OR=3.4) and use illicit drugs (OR=2 6). Logistic regression adjusted for age indicated that drivers who fought or discussed in traffic (OR = 2.2), which drove without a seat belt (OR = 1.9) and that reported using illicit drugs in the last 12 months (OR = 2.0) had higher chances of having ingested AmED. CONCLUSION: This study indicates an association between the combined intake of alcohol with energy drinks and more likely to have TRBs. Investment is needed in research and preventive actions for this population

Objetivo: Avaliar, em uma amostra de CAPSad das regiões Sul e Sudeste do município de São Paulo, a satisfação dos usuários com o serviço e a mudança percebida por esses usuários com relação à assistência recebida e investigar as variáveis associadas. Metodologia: Pesquisa avaliativa, de método quantitativo transversal, descritivo e exploratório que integra um projeto matricial desenvolvido para avaliar medidas de impacto das políticas para ações em álcool e outras drogas. Coletaram-se 114 entrevistas em cinco CAPSad das regiões Sul e Sudeste do município de São Paulo; inicialmente foram sorteados 150 usuários para compor a amostra, por método aleatório simples sem reposição. A coleta foi realizada entre o ano de 2013 e o primeiro semestre de 2014. As variáveis dependentes foram a satisfação global com os serviços e mudança percebida após o tratamento; as variáveis independentes referiam-se às características socioeconômicas e clínicas dos usuários dos serviços e à satisfação global (para o caso de análise univariada e múltipla de correlação com a mudança percebida). Realizou-se análise descritiva, univariada e múltipla por meio de regressão de Mínimos Quadrados Ordinários. O nível de significância foi de 5%; sendo aceito o nível de significância de 30% para entrada das variáveis independentes no modelo múltiplo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo (Protocolo: 1.001/2011). Resultados: As variáveis independentes, renda familiar no último mês (p=0,043; =0,190) e escolaridade (p=0,031; =-0,203), apresentaram correlação com a satisfação global; e a variável situação conjugal (p=0,040; =-0,196) apresentou correlação com a mudança percebida. Pela análise múltipla, a variável escolaridade apresentou correlação com a satisfação global (p-valor0,05), e as variáveis etnia, renda familiar no último mês, internação psiquiátrica anterior ao tratamento no CAPSad e presença de outro problema de saúde permaneceram no modelo múltiplo como variáveis de controle (r2=0,06). As variáveis situação conjugal e satisfação global apresentaram correlação com a mudança percebida (p-valor0,05) e as variáveis etnia, internação psiquiátrica anterior ao tratamento no CAPSad, presença de outro problema de saúde e hábito de fumar permaneceram no modelo como variáveis de controle (r2=0,13). A distribuição da satisfação e da mudança percebida pelos usuários apresentaram desvio à direita, indicando escores altos; com distribuição normal. Conclusões: Poucos estudos correlacionam variáveis sóciodemográficas e clínicas com a satisfação global com o serviço e a mudança percebida, mas essas variáveis mostraram importante correlação no presente estudo. A satisfação global com o serviço mostra ser fator preditivo de maiores escores de mudança percebida, portanto é um fator importante de avaliação para que resultados clínicos objetivos sejam alcançados. São necessários mais estudos inferenciais sobre a satisfação com o serviço e a mudança percebida. / Objective: To evaluate, in a sample of CAPSad in Southern and Southeastern regions of São Paulo, the satisfaction of users about the services and change perceived, regarding the care received and to investigate the associated varia-bles. Methodology: an evaluative study, cross-sectional, descriptive and exploratory using quantitative methods. This study incorporates a matrix project developed to measure and assess the impact of the policy actions for alcohol and other drugs. Data was collected with 114 interviews in five CAPSad in Southern and Southeastern regions of São Paulo; 150 users initially were drawn for the sample by simple random method without replacement. Data collection was conducted between 2013 and the first half of 2014. The dependent variables were overall satisfaction with services and perceived change after treatment; the independent variables were related to socioeconomic and clinical characteristics of users of the services and overall satisfaction (in the case of univariate and multivariate analysis of correlation with the perceived change). It was conducted a descriptive, univariate model followed by multiple analysis, using the method of ordinary least squares. The significance level was 5%; the variables entered in the multiple model had a significance level of 30% or less. The study was approved by the Research Ethics Committee of the School of Nursing, University of São Paulo (Protocol: 1001/2011). Results: The independent variables family income in the past month (p = 0.043; = 0.190) and education (p = 0.031; = -0.203) correlated with overall satisfac-tion; and the variable marital status (p = 0.040; = -0.196) correlated with the perceived change. By multivariate analysis schooling variable correlated with overall satisfaction (p-value 0,05), and ethnicity variables, household income last month, previous psychiatric hospitalization and treatment at CAPSad pres-ence of other health problems remained in the model multiple as control variables (r2 = 0.06). The variables marital status and overall satisfaction correlated with the perceived change (p-value0,05) and ethnicity variables, previous psychiatric hospitalization treatment at CAPSad, presence of other health problems and smoking variables remained in the model as control (r2 = 0.13). The distribution of satisfaction and perceived by the users change showed a shift to the right, indicating higher scores; with approximately normal distribution. Conclusions: Few studies have correlated sociodemographic and clinical varia-bles and overall satisfaction with the service and the perceived change, but these variables showed significant correlation in the present study. Overall satisfaction with the service proves to be predictive of higher scores of perceived change, so it is an important evaluation factor for clinical outcome goals are achieved. More inferential studies on satisfaction with the service and the perceived changes are needed.

Introdução: O uso problemático de álcool prejudica não só o indivíduo, mas a dimensão familiar, social e o ambiente de trabalho, bem como gera custos à sociedade. O ambiente de trabalho apresenta diversos fatores estressantes, como os relacionados às condições do trabalho e aos fatores psicossociais que são passíveis de influenciar no rendimento, na satisfação laboral e na saúde do trabalhador, os quais favorecem a presença de estresse ocupacional. Além dos riscos ocasionados pelo consumo de álcool no ambiente de trabalho, tais como acidentes ocupacionais e absenteísmo, o uso abusivo de álcool pode servir de estratégia de coping para o enfrentamento das situações estressantes no trabalho e, desta forma, aliviar o estresse ocupacional. Objetivos: Identificar a prevalência de consumo de álcool e testar sua associação com variáveis sociodemográficos, econômicos, de trabalho e de condições de saúde entre servidores públicos universitários. Material e Método: Trata-se de estudo epidemiológico, descritivoexploratório, tipo corte transversal do qual participaram 925 servidores técnicosadministrativos de uma universidade pública do interior do Estado de São Paulo. A coleta de dados foi realizada por meio da aplicação de três instrumentos: Questionário de dados sociodemográficos, econômicos e características do trabalho, Alcohol Use Disorders Identification Test (AUDIT) e Job Stress Scale (JSS). Foram realizadas análise descritiva das características da amostra e Odds Ratio (OR) como medida de associação, estimado por meio das análises de regressão logística bivariada e multivariada, sendo utilizado o modelo hierarquizado criado para a entrada das variáveis. Para o controle das variáveis de confusão foram mantidas aquelas com p 0,20. Foram consideradas significantes as associações com p 0,05. Resultado: Maior incidência era do sexo feminino (54,92%), casados (65,84%), com idade média de 43,08 anos, ensino superior completo (50,27%) e renda per capita média de R$1333,18 (dp=861,00). O tempo médio de vínculo empregatício foi de 13,5 anos (dp=10,3), maioria nas funções de nível médio (52,76%) e maior inadequação da função exercida para o nível de escolaridade (52,97%). A prevalência do uso problemático de álcool foi de 13,19%, com 27,35% de abstêmios. O consumo excessivo episódico (binge drinking) foi de 36,75%, além disso, 5,8% já causaram problemas a si mesmos ou a outros após terem bebido e 6,2% referiram que algum parente, amigo ou médico já se preocupou com seu modo de beber. Fumantes ativos somaram 13,95%. Quanto aos níveis de exposição ao estresse no trabalho, 30,6% dos entrevistados apresentaram baixo desgaste, embora 18,6% apresentaram alto desgaste, o qual configura em estresse ocupacional. Maiores chances de uso problemático de álcool: ser homens (OR=4,51; IC95%: 2,92 - 6,97), fumante (OR = 3,87; IC95%: 2,23 - 6,70) e possuir ensino fundamental (OR=1,8; IC95%: 1,00 - 3,27). Por outro lado, quanto menor o tempo de vínculo com a instituição, menor as chances de uso problemático de álcool. Conclusão: Os futuros planos de intervenções como a promoção da saúde e prevenção no ambiente de trabalho, devem considerar as seguintes características de risco: ser homem, fumante e possuir ensino fundamental. As informações deste estudo pode ser uma primeira ação para trabalhos futuros nesta população. / Introduction: The problematic use of alcohol prejudices not only the individual but the family and social dimension, working environment, as well as generate costs to society. The work environment presents several stressful factors, such as those related working condition and psychosocial factors that are likely contributors that influence the performance, satisfaction labor and the worker´s health, which provides occupational stressing. Besides risks caused by alcohol use in the workplace, such as occupational accidents and absenteeism, the abuse of alcohol can serve as a coping strategy to face stressful situations at work aiming to relieve the occupational stress. Objectives: Identify the prevalence of alcohol consumption and test its association in terms variables with sociodemographics, economics, labor and health condition among public servers of the university. Material and Methods: This epidemiological study is descriptive exploratory, cross-sectional where participated 925 administrative technical staff of a public university in the state of Sao Paulo. Data collection was made through application of three instruments: Questionnaire of sociodemographic, economic and job characteristics, Alcohol Use Disorders Identification Test (AUDIT) and Job Stress Scale (JSS). It was performed a descriptive analysis of the characteristics of the sample and an odds ratio (OR) as a measure of association, estimated by the analysis of bivariate and multivariate logistic regression, by using the hierarchical model created for input variables. To control of confounding variables were maintained with p 0.20. Associations were considered significant at p 0.05. Result: Increased incidence were female (54.92%), married (65.84%), with average age of 43.08 years, university graduates (50.27%) and average per capita income of R $ 1,333.18 (sd=861.00). The average length of employment was 13.5 years (sd=10.3), most of the functions of middle level (52.76%) and most inadequate function performed for the level of education (52.97%). The prevalence of problematic alcohol use was 13.19% with 27.35% of abstainers. Excessive consumption episodic (binge drinking) was 36.75%, in addition, 5.8% have already caused problems to themselves or others after drinking and 6.2% reported that a relative, friend or doctor has already been concerned with their drinking. Active smokers amounted to 13.95%. The levels of exposure to job stress, 30.6% presented low wear, while 18.6% had high wear, which sets in occupational stress. Higher chances of problematic alcohol use: to be men (OR: 4.51; 95% CI: 2.92-6.97), smokers (OR: 3.87; 95% CI: 2.23-6.70) and primary education level (OR: 1.8; 95% CI: 1.00-3.27). On the other hand, as the shorter time working in the institution, lower will be the chances of problematic alcohol use. Conclusion: For future plans of interventions such as health promotion and prevention in the workplace, it should be considered the following risk characteristics: being male, smoking and primary education level. The information in this study may be a first action for future work in this population.

<p>There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data.</p><p>Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002.</p><p>It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed.</p>

There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data. Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002. It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed.

Magistro baigiamajame darbe analizuojama šiuolaikinė Lietuvos alkoholio kontrolės politika. Stengdamasi atskleisti ir įvertinti Lietuvos alkoholio kontrolės politikos problemas, autorė atliko viešosios nuomonės tyrimą-apklausą, mokslinės literatūros analizę bei naudojo kitus mokslinius metodus. Darbe ne tik atskleidžiamas nepakankamas alkoholio kontrolės įgyvendinimas Lietuvoje, bet ir pateikiamos rekomendacijos, kaip jį pagerinti taikant efektyvias mokslu pagrįstas bei pasaulyje naudojamas alkoholio kontrolės priemones. Lietuvos gyventojai (apklausos rezultatų duomenimis) ir alkoholio kontrolės srities ekspertai alkoholio politiką šalyje vertina vidutiniškai. Daugelis Lietuvos gyventojų bei ekspertų pritartų griežtesnei alkoholio kontrolės politikai. Vienas iš didžiausių trukdžių įrodymais grįstai alkoholio politikai vystyti – aktyvi alkoholio pramonės įtaka šalyje. / Master's thesis analyzes the contemporary Alcohol Control Policy of Lithuania. Author of the work conducted a public opinion survey-interview, used the analysis of scientific literature and other methods of research to disclose and evaluate the issues of the Lithuanian Alcohol Control Policy. The paper not only reveals the lack of implementation of alcohol control in Lithuania, but also provides guidance on how to improve it with/adapting the effective science-based and used globally alcohol control measures. Lithuanian residents (survey data) and alcohol-control experts have an average view of this policy. Many of them support the stronger alcohol control policy. One of the major constraints on evidence-based alcohol policy development – strong influence of the alcohol industry in the country.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Thesis (Ph.D.)--University of Tennessee Health Science Center, 2006. / Title from title page screen (viewed on October 26, 2007 ). Research advisor: Mona Newsome Wicks, Ph.D., RN. Document formatted into pages (xii, 174 p. : ill.) Vita. Abstract. Includes bibliographical references (p. 115-132).

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