La consommation excessive d’alcool présente des risques élevés pour l’individu et pour la société ; elle est fréquemment associée à une augmentation du risque d’accidents, d’actes de violence, et peut également conduire à court et/ou à long terme à de graves maladies et à des problèmes sociaux. Dès lors, l’utilisation de marqueurs fiables permettant de détecter une consommation excessive d’alcool, ponctuelle ou chronique, s’avère nécessaire pour prévenir des conséquences néfastes de l’abus d’alcool. L’éthylglucuronide (EtG) est un marqueur d’alcoolisation utilisé en toxicologie clinique (alcoologie) et médicolégale. Par rapport aux marqueurs indirects d’alcoolisation (CDT, &#947;-GT), ce métabolite mineur de l’éthanol est très spécifique et est quantifiable dans diverses matrices biologiques. La production d’EtG est catalysée par des enzymes de la famille des UDP-glucuronosyl-transférases (UGT). Cependant, les UGT impliquées dans la glucuronoconjugaison de l'éthanol, ainsi que les sources potentielles de variabilité interindividuelle de la production d'EtG, sont encore mal connues. Nos travaux ont ainsi consisté à (1) développer et valider une méthode de dosage de l’EtG dans différentes matrices biologiques par chromatographie en phase gazeuse couplée à la spectrométrie de masse en tandem, (2) identifier les UGT humaines impliquées dans la glucuronoconjugaison de l’éthanol et étudier la contribution relative de chaque isoforme active au niveau hépatique, (3) étudier l’impact de substances fréquemment utilisées par les consommateurs d’alcool sur la production d’EtG in vitro, (4) étudier l’impact de polymorphismes génétiques fonctionnels des UGT sur la production hépatique d’EtG, et enfin (5) évaluer l’impact de la consommation de cannabis et d’autres drogues sur la production d’EtG à l’aide de prélèvements post-mortem. Ces travaux ont notamment permis de montrer que (1) l'éthanol est glucuronoconjugué principalement par le foie, puis dans une moindre mesure par les reins et par l'intestin, (2) les UGT1A9 et 2B7 sont les deux enzymes majoritairement impliquées dans la glucuronoconjugaison de l’éthanol, quel que soit l’organe considéré, (3) la morphine, la codéine, la nicotine et la cotinine n’entraînent aucune modification des taux de production d’EtG in vitro ; le lorazépam et l'oxazépam augmentent légèrement cette production (p = 0,2 et 0,065, respectivement) ; le cannabidiol inhibe la glucuronoconjugaison de l’éthanol par un mécanisme non-compétitif (CI50 = 1,17 mg/L; Ki = 3,1 mg/L), alors que le cannabinol augmente cette glucuroconjugaison de manière concentration-dépendante (p <0,05), (4) les SNP c.-900G>A affectant l’UGT2B7 et IVS1+399T>C affectant l’UGT1A9 augmentent légèrement la production d’EtG in vitro. Enfin (5) le rapport des concentrations sanguines EtG/éthanol apparaît significativement plus élevé chez des co-consommateurs de cannabis et/ou d’autres drogues que chez des consommateurs d’alcool seul. L’ensemble de ces résultats démontre l’existence de plusieurs facteurs pouvant potentiellement influencer la production d’EtG et devraient donc être pris en considération lors de l’interprétation de sa concentration in vivo. / Alcohol abuse is frequently associated with an increased risk of road accidents and violence, and can also lead to serious social and health problems. Therefore, the use of reliable markers to detect excessive punctual and/or chronic consumption of alcohol is necessary to prevent the harmful consequences of alcohol abuse. Ethylglucuronide (EtG) has been proposed as a marker of alcohol consumption in a variety of clinical and forensic contexts. Compared with the indirect markers (e.g. CDT, &#947;-GT), this minor metabolite of ethanol is very sensitive and specific, and is quantifiable in various biological matrices. It is formed by conjugation of ethanol with uridine 5’-diphosphate glucuronic acid (UDP-GA) via the action of UDP-glucuronosyltransferase (UGT) enzymes. However, the knowledge of the UGTs involved in the glucuronidation of ethanol, and the potential sources of the interindividual variability of EtG production are still not clearly established. The aims of our work were (1) to develop and validate a method for the determination of EtG in different biological matrices by gas chromatography coupled with tandem mass spectrometry, (2) to identify the human UGT isoforms involved in the glucuronidation of ethanol, and then to evaluate qualitatively and quantitatively their specific contribution in the formation of EtG, (3) to study the impact of the co-administration of drugs frequently used by ethanol consumers on the in vitro production of EtG, (4) to study the impact of functional genetic polymorphisms of two UGTs on the hepatic production of EtG, and finally (5) to study the impact of the consumption of cannabis and other drugs on the production of EtG using post-mortem samples. The main results of our study showed that (1) ethanol is primarily glucuronidated by the liver and, to a lesser extent, by kidneys, (2) UGT1A9 and 2B7 were identified as the main human UGTs involved in ethanol glucuronidation, (3) morphine, codeine, nicotine, and cotinine did not modify EtG in vitro formation rate; lorazepam and oxazepam produced a minor, but not significant, increase of EtG formation. Only cannabinol and cannabidiol significantly affected ethanol glucuronidation; cannabinol significantly increased the glucuronidation of ethanol in a concentration-dependent manner, whereas cannabidiol inhibited the glucuronoconjugaison of ethanol by a non-competitive mechanism (CI50 = 1.17 mg / L; Ki = 3.1 mg / L), (4) the SNP c.-900G>A and IVS1+399T>C affecting UGT2B7 and UGT1A9, respectively, seem to increase the in vitro production of EtG, and (5) cannabis and/or drugs consumption (mainly opioids, benzodiazepines, and paracetamol) seem to be associated with ratios of blood concentrations of EtG/ethanol significantly higher than those observed among only alcohol consumers. Taken together, these results show the existence of several factors that could potentially influence the production of EtG, and that should be taken into account when interpreting its concentration in vivo.

Alcohol abuse in families remain a serious problem in South Africa. Early exposure to dysfunctional family patterns may contribute to juvenile offending. Such an exposure will be detrimental to children’s development and may create emotional problems for them. It would appear that certain factors contribute towards juvenile delinquency such as divorce among parents, single parent families, unemployment of parents, family violence, substance abuse and poverty. The researcher was motivated to undertake this study as she observed in the field of Social Work that nearly all juvenile offenders were exposed to alcoholism in their families of origin. The question arised whether there is a relation between alcohol abuse in the family system and juvenile delinquency. The goal of this study was to explore the extent to which alcohol abuse in the family system may contribute towards juvenile delinquency and imprisonment. The researcher conducted a qualitative study through which the goal of the study has been achieved. Further research in this field is recommended to prevent the effect alcohol abuse may have on the family system. / Dissertation (MA (Social Work))--University of Pretoria, 2005. / Social Work / unrestricted

No description available.

Introduction: Severe mental illness (SMI), Human immunodeficiency virus (HIV) infection and hazardous alcohol use are global epidemics. Each condition is independently associated with significant adverse health outcomes. The presence of two or more of these conditions in one individual may result in worse health outcomes. A key mediator of poor health outcomes are factors such as medication adherence. In resource-limited countries like South Africa, the impact of psycho-social factors may contribute further to worse health outcomes. These factors include poverty and unemployment; as well as gender. In South Africa, proportionately more women are infected with HIV than men; and they are also vulnerable to the problems of trauma and interpersonal violence. The main aim of this study was to investigate the prevalence of a triple co-morbidity of SMI, HIV infection and hazardous alcohol use in a female population at a community psychiatric clinic in Cape Town South Africa; and the impact of this triple comorbidity on medication adherence. Furthermore, we set out to identify demographic and clinical variables that are predictors of poor adherence to both psychotropic medication and ART where applicable. Methods: We conducted a cross-sectional study of female patients presenting to Gugulethu psychiatric clinic over a ten-month period. Demographics and clinical variables were explored using the Alcohol Use Disorders Identification Test (AUDIT); the adapted Morisky Scale to Assess Adherence to Psychotropic Medications; and an adherence to HIV antiretroviral treatment self-assessment instrument. A descriptive analysis of the demographic and predictor variables was undertaken to explore the prevalence of concurrent HIV infection and hazardous alcohol use in out-patients with SMI; as well as to investigate whether co-morbidity is associated with poor levels of adherence to psychotropic medication, as well as antiretroviral treatment (ART) in HIV positive patients. Results: We interviewed 127 patients, of whom 55 were HIV positive (43.3%). The overall prevalence of a triple comorbidity in this population was 7.9%. Only 20% within this triple comorbidity group were adherent to their psychotropic medication. Out of the 10 participants with a triple comorbidity, only five were on ART. Of these 5 participants, only two were adherent. Individuals with hazardous alcohol use were less adherent to psychotropic medication compared to those without. The seven respondents in the dual diagnosis group (SMI and hazardous alcohol use) had the lowest overall psychotropic adherence levels compared to the other subgroups (0%). Furthermore, concurrent hazardous alcohol use predicted poorer levels of compliance to ART for those with HIV infection. Conclusion: The presence of a triple diagnosis was not found to be a predictor of poorer medication adherence, compared to having one or two diagnoses. Nevertheless, there was evidence that concurrent hazardous drinking in SMI patients predicted poor compliance to both psychotropic and ART treatment regimens (for those living with HIV). These patients should be supported in future interventions to improve medication adherence and reduce hazardous drinking.

No description available.

Calamity of the White Picket is a collection of essays that portray how perfection-whether a perfect image, perfect relationship, perfect friendship, or perfect family-becomes withered down, destroyed, and turned into something else. They explore how the idealized image of a family surrounded by a cute white picket fence is dismantled and rearranged through theft, addiction, and a disintegrated family. The essays explore drug addictions, childhood nostalgia, the relationship between heritage and property, innocence, and a stolen best friend. The collection is a train ride of family problems, broken friendships, lying and stealing, and hidden secrets about love and sex. Through these essays, I let go of my versions of the white picket fence, and embrace the new and complicated life that replaces it, ultimately still trying to maintain happiness.

No description available.

Thesis (Ph. D.)--University of California, San Diego, and San Diego State University, 2009. / Title from first page of PDF file (viewed May 8, 2009). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 67-79).

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Syftet med den här studien är att genom en kvalitativ intervjustudie undersöka vilken typ av motivation samt, i den mån de existerar, vändpunkter som lett till att individer har tagit sig ur ett alkoholmissbruk. Studien har utförts genom sex intervjuer med privatpersoner som har levt med alkoholmissbruk och via behandling fått hjälp att ta sig ur sagda missbruk. Intervjuerna bokades med hjälp av socialtjänsten i en mellansvensk kommun där samtliga respondenter har utfört sin behandling. Vi har tolkat vår empiri genom stämplingsteori och defining moments. Resultatet presenterar teman som belyser likheter i respondenternas upplevelser. Resultatet påvisar att individer behöver få en insikt om sitt missbruk för att behandling ska kunna ha en positiv påverkan. Denna insikt införskaffas genom olika processer eller fysiska skador som påverkat respondenterna liv. Även motivation från individen själv och det privata nätverket påverkar möjligheterna att ta sig ur ett alkoholmissbruk. Respondenterna ansåg att behovet av behandling är nyckeln för att bli fri från alkoholmissbruk då de ansåg att de inte hade kunskap eller möjlighet för att göra det själva. Detta är något som stärks av tidigare forskning inom området. / The purpose of this study is that through a qualitative interview study investigating what kind of motivation and, to the extent they exist, turning points that led individuals to emerged from an alcohol addiction. The study was conducted through six interviews with individuals who have been living with alcohol abuse and through the treatment received help to get out of said abuse. The interviews was booked with the help of the social services in a Swedish municipality where all respondents have completed their treatment. We have interpreted our empiricism by labeling theory and defining moments. The result presents themes that highlight the similarities in the respondents' experiences. The result demonstrates that individuals need to get an insight into his addiction to treatment will have a positive impact. This insight is acquired through various processes or physical damage that affected respondents lives. The motivation of the individual and the private network allso affects the ability to get out of an alcohol abuse. Respondents felt that the need for treatment is the key to freedom from alcohol abuse when they felt that they did not have the knowledge or the ability to do it themselves. This is something that is supported by previous research in the area.