Resumo: Beber se embriagando, beber pesado episódico ou "binge drinking" é definido como o consumo de 5 ou mais doses de bebidas em uma ocasião, sendo comum entre os jovens. Este padrão de consumo é freqüente e preocupante, uma vez que se associa a graves conseqüências negativas. Objetivo: avaliar todos os calouros de 2004 do Campus da Unesp de Botucatu que faziam "uso de risco" de álcool, comparando-os com um grupo sem risco, acompanhando-os em seus comportamentos e conseqüências com relação ao beber por 24 meses. Neste estudo de caso-controle foram entrevistados 457 calouros dos 533 matriculados em 2004 em qualquer dos 11 cursos oferecidos no campus. O uso de risco de álcool foi definido pelo escore do AUDIT maior ou igual a 8 e/ou RAPI maior ou igual a 7 nos últimos 12 meses. Foram identificados 139 alunos chamados de Grupo de Risco (GR), que foram pareados por sexo e curso com outros 139 estudantes, identificados como Grupo Sem Risco (GSR). O pareamento foi realizado através de sorteio aleatório. A amostra total na linha de base foi de 278 alunos. Foi realizado seguimento de 12 e 24 meses. Houve uma tendência significativa à diminuição do uso de bebidas no GR, bem como diminuição de conseqüências negativas. No GSR houve leve aumento no consumo de álcool, mas não das conseqüências negativas ao longo do tempo. No entanto, ambos permaneceram no mesmo padrão da linha de base, ou seja, de risco e sem risco. Os homens beberam mais que mulheres e as alunas do GR sofreram mais quedas e fraturas comparadas aos alunos. O GR teve, ainda, pior desempenho escolar. Os principais fatores de risco para o padrão de uso de álcool do tipo "beber se embriagando" para os estudantes de ambos os sexos foram ter amigos que também tinham tal padrão e ter usado drogas ilegais nos últimos 12 meses. Para as mulheres, foi fator de proteção morar sozinha. / Abstract: Episodic heavy drinking or "binge drinking" is defined as the consumption of 5 or more drinks in one occasion, and it is common among young people. This pattern of consumption is frequent and worrying as it is associated with serious negative consequences. Objective: evaluating all 2004 freshmen from the Unesp Campus of Botucatu which were risky users comparing them with a matched non-risky group on their behavior, consequences relative to drink in a 24 months follow-up. Methods: in this casecontrol study about 457 freshmen of the 533 enrolled were interviewed in all the 11 courses offered in the campus. The risky use of alcohol was defined by an AUDIT score greater than or equal to 8 and / or RAPI greater than or equal to 7 in the last 12 months. A hundred thirty nine students were identified and called Risky Group (GR) and matched by sex and course with other 139 students nonrisky alcohol use identified as Non-risky Group (GSR). The matching was carried through random drawing. The total sample at the baseline was 278 students. Persuing of 12 and 24 months was carried through. Results: The reduction of the drink use had a significant trend in the GR, as well as the reduction of negative consequences. In the GSR, there was increase of the alcohol consumption, but not of the negative consequences throughout the time. However, both had remained the same in standard of base line, that is, of risk or without risk. Men drank more than the women and girls of GR suffered more falls and fractures compared to men. The GR had, still, worse school performance. The main risk factors for "binge drinking" for students of both sexes were to have friends who had such standard and to have used illegal drugs in the last 12 months. For women, to live alone was a protection factor. Conclusions: Although without intervention, the students had tended to diminish the alcohol use over the time, but the comsuption of alcohol remained at levels of concern and risk. / Orientador: Ivete Dalben / Coorientador: Florence Kerr-Corrêa / Banca: Maria Odete Simão / Banca: Jair Licio Ferreira Santos / Mestre

abstract: Driving under the influence (DUI) is a problem in American society that has received considerable attention over recent decades from local police agencies, lobby groups, and the news media. While punitive policies, administrative sanctions and aggressive media campaigns to deter drinking and driving have been used in the past, less conventional methods to restructure or modify the urban environment to discourage drunk driving have been underused. Explanations with regard to DUIs are policy driven more often than they are guided by criminological theory. The current study uses the routine activities perspective as a backdrop for assessing whether a relatively new mode of transportation - an urban light rail system - in a large metropolitan city in the Southwestern U.S. can alter behaviors of individuals who are likely to drive under the influence of alcohol. The study is based on a survey of undergraduate students from a large university that has several stops on the light rail system connecting multiple campuses. This thesis examines whether the light rail system has a greater effect on students whose routines activities (relatively unsupervised college youth with greater access to cars and bars) are more conducive to driving under the influence of alcohol. An additional purpose of the current study is to determine whether proximity to the light rail system is associated with students driving under the influence of alcohol, while controlling for other criminological factors / Dissertation/Thesis / M.S. Criminology and Criminal Justice 2014

A associação entre consumo de bebidas alcoólicas e a incidência de hipertensão pode ser dependente do padrão de consumo e raça. Em um estudo de coorte de base populacional, foram entrevistados no domicílio 1089 adultos, selecionados ao acaso. A pressão arterial e medidas antropométricas foram aferidas de acordo com recomendações padronizadas. A quantidade de álcool consumida foi avaliada por um questionário de quantidade-freqüência. Binge drinking foi definido pelo consumo de 5 ou mais drinques em uma ocasião para homens ou 4 drinques para mulheres, e abuso de álcool, por consumo de 30 ou mais gramas por dia em homens ou 15 g ou mais em mulheres. Os entrevistadores classificaram a cor da pele dos participantes em brancos e não-brancos. Casos incidentes de hipertensão foram caracterizados por PA ≥ 140/90 mmHg ou uso de medicamento anti-hipertensivo. A razão de risco (RR) para incidência de hipertensão arterial foi computada em modelo de Cox. Entre os 589 indivíduos normotensos na entrevista basal, foram identificados 127 casos incidentes de hipertensão, após um seguimento de 5,6 ± 1,1 anos. Não houve associação de binge drinking e dependência de álcool (CAGE) com a incidência de hipertensão. A RR ajustada (idade, educação) para a incidência de hipertensão (IC 95% ) foi significativa apenas para indivíduos não-brancos que consumiam 30 g ou mais de etanol por dia: 7,3 (1,4 - 39,3). A pressão arterial sistólica aumentou entre os abusadores não brancos 16,1 ± 3,5 mmHg, em comparação com 4,9 ± 1,5 mmHg entre os abusadores brancos (P= 0,004). Indivíduos com ancestrais africanos que consumisam grandes quantidades de álcool apresentaram maior risco de desenvolverem hipertensão arterial. Este risco não foi explicado por binge drinking ou dependência de álcool. / The association between alcoholic beverage consumption and incidence of hypertension may be dependent of the pattern of consumption and race. In a population-based cohort study, 1089 adults, interviewed at home, had BP and anthropometric measurements carried out according to standardized recommendations. Alcohol consumption was ascertained by an amount-frequency questionnaire. Binge drinking was defined by consumption of 5 or more drinks in one occasion for male or 4 drinks for women, and abuse of alcohol by consumption of 30 or more grams per day in men or 15 g or more in women. Interviewers classified the skin color of participants in white and non-white. Incident cases of hypertension were characterized by BP ≥ 140/90 mmHg or use of hypertension medication. Hazard ratios (HR) were computed in a Cox model. Among 589 normotensive individuals in the baseline visit, 127 incident cases of hypertension were identified, after a follow up of 5.6 ± 1.1 years. Binge drinking and alcohol dependency (CAGE) were not associated with the incidence of hypertension. Adjusted (age, education) HR for the incidence of hypertension (95% CI) was significant only for non-white individuals who consumed 30 g or more of ethanol per day: 7.3 (1.4 to 39.3). Systolic blood pressure of black abusers increased 16.1 ± 3.5, in comparison with 4.9 ± 1.5 mmHg among white abusers (P = 0.004). Individuals with an African ancestry, who consumed larger amounts of ethanol, were at higher risk of developing hypertension. This risk was not explained by binge drinking or addiction to alcohol.

Magister Artium (Social Work) - MA(SW) / Heavy alcohol drinking is a serious health concern in many African countries such as Namibia and South Africa. The heavy use of alcohol is mainly due to avoid coping with the realities of life. There is however, a paucity of research on heavy alcohol use amongst women, particularly in Oshana region of Namibia, where problem drinking is threatening the well-being of women and society. This study explored the psycho-social determinants of women who are heavy alcohol users in the Oshana region. The study design was explorative and descriptive within a qualitative approach. The social constructionist theory underpinned this study. Four participants were randomly selected from the Developmental Social Services caseload which led the researcher to snowball the other four participants for a total of eight participants in the study. Data was collected by means of semi-structured face-to-face interview with the aid of an interview guide. Interviews were transcribed verbatim and field notes were taken. Thematic analysis was used to analyse and interpret the data. The participants identified with coping with realities among women heavy drinking. They reported psychological and social factors affected the well- being of women drinking. These factors included poverty, unemployment, family pressure or influence, availability and accessibility of alcohol, expression, stress, low self-esteem, fear of loneliness and many others. Based on these results, some of the suggestions put forward by all the participants and the researcher concluded the study with a recommendation that an awareness can be created by service providers such as social workers working with women who are heavy drinkers to establish and improve alcohol programmes in Oshana Region and Namibia as a whole.

Doctor of Philosophy / Department of Psychology / Laura A. Brannon / Binge drinking is a serious health problem among American college students (Wechsler, Lee, Kuo, & Lee, 2000a). One technique that may reduce binge drinking is compliance. Cialdini (2001) defined compliance as taking an action because it has been requested and described sequential request tactics, including the commitment/consistency-based foot-in-the-door (FITD) tactic, and the reciprocity-based door-in-the-face (DITF) tactic. Cialdini claimed that these tactics yield automatic compliance. The present research investigated Cialdini’s automaticity assumption within the context of reducing binge drinking, by including a neutral or weak message along with the compliance request (consistent with Brannon & Brock, 2001). The main hypothesis was that compliance is not automatic, as demonstrated by differential compliance consistent with message strength. Parallel experiments investigated compliance with requests to reduce one’s drinking behavior (Experiment 1, N=129) or communicate about responsible drinking (Experiment 2, N=122). Participants were randomly assigned to one of six conditions in each experiment. Consistent with the purpose of each experiment, participants indicated whether they would comply with initial requests consistent with FITD and DITF methodology, or were not asked to comply with an initial request (control); read either a neutral or weak message about the importance of moderate alcohol consumption; then responded to the target request (dependent variable) by reporting the likelihood that they would not drink excessively for one week (Experiment 1) or would discuss responsible drinking with someone (Experiment 2). Participants in both experiments completed demographic and alcohol consumption information and a social desirability measure (Strahan & Gerbasi, 1972). Data were submitted to 2(Strength) × 3(Appeal) × 2(Gender) ANCOVAs (drinks per occasion and social desirability were covariates). Experiment 1 revealed a significant Strength × Appeal interaction, with the DITF and FITD appeals eliciting lower compliance rates than the control appeal when accompanied by a weak persuasive message, thereby refuting Cialdini’s automaticity assumption. A significant main effect for appeal in Experiment 2 (DITF yielded lower compliance than FITD or control appeal) did not support Cialdini’s (2001) claim. Correlates of drinking behavior among college students are discussed, as are implications of the present research for compliance theory and reducing binge drinking on American college campuses.

Doctor of Philosophy / Department of Psychology / Laura A. Brannon / Two studies address the serious problem of college student binge drinking. Both studies identify factors that improve the effectiveness of public service announcements (PSAs) encouraging responsible drinking presented through a website simulation. Study 1 tested four levels of Message Personalization (i.e., extent to which the PSA targets important aspects of the individual's personality) by comparing the effectiveness of messages matched to the person's Big Five personality traits, their actual self-schema, their ideal self-schema, or a non-personalized control message. Matching to actual self-schema has been found to be effective in past research. However, it was expected that the more thoroughly personalized the message, the more effective it would be. Results revealed that in no instance was the most thoroughly personalized condition (Big Five matched) or the alternate way of matching to schema (ideal self-schema) more effective than the actual self-schema matching. When designing PSAs, there appears to be a threshold of personalization. Research related to testing PSAs discouraging binge drinking should continue to pursue self-schema matching rather than the more complicated Big Five matching. Study 2 tested Person Matching (i.e., whether the PSA matches the person's self-schema type or not) and two types of Context Matching (i.e., whether the PSA matches the Topic or Values of the message context) to determine their relative influence on the effectiveness of the PSA. It was expected that PSAs matched to any of these factors would be more effective than messages not matched, and that Person Matching would be more influential on the PSAs effectiveness than the two types of context matching. Person Matching reduced intentions to drink while staying in/home, but Topic Matching reduced intentions to drink when going out, suggesting that different factors are important for PSAs targeting drinking behavior in different locations. The interaction of Topic Matching and Values Matching indicate that the PSA should not match the message context too closely. Again, there appears to be a matching threshold; increasing the number of factors the message matches does not increase message effectiveness, possibly because it makes the message too redundant with the webpage content.

Nonsuicidal Self-Injury (NSSI), or the deliberate damage of bodily tissue without suicidal intent, is a prevalent issue in young people. Relative to those who have never self-injured, young people with either recent (i.e., past-year) or distal (i.e., lifetime, but not in the past year) histories of NSSI demonstrate difficulties with emotion regulation, the process of modulating emotional responses. Emotion regulation difficulties are a risk factor for other forms of Self-Damaging Behaviours (SDBs), including binge drinking, substance use, and binge eating, which are more prevalent among individuals with a history of NSSI. Prominent theoretical models of NSSI and other SDBs posit that these behaviours may share a common function of altering negative mood states, explaining their frequent co-occurrence. The present study hypothesized that first-year university students with distal, recent, or no history of NSSI a) would differ in their rates of SDB engagement over seven months, and b) would differ in their strength of association between changes in stress and concurrent SDB engagement. Further, the present study hypothesized that emotional dysregulation would moderate the association between stress and SDB engagement. Multilevel modelling with longitudinal data from two cohorts of first-year undergraduates (N=540) revealed that students with either distal or recent NSSI histories were more likely to engage in substance use than their peers who had never self-injured, but did not report a greater frequency of binge eating or binge drinking. Regardless of NSSI history, substance use was unrelated to within-person changes in stress or emotional dysregulation. Higher-than-usual stress was associated with increased frequency of binge eating and binge drinking, but this association was unrelated to NSSI history or emotional dysregulation. Results suggest that elevated risk for substance use may persist even after NSSI has stopped, while other forms of SDBs (i.e., binge drinking and binge eating) were not predicted by NSSI history. Further, results suggest that some SDBs (i.e., binge drinking and binge eating) are enacted more frequently during periods of stress, but that this pattern is not unique to those with a history of NSSI or those who struggle to regulate their emotions. Consistent with person-centred models of NSSI recovery, these results suggest that vulnerability to some SDBs may persist even after NSSI has stopped. Future research should further examine the mechanisms underlying the complex association between NSSI and SDBs. / Graduate

Background: Binge drinking (BD) is common in Peru, but may not be routinely detected by standard assessments of hazardous drinking. Objectives: We describe prevalence and risk behaviors of men who have sex with men (MSM) and transgender women (TW) in Peru who met criteria for BD as compared with those who met criteria for hazardous drinking. Methods: In a cross-sectional sample of MSM and TW from Lima (2012-2014), we calculated prevalence of BD (consuming ≥6 alcoholic drinks per occasion by AUDIT-3 criteria), conducted bivariate analyses of associations of BD with demographic and behavioral characteristics, and compared prevalence and behaviors of BD to those of hazardous drinkers (identified by AUDIT-10 criteria). Results: Of 1,520 MSM (n = 1,384) and TW (n = 137) with median age 27 years, 74.4% of MSM and 86.9% of TW met criteria for BD. Among MSM, BD was associated with a greater likelihood of using alcohol (41.6% vs. 13.8%; p <.01) or drugs (7.8% vs. 2.8%; p <.01) prior to a recent sexual contact. Among TW, BD was associated with greater frequency of alcohol use (44.9% vs. 11.1%; p <.01) or unprotected anal intercourse (58.8% vs. 33.3%; p =.04) during ≥1 of their three most recent sexual contacts. There was a higher prevalence of BD (75.5%) than hazardous drinking (53.2%) in our sample, with binge drinkers exhibiting similar sexual risk behaviors to hazardous drinkers. Conclusions: Binge drinking is common among MSM and TW in Lima, associated with risky sexual behavior, and may not be adequately captured by AUDIT-10 criteria. / Revisión por pares

Objective: Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. Methods: A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey (CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The overall prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p < 0.0001) and residence groups had significant interactions with gender, age group, education level, and employment status (p < 0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p < 0.05). Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. Conclusions: Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions.

Excessive alcohol consumption (EAC) is an important public health problem. Several researchers have examined work-related influences on EAC, but few have investigated the predictors of EAC related to business travel. This study measured the association between EAC and frequency of business travel, duration of business travel, and job industry among U.S. business travelers. Research was conducted within the social-ecological theoretical framework. Snowball sampling was used to gather data from 187 business travelers. Data were evaluated using bivariate analysis to assess the association between measures of EAC and each independent variable. Multiple logistic regression was used to adjust for covariates. Respondents aged 45-54 and 55 and older had significantly lower odds of binge drinking than those aged 18-34, OR = 0.33, 95% CI [.11, .98], p < .05; and OR = .13, 95% CI [.03, .55], p < .01, respectively. Females aged 55 and older and all females who traveled frequently in the previous month had lower odds of binge drinking compared to females 18-34 and infrequent female travelers (OR = .03, 95% CI [.00, .37], p < .01; OR = .34, 95% CI [.12, .99], p < .05, respectively). Both males (compared to females) and Protestants (compared to Catholics) had lower odds of heavy drinking (OR = .34, CI [.14,.84], P < .05; OR = .301, CI [.09,.99], P < .05, respectively). Results highlight the prevalence of EAC among business travelers, particularly among females. Multilevel interventions are proposed, which may reduce health-related disparities associated with EAC among this population of business travelers.