Thesis (M.S.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 52 pages. Includes bibliographical references.

Thesis (M.S.P.H.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 114 pages. Includes bibliographical references.

Introduction: The public health system is of central importance in efforts to reduce the burden of chronic disease, yet there are no national data on organizational capacity (OC) or dissemination practices pertaining to chronic disease prevention (CDP) programming in the public health system. The aim of this thesis is to investigate OC and dissemination practices within the Canadian public health system. Two new conceptual models pertaining to these constructs were developed, and a survey of all public health organizations across Canada engaged in CDP was conducted in 2004-5. / Method: Data were collected in telephone interviews with persons most knowledgeable about CDP programming in 77 "resource" organizations that develop and transfer CDP innovations to other organizations, and 216 "user" organizations that adopt and deliver CDP programs in specific populations. Reliable measures of the constructs of interest were developed using principal components analyses. Levels of OC, its potential determinants, and involvement in CDP programming were compared across three types of organizations and across Canada. In addition, levels of 13 dissemination-related practices were compared across organizations and independent correlates of dissemination were identified in multiple linear regression. / Results: Levels of skill and involvement were highest for tobacco control and healthy eating programming; lowest for stress management, social determinants of health, and program evaluation. Any notable differences in skill levels favoured central Canada. Resource adequacy was low overall; lowest in eastern Canada and within formal public health organizations. Supports for OC were highest in central Canada and in grouped organizations. Dissemination practices most heavily engaged in included: Identification of barriers to adoption/implementation of the innovation, tailoring dissemination strategies and design of dissemination plan. There was little coherence across organizations in the number or types of dissemination practices engaged in. Skill at planning/implementing dissemination, external sources of funding, type of resource organization, attitude toward the process of collaboration, and user-centeredness were all positively associated with dissemination (R2=0,42; F value 8.20, p<0.0001). / Conclusions: These results provide a backbone for organizational research in public health systems. Strengths and gaps identified in OC and dissemination practices will guide strategic investment in the public health system.

Prostate cancer remains one of the most commonly diagnosed cancers in men and is a leading cause of cancer death. While great success has been achieved at curing early stage prostate cancer, limited success has been obtained when treating late-stage hormone independent prostate cancer. This is due to the increased propensity for skeletal and non-skeletal metastases. Thus development of novel effective therapeutic modalities against late stage prostate cancer is of critical importance. / Towards these objectives, I have focused my attention on the role of prostate secretory protein (PSP-94) which is expressed in normal individuals and in patients with early stage prostate cancer. Using our well established in vivo models of prostate cancer, I have evaluated the ability of PSP-94 and its amino acids 31-45 required (PCK3145) to decrease tumor growth and skeletal metastases in vivo and evaluated the potential mechanism(s) associated with PCK3145 anti-cancer actions. / Prostatic cancer can also develop as a result of epigenetic activation of tumor promoting genes. To evaluate the role of methylation in prostate cancer, late stage prostate cancer cells were treated with the universal methylating agent S-adenosylmethionine (SAM) and an anti-sense oligonucleotide directed against MBD2 (AS). Scrambled oligonucleotide was included as a control (S). Both SAM and MBD2-AS resulted in inhibition in uPA, MMP-2 and VEGF production leading to decreased tumor cell invasive capacity. However, SAM and MBD2-AS were not able to either further repress partially methylated genes (GSTP1) or reactivate already methylated genes (AR). Furthermore, SAM and MBD2-AS treatment resulted in significant reduction in tumor growth in vivo . Immunohistochemical and RT-PCR analyses carried out on SAM and MBD2-AS tumors revealed decreased protein and mRNA expression of uPA and MMP-2 which was partially due to increased methylation of the respective promoters even after 10 weeks post in vitro treatment as analyzed by bisulfate sequencing. In addition decreased levels of angiogenesis and tumor survival markers were observed. / Collectively, these studies are aimed at the development of novel reliable approached to diagnose and treat advanced, hormone refractory prostate cancer to reduce tumor associated morbidity and mortality.

Among elderly people, falls lead to a considerable amount of immobility, morbidity, and mortality. The purpose of this study was to develop and evaluate methods for predicting falls, and to evaluate a fall prevention program among elderly people living in residential care facilities. A fall was defined as any event in which the resident unintentionally came to rest on the floor or the ground regardless of whether or not an injury was sustained. In developing the prediction methods, it was hypothesised that older persons showing difficulties in performing a familiar second task while walking were more likely to fall within six months. For residents who stopped walking when talking, the relative risk of falling was 3.5 (95% CL2.0-6.2) compared to those who continued walking. For residents with a time difference (diffTUG) of at least 4.5 seconds between two performances of the Timed Up&amp;Go test, with and without carrying a glass, the hazard ratio for falls was 4.7 (95% Cl: 1.5-14.2) compared to those with a shorter diffTUG. A screening tool, the Mobility Interaction Fall (MIF) chart, was developed and evaluated, then validated in a new sample. This tool included a mobility rating, ‘Stops walking when talking’, ‘diffTUG’, a test of vision, and a concentration rating. In the first sample, the hazard ratio was 12.1 (95% 0:4.6-31.8) for residents classified as ‘high-risk’ compared to ‘low-risk’. The positive predictive value was 78%, and the negative predictive value, the sensitivity, and the specificity were above 80% for falling in six months. In the second sample the prediction accuracy of the MIF chart was lower (hazard ratio 1.7, 95% Cl: 1.1-2.5) and a 6-month fall history or a global rating of fall risk by staff were at least equally valuable. A combination of any two of the methods - the MIF chart, staff judgement, fall history - was more accurate at identifying high risk residents than any method alone. Half of the residents classified by two methods as ‘high risk’ sustained a fall within 6 months. In a randomised study a prevention program directed to residents, staff, and environment resulted in a significant reduction in the number of residents falling (44% vs. 56%; odds ratio 0.62, 95% CF0.41-0.92), the incidence of falls (incidence rate ratio IRR 0.80, 95% CF0.69-0.94) and of femoral fractures (IRR 0.25, 95% 0:0.08-0.82) in the intervention compared to the control group. In conclusion, a combination of any two of the staff judgement, fall history or MIF chart has the potential to identify a large proportion of residents at particular high fall risk. A multidisciplinary and multifactorial fall prevention program directed to residents, staff, and the environment can reduce the numbnumber of residents falling, of falls and of femoral fractures. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 2000,, härtill 5 uppsatser</p> / digitalisering@umu

Dissertation (Ph.D.)--University of South Florida, 2008. / Title from PDF of title page. Document formatted into pages; contains 106, 1 pages. Includes vita. Includes bibliographical references.

Made available in DSpace on 2015-07-22T20:50:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-28. Added 1 bitstream(s) on 2015-08-11T03:26:00Z : No. of bitstreams: 1 Publico-11922.pdf: 2026305 bytes, checksum: 6748d516ad453759f76cc254710a50b1 (MD5) / OBJETIVO: avaliar o efeito de um programa de treinamento de força muscular progressiva e propriocepção, na força muscular do quadríceps, no equilíbrio, na qualidade de vida e na redução do risco de quedas em mulheres com osteoporose pós-menopausa. MÉTODOS: Foram selecionadas cem mulheres sedentárias com idade entre 55 e 75 anos com osteoporose pós-menopausa, randomizadas em dois grupos: grupo intervenção composto por 50 pacientes submetidas a 18 semanas de treinamento de força muscular progressiva do quadríceps (a 50%, 60%, 70% até 80% de 1-RM – uma repetição máxima), e de propriocepção, associados ao tratamento clínico medicamentoso para osteoporose; e grupo controle também composto por 50 pacientes que receberam apenas o tratamento clínico medicamentoso. Força muscular, equilíbrio, mobilidade funcional e qualidade de vida foram avaliados no início e ao final da pesquisa através do Teste de Uma Repetição Máxima (1-RM), Berg Balance Scale (BBS), Timed Up & Go Test (TUG) e SF-36. Número de quedas foi avaliado 6 meses que antecederam à pesquisa e nos 6 meses seguintes. RESULTADOS: 85 pacientes concluíram a pesquisa. Os valores para SF-36 melhoraram em todas as oito sub-escalas no grupo intervenção (p ≤ 0.0018), Timed Up & Go Test (p < 0,0001), do teste de 1-RM (p < 0,0001), da Berg Balance Scale (p < 0,0001), e, ainda, uma redução do risco de quedas no grupo intervenção comparada ao grupo controle (IRR 0.263, 95% IC 0.10, 0.68). CONCLUSÃO: A associação do treinamento de força muscular progressiva para quadríceps e o treinamento proprioceptivo é efetivo na redução do risco de quedas, no aumento da força muscular do quadríceps, na melhora do equilíbrio estático e dinâmico, na melhora da capacidade funcional e da qualidade de vida em mulheres com osteoporose pós-menopausa. / OBJECTIVE: To evaluate the effect of a progressive muscular strength and proprioception training program on the muscle strength of the quadriceps, balance, quality of life and reduction in the risk of falls in postmenopausal women with osteoporosis. METHODS: One hundred sedentary postmenopausal women with osteoporosis, ages ranging from 55 to 75, were selected and randomized into two groups: the intervention group comprised of 50 patients who underwent a 18-week of progressive load training for the quadriceps muscle (50%, 60%, 70% up to 80% of 1- RM – one maximum repetition) and proprioception training associated to a drug treatment of osteoporosis and the control group that included 50 patients who only underwent a drug treatment of osteoporosis. The muscular strength, balance, functional mobility and quality of life were evaluated in the beginning and end of the research through the One Maximum Repetition Test (1-RM), Berg Balance Scale (BBS), Timed Up & Go Test (TU & GT) and SF-36. The number of falls was evaluated 6 months preceding the research and in the following six months. Results: Eighty-five patients concluded the research. The program promoted a significant difference among the groups for SF-36 in the eight sub-scales (p ≤ 0.0018), Timed Up & Go Test (p < 0.0001), 1-RM test (p < 0.0001), Berg Balance Scale (p < 0.0001) and also a decrease in the number of falls in the intervention group compared to control (IRR 0.263, 95% CI 0.10, 0.68). Conclusion: The association of progressive strength training for the quadriceps and the proprioceptive training is effective for the prevention of falls, increasing the muscle power, the static and dynamic balance and increasing the speed of the motor responses, therefore improving the performance of daily activities. / TEDE / BV UNIFESP: Teses e dissertações

Qin, Jing. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 162-218). / Abstract also in Chinese. / Acknowledgment --- p.i / Abstract --- p.ii / 摘要 --- p.iv / Table of Content --- p.vi / List of Figures --- p.x / List of Tables --- p.xv / Abbreviations --- p.xvii / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Ganoderma spp --- p.1 / Chapter 1.1.1 --- Introduction of Ganoderma spp --- p.1 / Chapter 1.1.2 --- Bioactivities of Ganoderma spp --- p.3 / Chapter 1.1.3 --- Endocrine system and breast cancer --- p.11 / Chapter 1.1.3.1 --- Estrogen --- p.11 / Chapter 1.1.3.2 --- Estrogen receptors --- p.12 / Chapter 1.1.3.3 --- Estrogen responsive genes --- p.15 / Chapter 1.1.3.3.1 --- pS2 --- p.15 / Chapter 1.1.3.3.2 --- Progesterone receptor --- p.18 / Chapter 1.1.3.4 --- Androgen --- p.21 / Chapter 1.1.3.5 --- Androgen receptor --- p.23 / Chapter 1.1.3.6 --- Androgen responsive gene --- p.24 / Chapter 1.1.3.6.1 --- Transmembrane prostate androgen-induced RNA --- p.24 / Chapter 1.1.3.6.2 --- Uridine diphosphate glucose dehydrogenase --- p.26 / Chapter 1.1.3.7 --- Breast cancer --- p.26 / Chapter 1.2 --- "Endocrine Disruption of p,p '-DDE" --- p.28 / Chapter 1.2.1 --- Introduction of p´ةp '-DDE --- p.28 / Chapter 1.2.2 --- "p,p '-DDE in environments" --- p.29 / Chapter 1.2.3 --- "p,p '-DDE in human body" --- p.32 / Chapter 1.2.4 --- "p,p '-DDE and reproductive system" --- p.33 / Chapter 1.2.5 --- Endocrine disruptor --- p.35 / Chapter 1.2.6 --- "Action mechanism of p,p '-DDE on endocrine system" --- p.37 / Chapter 1.2.7 --- Apoptosis --- p.39 / Chapter 1.3 --- Food therapy against endocrine disruption --- p.41 / Chapter 1.3.1 --- Food therapy and functional food --- p.41 / Chapter 1.3.2 --- Ganoderma as a Functional food --- p.47 / Chapter 1.3.3 --- Cancer prevention by dietary agents --- p.47 / Chapter 1.3.4 --- Hormone therapy --- p.48 / Chapter 1.3.5 --- Hormone-related properties of Ganoderma spp --- p.50 / Chapter 1.4 --- The aim of the study --- p.51 / Chapter Chapter 2 --- Materials and Methods --- p.52 / Chapter 2.1 --- Ganoderma samples --- p.52 / Chapter 2.2 --- Artificial cultivation of Ganoderma spp --- p.54 / Chapter 2.3 --- Molecular identification of Ganoderma spp --- p.55 / Chapter 2.3.1 --- Extraction of genomic DNA --- p.55 / Chapter 2.3.2 --- Gene-specific polymerase chain reaction (PCR) --- p.56 / Chapter 2.3.3 --- Gel electrophoresis --- p.56 / Chapter 2.3.4 --- Purification of PCR amplified product for sequencing --- p.57 / Chapter 2.3.5 --- Cycle-sequencing --- p.57 / Chapter 2.3.6 --- Sequencing --- p.58 / Chapter 2.3.7 --- Sequence analysis --- p.58 / Chapter 2.4 --- Chemical analyses of Ganoderma spp --- p.59 / Chapter 2.4.1 --- Polysaccharide preparations --- p.59 / Chapter 2.4.2 --- Terpene profile --- p.60 / Chapter 2.4.3 --- Fatty acid profile --- p.60 / Chapter 2.5 --- Anti-oxidation activities --- p.61 / Chapter 2.5.1 --- Superoxide radical scavenging assay --- p.61 / Chapter 2.5.2 --- DPPH radical scavenging assay --- p.62 / Chapter 2.6 --- Anti-proliferation effect on human breast cancer cells --- p.62 / Chapter 2.7 --- Hormone-like effects --- p.63 / Chapter 2.7.1 --- E-screen test --- p.63 / Chapter 2.7.2 --- In vitro estrogen receptors (ERs) competitor binding assays --- p.64 / Chapter 2.7.3 --- "Recombinant yeast cell based ER-, AR- and PGR-responsible promoter assays" --- p.65 / Chapter 2.7.3.1 --- Recombinant yeasts --- p.65 / Chapter 2.7.3.2 --- Growth medium for recombinant yeasts --- p.66 / Chapter 2.7.3.3 --- "ER, AR and PGR assays" --- p.67 / Chapter 2.7.3.4 --- β-Galactosidase assay --- p.67 / Chapter 2.7.4 --- Real time PCR --- p.68 / Chapter 2.8 --- Flow cytometry --- p.71 / Chapter 2.9 --- Comet assay --- p.71 / Chapter 2.10 --- DNA microarray --- p.73 / Chapter 2.10.1 --- Total RNA isolation --- p.73 / Chapter 2.10.2 --- cDNA synthesis --- p.73 / Chapter 2.10.3 --- Preparation of labelled cDNA --- p.74 / Chapter 2.10.4 --- cDNA purification --- p.74 / Chapter 2.10.5 --- Oligo GEArray hybridization --- p.75 / Chapter 2.10.6 --- Chemiluminescent detection --- p.76 / Chapter 2.10.7 --- Data analysis --- p.77 / Chapter Chapter 3 --- Results --- p.78 / Chapter 3.1 --- Analysis of Ganderma spp --- p.78 / Chapter 3.1.1 --- Mycelia and fruiting bodies --- p.78 / Chapter 3.1.2 --- Identification of Ganoderma spp --- p.79 / Chapter 3.1.3 --- Chemical properties of samples --- p.80 / Chapter 3.1.4 --- Anti-oxidation activities --- p.90 / Chapter 3.1.5 --- Anti-proliferation effect on human breast cancer cells --- p.90 / Chapter 3.1.6 --- Hormone-like bioactivities --- p.93 / Chapter 3.1.6.1 --- E-screen test --- p.93 / Chapter 3.1.6.2 --- In vitro estrogen receptors (ERs) competitor binding assays --- p.94 / Chapter 3.1.6.3 --- "Recombinant yeast cell-based ER-, AR- and PGR-responsible promoter assays" --- p.95 / Chapter 3.1.6.4 --- ER- and AR-pathway gene expression by real time PCR --- p.97 / Chapter 3.2 --- "Action mechanism of p,p' -DDE" --- p.99 / Chapter 3.2.1 --- E-screen --- p.99 / Chapter 3.2.2 --- In vitro estrogen receptors (ERs) competitor binding assays --- p.101 / Chapter 3.2.3 --- Recombinant yeast cell based ER- and AR-responsible promoter assays --- p.103 / Chapter 3.2.4 --- ER- and AR-pathway gene expression by real time PCR --- p.106 / Chapter 3.3 --- Ganoderma tsugae mycelia extract against p.p' -DDE --- p.109 / Chapter 3.3.1 --- E-screen test --- p.109 / Chapter 3.3.2 --- ER- and AR-pathway gene expression by real time PCR --- p.110 / Chapter 3.3.3 --- Analysis of cell cycle --- p.112 / Chapter 3.3.4 --- Analysis of DNA damage --- p.114 / Chapter 3.3.5 --- Analysis of sub-G1 peak --- p.117 / Chapter 3.3.6 --- DNA damage and apoptosis relative gene expression by real time PCR --- p.120 / Chapter 3.3.7 --- DNA microarray --- p.121 / Chapter Chapter 4 --- Discussion --- p.131 / Chapter 4.1 --- Analysis of Ganoderma spp --- p.131 / Chapter 4.2 --- Effects of p.p´ة-DDE --- p.144 / Chapter 4.3 --- Protective effects of G. tsugae against p.p' -DDE --- p.151 / Chapter 4.4 --- Further investigation --- p.159 / Chapter 4.5 --- Conclusion --- p.160 / References --- p.162

Submitted by Socorro Pontes (socorrop@ufersa.edu.br) on 2017-02-08T15:08:05Z No. of bitstreams: 1 ThaísAK_DISSERT.pdf: 1952872 bytes, checksum: d756cff8a38a02ad11767b390ea5ce27 (MD5) / Made available in DSpace on 2017-02-08T15:08:05Z (GMT). No. of bitstreams: 1 ThaísAK_DISSERT.pdf: 1952872 bytes, checksum: d756cff8a38a02ad11767b390ea5ce27 (MD5) Previous issue date: 2016-02-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Visceral leishmaniasis (VL) is a potentially fatal chronic disease when left untreated. In Brazil, is caused by the protozoan Leishmania infantum is transmitted primarily by sandfly Lutzomyia longipalpis, the dog as the main reservoir. The control of this disease has been in a challenge to public health, and as a proposal for a measure of control of canine VL using dog collars impregnated with deltamethrin to 4% in dogs. Thus, the research aims to assess the effectiveness of these collars on the prevalence of canine VL and infection rate of sandfly to L. infantum in endemic areas for VL. The survey was conducted in two areas equidistant from the city of Mossoró/RN, with similar environmental characteristics. In both of these areas were carried out two surveys every six months and to serologic canines are search for a year, and in a were performed only the procedures mentioned above, being named Control Area (AC) and the other, in addition to the steps mentioned earlier were also carried out two collaring dogs with collars impregnated with deltamethrin the 4% that occurred every six months This area was named “Encoleiramento” Area (AE). For diagnosis of canine VL was made DPP and ELISA. The analysis of the prevalence of canine VL was carried out through the Chi-square test and the incidence rate of the disease through the Odds ratio. For the collection of sandflies were selected three houses in each of the areas, the insects were collected monthly using CDC light traps and separated by species, sex, stage of investigation and research. The morphological identification of sandflies and the females were subjected to real-time PCR for the detection of DNA of L. infantum. With regard to prevalence and incidence rates of VL, evaluating the areas in isolation, one could observe that the use of dog collars was able to reduce the prevalence of the disease in AE and 53 to 59% reduction in the risk of illness. As the sandfly, collected the species L. longipalpis, L. evandroi, L. cortelezzii and L. migonei, with 81,8% % L. longipalpis. Positive pools were obtained from L. longipalpis of AE only during the first investigation while in AC could observe the presence of DNA of the parasite in vector in both investigations. Based on the results, the use of impregnated with deltamethrin collars to 4% has the potential to reduce the prevalence of canine VL as well as allows a reduction in at least 53% the risk of illness. It is also possible to suggest that the continued use of these dog collars can have the potential to reduce the rate of infected sandflies. Thus, impregnated with deltamethrin collars to 4% can be indicated as a control measure for the disease, together with other measures currently recommended / A leishmaniose visceral (LV) é uma doença crônica potencialmente fatal quando não tratada. No Brasil, é causada pelo protozoário Leishmania infantum é transmitida principalmente pelo flebotomíneo Lutzomyia longipalpis, tendo o cão como principal reservatório urbano. O controle desta afecção tem consistido em um desafio para a Saúde Pública, e como proposta de medida de controle da LV canina tem-se a utilização de coleiras impregnadas com deltametrina a 4% em cães. Assim, a pesquisa tem como objetivo avaliar a efetividade dessas coleiras sobre a prevalência da LV canina e taxa de infecção de flebotomíneos para L. infantum em áreas endêmicas para LV. A pesquisa foi realizada em duas áreas equidistantes do município de Mossoró/RN com características ambientais semelhantes. Em ambas as áreas foram realizados dois inquéritos sorológicos caninos semestrais e a pesquisa de flebotomíneos. Na Área Controle (AC) foram realizados os procedimentos anteriormente citados e na Área Encoleiramento (AE) foram também realizados dois encoleiramentos caninos com coleiras impregnadas com deltametrina a 4% que ocorreram a cada seis meses. Para diagnóstico da LV canina foram realizados o teste rápido DPP e ELISA. A análise da prevalência da LV canina foi realizada através do teste de Qui-quadrado e da taxa de incidência através do Odds ratio. A pesquisa de flebotomíneos teve duração de um ano em três residências de cada uma das áreas. Os insetos foram coletados mensalmente utilizando armadilhas luminosas tipo CDC e separados por espécie, sexo, primeiro ou segundo inquérito e área da pesquisa. Foi realizada a identificação morfológica dos flebotomíneos e as fêmeas foram submetidas à técnica de PCR em tempo real para a detecção de DNA de L. infantum. Com relação às taxas de prevalência e incidência da LV canina, avaliando-se as áreas isoladamente, pôde-se observar que o uso das coleiras foi capaz de reduzir a prevalência da doença na AE e reduzir em 53 a 59% o risco de adoecimento. Quanto aos flebotomíneos, foram coletadas as espécies L. longipalpis, Lutzomyia evandroi, Lutzomyia cortelezzii e Lutzomyia migonei, sendo que 81,8% destes insetos eram L. longipalpis. Foram obtidos pools positivos de L. longipalpis da AE somente durante o primeiro inquérito ao passo que na AC pôde-se observar a presença do DNA do parasita no vetor em ambos os inquéritos. Com base nos resultados, pode-se afirmar que a utilização de coleiras impregnadas com deltametrina a 4% reduziu a prevalência da LV canina, e permite reduzir em pelo menos 53% o risco de adoecimento. Também é possível sugerir que o uso contínuo destas coleiras pode ter o potencial de reduzir a taxa de flebotomíneos infectados. Dessa forma, coleiras impregnadas com deltametrina a 4% podem ser indicadas como medida de controle para a LV canina, aliada as demais medidas atualmente preconizadas / 2017-02-08

Made available in DSpace on 2015-12-06T23:47:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2008 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / O uso abusivo de álcool tem sido um problema crescente, tanto em termos de saúde individual quanto coletiva. A detecção precoce do uso de risco de álcool seguida por intervenção breve, pode ser uma importante estratégia para evitar o agravamento dos problemas sociais, de saúde física e mental dos usuários. Objetivos: avaliar a eficácia de uma Intervenção Breve de sessão única, realizada em unidades de saúde, na redução do consumo ou de problemas associados ao uso de risco de bebidas alcoólicas; analisar a influência do nível inicial de problemas associados ao uso de álcool no resultado da intervenção; comparar as taxas de prevalência de usuários de risco de substâncias psicoativas detectadas por profissionais de saúde com as detectadas por pesquisadores, usando o instrumento ASSIST. Metodologia: os instrumentos de detecção e os procedimentos de intervenção breve foram aplicados por pesquisadores ou por profissionais de saúde, que receberam um treinamento padronizado na aplicação do ASSIST e da Intervenção Breve (IB). O instrumento de detecção foi aplicado a 4335 pacientes que foram atendidos nos serviços de saúde com queixas gerais de saúde. Os 208 pacientes que pontuaram no ASSIST na faixa de uso de risco para álcool (108 com pontuação baixa – entre 11 e 15 e 100 com pontuação alta – entre 16 e 26) foram aleatoriamente alocados ao grupo Controle (CONT N=106) ou ao grupo Intervenção Breve (IB N=102). Resultados: Considerando como indicador de resultado a pontuação no instrumento de triagem ASSIST, três meses após a avaliação inicial (seguimento), observou-se redução significativa em relação à pontuação inicial (basal) nos dois grupos. A chance de sucesso foi significativamente maior (odds ratio = 5,68, IC 95% 2,8 – 11,7) no grupo que recebeu Intervenção Breve do que no grupo controle. Por outro lado, a chance de sucesso foi significativamente menor (odds ratio = 0,39, IC 95% 0,19 – 0,81) para os pacientes com alto nível basal de pontuação no ASSIST do que para os pacientes com baixo nível inicial de pontuação. Foi detectada menor porcentagem de uso de risco de álcool nos pacientes de São Paulo/Diadema (6,8%), onde os profissionais de saúde aplicaram o ASSIST, do que em Curitiba (13,3%), onde os pesquisadores aplicaram o ASSIST. Por outro lado, detectou-se maior prevalência de uso sugestivo de dependência de álcool em SP (3,8%) do que em Curitiba (0,2%). Em relação à maconha também foi detectada menor prevalência de uso de risco em SP (1,6%) do que em Curitiba (4,9%), o mesmo ocorrendo em relação à cocaína (0,7% em SP e 1,5% em Curitiba). A prevalência de uso sugestivo de dependência foi semelhante (maconha: 0,5% em SP e Curitiba e cocaína: 0,4% em SP e 0,7% em Curitiba). Discussão: A intervenção breve de sessão única aplicada por profissionais de saúde (ou por pesquisadores) imediatamente após a detecção do uso de risco de álcool pelo instrumento ASSIST mostrou-se eficaz na redução de problemas associados ao uso de álcool, sendo o sucesso da intervenção maior em pacientes com menor comprometimento. É possível que as diferenças de detecção observadas sejam devidas à falta de aleatorização na aplicação do instrumento por parte de alguns profissionais de saúde de São Paulo, enquanto que os pesquisadores do Paraná o aplicaram de modo aleatório. Os resultados indicam ser possível a utilização destas técnicas em serviços de atenção primária à saúde após um breve treinamento dos profissionais de saúde.. / The abusive use of alcoholic beverages is a growing problem as regards individual and public health. The early detection of risk use of alcohol followed by brief intervention can be an important strategy in order to prevent the aggravation of physical and mental health conditions as well as of social problems. Objectives: To evaluate the efficacy of a single session of Brief Intervention, performed in primary health care services, in the reduction of alcohol consumption or related problems; to analyze the influence of the initial level of alcohol-related problems on the outcome of the intervention; to compare the incidence rates of psychoactive substances risk users detected by health professionals with those detected by researchers using the screening instrument ASSIST. Methodology: The screening instruments (ASSIST) and the Brief Intervention (BI) were administered by researchers of or health professionals who had previously attended a standardized training. The screening instrument was administered to 4335 patients, users of primary health care services. The 208 patients who scored in the ASSIST risk range regarding alcohol (108 with low ASSIST scores – between 11 and 15 and 100 with high ASSIST scores – between 16 and 26) were randomly allocated to the control group (CONT N=106) or to the BI group (BI N=102). Results: Considering the ASSIST score in the follow-up (3 months after the basal evaluation) as the outcome indicator, we observed a significant reduction regarding the initial scores in both groups. The odds of success were significantly higher (odds ratio = 5.68, CI 95% 2.8 – 11.7) in the BI group than in the control group. On the other hand, the odds of success were significantly lower (odds ratio = 0.39, CI 95% 0.19 – 0.81) in the group of patients with higher initial ASSIST scores. A lower percentage of alcohol risk users was detected in São Paulo/Diadema (where the health professionals administered the ASSIST) than in Curitiba/Palmas (where the researchers administered the ASSIST). A lower percentage of risk alcohol use was detected in the patients of São Paulo/Diadema (6.8%), where the health professionals applied the ASSIST, than in Curitiba (13.3%), where the researchers applied it. On the other hand, we detected a higher prevalence of use suggestive of alcohol dependence in SP (3.8%) than in Curitiba (0.2%). As regards marijuana, a lower prevalence of risk use was also detected in SP (1.6%) than in Curitiba (4.9%), and also as regards cocaine (0.7% in SP and 1.5% in Curitiba). The prevalence of use suggestive of dependence was similar (marijuana: 0.5% in SP and Curitiba, and cocaine: 0.4% in SP and 0.7% in Curitiba). Discussion: A single session of Brief Intervention administered by health professionals or researchers, immediately after the screening of alcohol risk use by the ASSIST was effective in the reduction of alcohol related problems, being the success higher in the patients with lower levels of problems. It is possible that the differences detected are due to the lack of randomization in the application of the instrument by some health professionals in São Paulo, since the researchers in Paraná applied it randomly. The results indicate that the use of a screening instrument and the administration of BI are feasible in primary health care services after a short training of the health professionals. / FAPESP: 03/06413-3 / BV UNIFESP: Teses e dissertações