Considering serious health, social and subsequently economic impacts which are rising due to the heavy alcohol consumption in the Czech Republic and the whole of Europe, the WHO proposed scientifically based tools, the aim of which is to minimize damage caused by alcohol. Health service is, therefore, highly recommended to establish Screening and brief interventions (SBI). The SBI method belongs to behavioural and cognitive-behavioural therapies. The goal is to identify people with risk or harmful alcohol consumption, to stop its usage, to diminish risks and get a motivation to seek specialized assistance. The majority of recommendations to establish SBI for risk and harmful drinking are especially aimed at primary care, mostly at doctors. Nurses with their broad competence in a lot of medical fields are left behind even though their activity including direct contact with patients involves analysing the levels of risk factors which alcohol is a part of. The purpose of the study is to clarify under which circumstances it is possible to effectively apply the SBI methodology into nursing practice in a selected Czech district, to describe the current engagement and extent of nurses' motivation to deal with alcohol prevention, to look for possibilities of SBI integration into real nursing practice and...

Although alcohol plays an important role in psychiatric morbidity, there is a general lack of strategies within psychiatric care to intervene at alcohol problems in an early stage (secondary prevention). The aim of this thesis was to increase knowledge of adequate forms of secondary alcohol prevention in psychiatric care.   The capacity of three brief screening instruments was investigated in a psychiatric outpatient sample (n=1811). The results indicate that the HED (heavy episodic drinking) screener, strongly recommended for health care settings, is not sufficiently sensitive in a psychiatric setting. Instead, the full AUDIT (Alcohol Use Disorders Identification Test) is recommended. The knowledge and attitudes of psychiatric staff members to problem-drinking patients were studied and the effects of a three-hour training course were investigated. Confidence in self-perceived capacity to intervene in more severe alcohol problems was raised among all staff after training. Awareness of early signs of problem drinking was raised among psychologists and social workers. The therapeutic attitude of the psychiatric staff was higher when compared with primary care staff. Two forms of brief intervention were delivered by clinical psychiatric staff. At 12 months, 29% of all participants had improved their drinking habits, moving from hazardous to non-hazardous level (21%) or from harmful to hazardous level (8%). In the improved group, mean AUDIT score was reduced from 11.0 points at baseline to 5.5 points. Differences in outcome between the two interventions could not be identified. Nine high-risk drinking young female psychiatric patients were interviewed, focusing on reasons for excessive drinking and factors facilitating a change in drinking habits. Alcohol played an important role in the lives of the young women. It made them feel social and helped them deal with unbearable emotions. It was also used as a means of self-harm, representing the first stage in an escalating self-harm process. They expressed a need for help from their caregivers in addressing the underlying reasons for drinking. Secondary alcohol prevention strategies including appropriate screening methods, staff training and the elaboration of tailored interventions are urgently needed in psychiatric care. The findings of this thesis can be used when forming such strategies.

Alcohol consumption during pregnancy is one potential risk factor for spontaneous abortion (SAb). Prior research suggested that heavy drinking during pregnancy was associated with significantly increased rates of SAb, but results for lower levels of drinking have been inconsistent. We examined the association between different levels and patterns of prenatal alcohol consumption and SAb in a high-risk inner-city sample. We hypothesized that higher levels, binge patterns, and more frequent drinking would be associated with increased rates of SAb. The quantity and frequency of self-reported peri-conceptional and repeated in-pregnancy maternal drinking volumes per beverage type were assessed with semi-structured interviews in a prospective subsample of 302 African-American mothers. Relations between various measures of prenatal alcohol exposure and SAb were assessed using logistic regression. After controlling for various potential confounders, there was a significant positive relation between average absolute alcohol use per day across pregnancy and SAb. Greater frequency of drinking episodes also predicted SAb: an average of even one day of drinking per week across pregnancy was associated with an increase in the incidence of SAb. However, contrary to our hypothesis, neither the amount of alcohol drunk per drinking day nor a measure of binge drinking was significantly related to SAb after controlling for confounders. Differences in when women who drank at risk levels initiated antenatal care may have under-estimated the impact of alcohol on SAb in this low-SES urban African-American sample. Some drinking measures averaged across pregnancy may have under-estimated consumption and overestimated risk of SAb, but other risk drinking measures that avoid this limitation show similar relations to SAb. Identifying fetal risk drinking in pregnant women is critical to increasing the effectiveness of interventions that reduce risk level alcohol consumption and protect from pregnancy loss.

Vatten i Sverige har länge ansetts hålla hög kvalitet, men trots detta inträffar årligensjukdomsfall orsakade av förorenat dricksvatten. I enlighet med livsmedelsverketsföreskrifter om dricksvatten ska dricksvatten vara ”hälsosamt och rent”. Detta är dock inteett praktiskt tillämpbart villkor, då ingen acceptabel risk har satts upp.Världshälsoorganisationen (WHO) och det amerikanska naturvårdsverket (US EPA) hardäremot satt upp gränser för vad som är en acceptabel sjukdomsrisk respektiveinfektionsrisk för dricksvatten.Denna studie syftade till att bedöma om reningen vid Hyndevads vattenverks, medavseende på mikroorganismer, möjliggör att en acceptabel risknivå uppnås. Detta hargenomförts med hjälp av metoderna Optimal desinfektionspraxis (ODP) ochMikrobiologisk riskanalys (MRA). ODP är ett norskt system för att bedömamikrobiologiska risker vid ett vattenverk och MRA är ett svenskt verktyg som genom att tahänsyn till variationer i vattenkvalitet och driftförhållanden beräknar hälsorisken. MRA gerutdata i form av infektions- och sjukdomsrisk för konsumenterna samt gör det möjligt attpå ett enkelt sätt jämföra olika typer av beredningar och scenarion med varandra.Vattenverket visade sig varken ha tillräckligt antal skyddsbarriärer, enligtlivsmedelsverkets rekommendationer, eller uppnå tillräcklig rening enligt ODP eller MRA.Resultaten har lett till bedömningen att reningen med avseende på mikroorganismer inte ärtillräcklig och att åtgärder är nödvändiga. Som åtgärd föreslås att nuvarande reningsprocesskompletteras. De tillbyggnader som enligt simuleringarna i MRA skulle klara US EPA:sgräns, som innebär att den årliga infektionsrisken underskrider 1/10 000, var: 1. Membranfiltrering med porstorlek 0,01-0,1 μm 2. En kombination av Ozon (2 mg/l), UV-ljus (25 mJ/cm2) och monokloramin iställetför nuvarande klorering, där tillbyggnaderna är beräknade för att behandla detkonstgjorda grundvattnet 3. Kemisk fällning vid god flockbildning och filtrering / For a long time Sweden has been known to have a high quality of water, although everyyear diseases occur due to drinking water. According to the Swedish National FoodAdministration drinking water shall be “healthy and clean”. In practice this is hard toapply, as an acceptable risk level has not been decided. The World Health Organization(WHO) and the American Environmental Protection Agency (US EPA) have specified theacceptable risk for illness and infection due to drinking water.The purpose of this study was to estimate if the process at Hyndevad water treatment plantachieves an acceptable risk level. This has been done by using the methods ODP (Optimaldisinfection practice) and MRA (Microbiological risk assessment). ODP is a Norwegianmethod to evaluate if the process is good enough. MRA is a Swedish tool that includesvariations in water quality and process operation which make it possible to replace riskestimates with calculated numbers. The data is given as risk of infection and disease for theconsumers. This makes it possible to compare different types of processes and scenarios.The study has shown that the water treatment plant neither provides sufficient protectivefence according to Swedish National Food Administration recommendations, nor iseffective enough according to ODP or MRA. This leads to the conclusion that thereduction of microorganisms is not good enough and actions are necessary. That is why itis suggested that the process is complemented. The additional processes that manage toaccomplish the limit according to US EPA, less than 1/10 000 infected per year, would be: 1. Membrane filtration with mesh size 0,01-0,1 μm 2. A combination of 2 mg O3/l, 25 mJ UV/cm2 and monochloramine instead of currentchlorination where the additional processes are calculated to treat the artificialgroundwater 3. Chemical precipitation with good flocculation and filtration

The purpose of this study was to explore the relationship between student leadership and alcohol use. Previous literature had examined alcohol use of leaders and non-leaders in high-use organizations — Greeks and athletes. This study extends that literature by focusing on leaders and non-leaders in low-use organizations, and by examining students with multiple leadership roles. The research used existing data from the Core Alcohol and Drug Survey. A random sample of 2,000 respondents was obtained from the Core Institute at Southern Illinois University – Carbondale. Respondents were leaders and non-leader members of minority and ethnic organizations and religious and interfaith groups. From this total sample, 624 students were active in minority organizations only, 865 were involved in religious groups only, and 511 were active in both. Dependent variables were drawn from four questions on the Core Survey concerning average number of drinks per week, consumption of five or more drinks at one sitting, negative consequences of alcohol use, and alcohol-related beliefs. No statistically significant differences were found in the alcohol use of leader and non-leaders who were active only in minority groups. Significant differences were found however, between leaders and non-leaders who were active only in religious groups. For these groups, leaders consumed alcohol, engaged in high-risk drinking, experienced negative consequences, and ascribed to alcohol-related myths at a lower rate than those not in leadership positions. Student in dual leadership positions across the whole sample reported significantly higher alcohol use than student involved in one leadership position. Students with leadership roles in both minority and religious organizations drank approximately three times as much (9.75 per week) as those who are leaders in only one type of organization (2.75 per week). The results of this study, understood in the context of the existing literature on alcohol and leadership in high-use organizations, suggest that a Leader Factor may exist: Leaders of student organizations tend to drink at least as much as non-leaders, and those with multiple leadership roles have the highest rate of involvement with alcohol. The single exception to this rule is leaders who are active in religious groups only. / Master of Arts

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The purpose of this grounded theory qualitative study was to examine the experiences of college students who defined themselves as high-risk drinkers in order to understand the meaning and purpose that engagement in such a leisure occupation held for them. By examining the world of high-risk drinking, the study also sought to develop an understanding of the impact that high-risk drinking had upon psychosocial development during the college years. Individual open-ended interviews were conducted with four male and four female participants (aged 21 to 27). The data were analyzed by three analysts utilizing constant comparative procedures. The findings revealed an emergent grounded theory indicating high-risk drinking adhere to the serious leisure hobby framework developed by Stebbins (2007). As such, the participants had a long-term time investment with drinking, developed special skills through sustained effort, solidified a unique identity as a hobbyist, found deep meaning and purpose through the hobby, and performed the hobby within a unique and special world in concert with other hobbyists. Their high-risk drinking provided structure and a sense of belongingness within the larger university context. Further, the findings indicate that across time, facilitating factors catalyzed their engagement in the hobby, while the moderating factors became less influential. The participants also believed that their highrisk drinking will easily diminish post-graduation merely by changing their life role and context. iv Envisioning high-risk drinking as a serious leisure hobby, rather than a psychiatric or medical disorder, provides an alternative framework upon which prevention and intervention programming may be focused. Occupational therapist could provide an important health care role on campuses by assisting students to (a) understand the factors underlying the appeal of high-risk drinking, (b) understand the implications that a restricted range of leisure occupations may have upon their health, psychosocial development, and occupational identity, and (c) explore alternative health-producing leisure occupations.