Tesis sobre el tema "Hazardous drinking"

Abstract Head injury is the leading cause of death and disability in trauma patients, and alcohol misuse is often associated with such injuries. Despite modern diagnostic facilities, the extent of traumatic brain injury (TBI) is difficult to assess and supplementary diagnostic tools are warranted. The contribution of alcohol misuse to traumas also needs to be elucidated, as the role of different patterns of alcohol drinking in particular has received less attention. We investigated the clinical utility of a novel serum marker of brain damage, protein S100B, as a tool for assessing TBI in patients with trauma. We also investigated the patterns of alcohol drinking among trauma patients and the trauma mechanisms in relation to blood alcohol concentration (BAC), with special emphasis on head traumas. Finally, we studied the early identification of hazardous drinkers among trauma patients. Serum protein S100B was found to be a feasible supplementary method for assessing TBI, as the latter was shown to elevate its levels significantly, the highest values being found in patients with severe injuries. S100B was also found to be elevated in patients with mild head injury, where it was associated with an increased risk of developing post-concussion symptoms (PCSs). Extracranial injuries also increased S100B values in patients with multitrauma. Accordingly, S100B was not specific to TBI. The more severe the extracranial injury, the higher the S100B value that was found. Binge drinking was found to be the predominant pattern in trauma patients. Alcohol intoxication on admission and hazardous drinking patterns were more often present in patients with head injury than in those with other types of trauma. The risk of sustaining a head trauma significantly increased with increasing BAC. The results also demonstrated that BAC on admission is the best marker of alcohol misuse in trauma patients. The BAC test depicts hazardous alcohol drinking better than conventional biochemical markers of alcohol misuse such as gamma-glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), carbohydrate-deficient transferrin (CDT), or mean corpuscular volume (MCV) of erythrocytes. The findings support the use of S100B as a supplementary method for assessing TBI and the use of BAC as a marker of alcohol misuse in trauma patients.

The current thesis aimed to explore the associations between hazardous drinking, automatic processing of alcohol-related cues and behavioural impulsivity. In addition to assessing the impact of these processes on hazardous drinking in isolation, the specific prediction of dual process models of addiction, that the association between automatic cognitive processes and hazardous drinking would be moderated by behavioural impulsivity, was also tested. These general research questions were investigated cross sectionally in young adult student populations (chapter 3), / adolescents (chapter 4), and older adults (chapter 5). The aim of the study described in chapter 6 was to investigate the effect of a priming dose of alcohol on these processes and their association with alcohol-seeking behaviour. Finally, chapter 7 was an investigation into the mediators and moderators of the effects of ego depletion on drinking behaviour from the perspective of dual process models of addiction. Automatic processing of alcohol-related cues predicted drinking behaviour in all cross sectional studies, although the specific aspects of automatic processes that predicted drinking behaviour differed. The effects of the alcohol prime and anticipated effects of alcohol on different measures of cognitive bias were inconsistent, and automatic cognitive processes only predicted ad-lib drinking in non-intoxicated individuals. Impulsivity only had a direct association with drinking within the sample of older adults, and neither the alcohol prime or ego depletion manipulation increased either measure of behavioural impulsivity. There was evidence that the alcohol priming effect was the result of general impairments in executive cognitive functioning. In the cross sectional studies support for dual process models of addiction was only found in the adolescent sample, in which impulsive decision making moderated the association between attentional bias and problem drinking in adolescents. There was evidence that increases in automatic approach responses towards alcohol-related cues following an alcohol prime were the result of impairments in executive cognitive function. Although ego depletion resulted in increased alcohol consumption this was not due to increased behavioural control by automatic cognitive processes. The results from the current thesis offer considerable support for incentive- motivational models of addiction, arid-highlight the importance of the roles of specific aspects of automatic cognitive processing in different samples. As behavioural impulsivity was only associated with hazardous drinking in older adults this suggests that cumulative experience with alcohol is necessary before these processes impact behaviour. Although support for dual process models of addiction was only found in adolescents, previous research would suggest that the predictions of these models are most likely to be found in such samples.

This thesis investigated drinking patterns in the Russian city of Novosibirsk, with a specific focus on hazardous drinking. It explored the relationship between hazardous drinking and social-economic characteristics, depressive symptoms and self-reported health. The study also provided an in-depth description of drinking patterns, consumption of ‘surrogate’ alcohol, and perceptions of the Russian drinking culture and the state’s alcohol policies. The research used a combination of quantitative and qualitative methods. First, it assessed alcohol consumption and drinking patterns using data from the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) cohort. Second, a series of 44 semi-structured interviews were conducted with men and women sampled from the HAPIEE cohort. Third, 40 semi-structured interviews were conducted among clients of an alcohol treatment facility. These interviews were focused on hazardous drinking. The main findings were as follows. First, hazardous drinking was common among men, but rare among women (30% of men and 1% of women reported binge drinking, 19% of men and 1% of women reported problem drinking, and 9% of men and less than 1% of women reported more than two negative consequences of drinking). Second, hazardous drinking was associated with lower education (e.g. men with secondary education were 1.9 times more likely to binge drink than men with university education), unemployment, poor health (men and women rating their health as good were more likely to binge than people with poor health), and with certain occupations (e.g. drivers or construction workers were likely to report binge drinking). Third, high accessibility of alcohol and a need to relieve withdrawal symptoms were common reasons for surrogate consumption given in interviews by participants from alcohol treatment facility. Finally, the Russian drinking culture was perceived as characterised by heavy drinking and strongly influenced by the interplay of individual and structural factors.

This thesis details a continuing body of research investigating the contribution of personality to disordered eating and alcohol abuse in young women. There is growing evidence of high levels of reward sensitivity in women with both disorders, and high levels of punishment sensitivity in dysfunctional eating women. However, it is unlikely that personality alone accounts for the development of such dysfunctional behaviour. Two studies were conducted to further examine the contribution of reward and punishment sensitivity to these disorders. In the first study, 443 university women completed self-report measures of alcohol use, dysfunctional eating, reinforcement sensitivity, parental drinking, family environment and maternal eating. Reward and punishment sensitivity were better predictors of disordered behaviour than family factors, although maternal dysfunctional eating significantly increased the risk of daughters' dysfunctional eating. Punishment sensitive daughters of bulimic mothers reported the highest level of bulimic symptoms themselves. Punishment sensitivity also functioned as a partial pathway variable between family risk and disordered eating. Given the stronger contribution of personality to disordered behaviour, a second study was conducted in which 131 women completed behavioural tasks under conditions of reward and punishment. Performance on a computerised measure of punishment sensitivity was associated with greater levels of dysfunctional eating but not drinking. However, performance on a card-sorting task of reward sensitivity failed to correlate with self-reported reward sensitivity or disordered behaviour. It was concluded that an innate sensitivity to reward increases the risk of disorders characterised by strong approach tendencies, whilst high punishment sensitivity, perhaps due to a chaotic family, increases the risk of dysfunctional eating, particularly daughters of eating disordered mothers.

This thesis details a continuing body of research investigating the contribution of personality to disordered eating and alcohol abuse in young women. There is growing evidence of high levels of reward sensitivity in women with both disorders, and high levels of punishment sensitivity in dysfunctional eating women. However, it is unlikely that personality alone accounts for the development of such dysfunctional behaviour. Two studies were conducted to further examine the contribution of reward and punishment sensitivity to these disorders. In the first study, 443 university women completed self-report measures of alcohol use, dysfunctional eating, reinforcement sensitivity, parental drinking, family environment and maternal eating. Reward and punishment sensitivity were better predictors of disordered behaviour than family factors, although maternal dysfunctional eating significantly increased the risk of daughters' dysfunctional eating. Punishment sensitive daughters of bulimic mothers reported the highest level of bulimic symptoms themselves. Punishment sensitivity also functioned as a partial pathway variable between family risk and disordered eating. Given the stronger contribution of personality to disordered behaviour, a second study was conducted in which 131 women completed behavioural tasks under conditions of reward and punishment. Performance on a computerised measure of punishment sensitivity was associated with greater levels of dysfunctional eating but not drinking. However, performance on a card-sorting task of reward sensitivity failed to correlate with self-reported reward sensitivity or disordered behaviour. It was concluded that an innate sensitivity to reward increases the risk of disorders characterised by strong approach tendencies, whilst high punishment sensitivity, perhaps due to a chaotic family, increases the risk of dysfunctional eating, particularly daughters of eating disordered mothers.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Applied Psychology<br>Full Text

Background University can be stressful, and some students use alcohol to handle their stress. The alcohol consumption in our youth affects future alcohol habits. Caregivers experience and attitude towards alcohol affects patients care and treatment. Purpose To investigate the stress level and number of hazardous drinkers among physiotherapy students at Uppsala Universitet. It was also to investigate the difference between the genders regarding stress and alcohol consumption, also the correlation between stress and alcohol consumption. Design and method This was a cross-sectional study with a correlating and comparative design where physiotherapy students answered a survey regarding stress and alcohol consumption. Results In this survey, 176 students participated of which 169 were analyzed. Twenty-one percent had a high stress level and 30% had a hazardous drinking. The women were more stressed (p=0,02), but no difference was seen between the genders regarding alcohol consumption (p=0,06). There was no correlation between stress and alcohol consumption for the whole group (r= 0,22, p=0,78), for women (r=0,12, p=0,21) or for men (r=-0,12, p=0,34). Conclusion A moderate to high stress level was common and 35% had a hazardous drinking or an abuse/dependence. The women had a higher stress level, but the alcohol consumption was similar between the sexes. There was no correlation between stress and alcohol consumption. However, interventions against stress and alcohol could be necessary since these students will have an important role in the future.

Thesis (Ph.D.)--University of Tennessee Health Science Center, 2006.<br>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).

Assessment of a significant number of water samples across South Africa by Casey and Meyer over a number of years, revealed that high concentrations (30- 32 mg/L) of bromine (Br) occur naturally within groundwater in South Africa, hence a potentially hazardous chemical constituent (PHCC). Br, the only liquid non-metallic element, is ubiquitous and an abundant trace element, but it has not been conclusively shown to perform essential functions in plants, micro organisms or animals (NRC, 2005). The recommended limit (maximum limit for no risk) for Br in drinking water was set at 1 mg/L by Kempster et al. (1980); Casey and Meyer (2001) recommend the relevant safety guideline for Br to be 0.01 mg/L. The aim of this project was to establish the effect of Br and iodine (I) in drinking water on the physiological parameters of broilers. This will contribute to verifying and refining water quality guidelines. The effect of six treatments administered as sodium bromide (NaBr) and potassium iodide (KI): 0 mg Br/L and 0 mg I/L; 1 mg Br/L; 1mg Br/L and 0.7 mg I/L; 0.7 mg I/L; 3 mg Br/L; 3 mg Br/L and 0.7 mg I/L, in the drinking water of 540 mixed Ross broiler chickens was investigated. The trial ran over a 42-day growth period from Day 1 post-hatching where mortalities, water and feed intakes were recorded daily. Chickens were weighed weekly and slaughtered at 4 and 6 weeks of age. Blood samples were taken before slaughter and free T3 and T4 hormone levels were quantified. Thyroid gland, liver and kidney samples were analysed for Br and I quantity. The different treatments of Br, irrespective of I, significantly decreased water intake (P=0.0232) and feed intake (P=0.0035) over the 42 days. The overall interaction of Br and I had no significant effect on water (P=0.0928) and feed (P=0.9593) intakes thus I did have an effective ameliorating effect on Br. FCR, weight gain and mortalities were not significantly affected by Br intake. This was also found for free T3 and T4 hormone levels. Br had an overall effect on the thyroid gland (P=0.0457), liver (P=0.0025) and kidney (P=0.0032) with accumulation of the PHCC within these three organs. It was apparent that 1 and 3 mg Br/L water administered to broilers or ingestion rates of 1.59 and 4.44 mg Br/L per bird per day, over a production period of 42 days did affect the production parameters of the birds sub-clinically. Another derivation to refine the water quality guidelines was that the administration of 0.7 mg I/L water or ingestion rates of 1.1 mg I/L per bird per day did alleviate the severe detrimental effect of the high PHCC. The 3 mg Br/L guideline is thus not too restrictive. Further research exposing the animals for a longer time period (exceeding 42 days) and exposing mature animals (producing nutritional products for human consumption) to these treatments would assist in quantifying these results.<br>Dissertation (MSc(Agric))--University of Pretoria, 2011.<br>Animal and Wildlife Sciences<br>unrestricted

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.

This thesis aims to add to the literature on self-affirmation as a means of reducing derogation of health risk messages, and engendering behaviour change. By exclusively sampling university students who drink hazardously, this study is also intended to add to the evidence base regarding interventions for alcohol misuse in this high-risk group. Part 1 of the thesis reviews another type of intervention for student drinking, namely, parent-based interventions. Numerous experimental studies have been published in recent years which examine the efficacy of this type of intervention. Findings suggest that parental influence on young people can extend into late adolescence and the early twenties, and, consequently, delivering an intervention solely to parents can produce effects on youth alcohol misuse. Part 1 therefore aims to summarise what is known about these interventions thus far, and make recommendations for future research. Part 2 of the thesis reports an experimental study of the efficacy of a self-affirmation manipulation on derogation of a health risk message, as well as changes in drinking behaviour one week after the intervention. Furthermore, it describes the results of a test of the effects of self-affirmation on automatic approach-avoidance biases to alcohol-related stimuli, which were assessed using a Relevant-feature Stimulus-Response Compatibility task. The third part of the thesis critically appraises aspects of Part 2. It elaborates on the decision-making processes involved in choosing a measure of implicit cognition, and formulating a risk message. It also describes difficulties with recruitment and how these were addressed, and concludes with reflections on the work from a clinical perspective.

Social capital, or social cohesion or group connectedness, can influence both HIV risk behavior and substance use. Because recent immigrants undergo a change in environment, one of the consequences can be a change in social capital. There may be an association among changes in social capital, and HIV risk behavior and substance use post immigration. The dissertation focused on the interface of these three variables among recent Latino immigrants (RLIs) in South Florida. The first manuscript is a systematic review of social capital and HIV risk behavior, and served as a partial background for the second and third manuscripts. Twelve papers with a measure of social capital as an independent variable and HIV risk as the dependent variable were included in the analysis. Eleven studies measured social capital at the individual level, and one study measured social capital at the group level. HIV risk was influenced by social capital, but the type of influence was dependent on the type of social capital and on the study population. Cognitive social capital, or levels of collective action, was protective against HIV in both men and women. The role of structural social capital, or levels of civic engagement/group participation, on HIV risk was dependent on the type of structural social capital and varied by gender. Microfinance programs and functional group participation were protective for women, while dysfunctional group participation and peer-level support may have increased HIV risk among men. The second manuscript was an original study assessing changes in social capital and HIV risk behavior pre to post immigration among RLIs in South Florida (n=527). HIV risk behavior was assessed through the frequency of vaginal-penile condom use, and the number of sexual partners. It was a longitudinal study using secondary data analysis to assess changes in social capital and HIV risk behavior pre immigration to two years post immigration, and to determine if there was a relationship between the two variables. There was an 8% decrease in total social capital (p ˂ .05). Reporting of ‘Never use’ of condoms in the past 90 days increased in all subcategories (p ˂ .05). Single men had a decrease in number of sexual partners (p ˂ .05). Lower social capital measured on the dimension of ‘friend and other’ was marginally associated with fewer sexual partners. The third manuscript was another original study looking at the association between social capital and substance use among RLIs in South Florida (n=527). Substance use with measured by frequency of hazardous alcoholic drinking, and illicit drug use. It was a longitudinal study of social capital and substance-use from pre to two years post immigration. Post-immigration, social capital, hazardous drinking and illicit drug use decreased (p˂.001). After adjusting for time, compared to males, females were less likely to engage in hazardous drinking (OR=.31, p˂.001), and less likely to engage in illicit drug use (OR=.67, p=.01). Documentation status was a moderator between social capital and illicit drug use. ‘Business’ and ‘Agency’ social capital were associated with changes in illicit drug use for documented immigrants. After adjusting for gender and marital status, on average, documented immigrants with a one-unit increase in ‘business’ social capital were 1.2 times more likely to engage in illicit drug use (p˂.01), and documented immigrants with one-unit increase in ‘agency’ social capital were 38% less likely to engage in illicit drug use (p˂.01). ‘Friend and other’ social capital was associated with a decrease in illicit drug use among undocumented immigrants. After adjusting for gender and marital status, on average, undocumented immigrants with a one-unit increase in ‘friend and other’ social capital were 45% less likely to engage in hazardous drinking and 44% less likely to use illicit drugs (p˂.01, p˂.05). Studying these three domains is relevant because HIV continues to be a public health issue, particularly in Miami-Dade County, which is ranked among other U.S. regions with high rates of HIV/AIDS prevalence. Substance use is associated with HIV risk behavior; in most studies, increased substance use is associated with increased chances of HIV risk behavior. Immigration, which is the hypothesized catalyst for the change in social capital, has an impact on the dynamic of a society. Greater immigration can be burdensome on the host country’s societal resources; however immigrants are also potentially a source of additional skilled labor for the workforce. Therefore, successful adaption of immigrants can have a positive influence on receiving communities. With Florida being a major receiver of immigrants to the U.S, this dissertation attempts to address an important public health issue for South Florida and the U.S. at large.

Hazardous alcohol consumption is an issue that affects a lot of university students today. Consuming alcohol tend to have a negative impact on both mental and physical aspects, which can lead to severe alcohol addictions in the future. This study investigates which background factors that causes the phenomenon of binge drinking by collecting and analysing data from Linköping University. The results were analysed with data mining techniques such as: decision trees, random forest, and logistic regression. The results showed that logistic regression were the most reliable method in predicting binge drinking with an accuracy of (86.50 %), precision (92.64 %) and recall (90.96 %). The findings also showed that participation in student events together with higher weekly alcohol consumption predicted binge drinking. Additionally, other risk factors were the amounts of time the students spent with their friends and the students activity in partaking in their programs section (program association). The results from this study suggest that the student culture not only influence alcohol consumption but it induces the habits of binge drinking.

Hazardous drinking in the elderly has become an important public health problem due to the ageing of the population and the fact that alcohol-related consequences are magnified in this age group. However, to date, few studies examine hazardous drinking in people aged 50 years or older and the factors associated with alcohol use. The aim of this thesis is to quantify hazardous drinking in people aged 50 years or older in Europe, according to gender and country, and to analyze the possible individual and contextual factors related to such consumption. Throughout the thesis, the source of information was the European project SHARE (Survey of Health, Ageing and Retirement in Europe), which includes data from different European countries. This thesis consists of five articles that attempt to respond to the different specific objectives. The results suggest that the prevalence of hazardous drinking in people aged 50 years or older is around 22%, with variations between countries. These variations can be explained by individual factors, such as age or gender, and various contextual factors, such as alcohol advertising restrictions and the unemployment rate. Finally, one of the contextual aspects that may have had more impact in recent years is the economic crisis. We found that, in people aged 50 to 64 years, the incidence of hazardous drinking was greater in those who lost their jobs. However, from 2006 to 2013 there has been a decrease in hazardous drinking and also in the average amount of alcohol consumed in people aged 50 to 64 years in Europe.<br>El consum de risc d'alcohol en la gent gran s'ha convertit en un important problema de salut pública degut a l’envelliment de la població i al fet que les conseqüències adverses del consum es magnifiquen en aquest grup d'edat. No obstant això, són pocs els estudis que analitzen el consum de risc d'alcohol en persones majors de 50 anys i els factors que s'associen al consum de risc. L'objectiu d'aquesta tesi és quantificar el consum de risc d'alcohol en persones de 50 anys o més a Europa segons gènere i país i analitzar els possibles factors individuals i contextuals relacionats amb aquest consum. Per tota la tesi, la font d'informació van ser les enquestes del projecte europeu SHARE (Survey of Health, Ageing and Retirement in Europe), amb dades de diferents països d’Europa. La tesi consisteix en 5 articles que intenten respondre als diferents objectius específics. Els resultats suggereixen que la prevalença de consum de risc d'alcohol en les persones de 50 anys o més està al voltant del 22%, amb variacions entre països, que poden explicar-se per factors individuals, com el sexe o l’edat, i per diversos factors contextuals, com les restriccions en la publicitat de les begudes alcohòliques o la taxa d'atur. Finalment, un dels aspectes contextuals que pot haver tingut més impacte en els darrers anys és la crisi econòmica. El que hem vist és que en persones de 50 a 64 anys la incidència de consum de risc d’alcohol era major en aquells que havien perdut la feina. Tanmateix, durant el període de 2006 a 2013 s’ha produït una davallada en el consum de risc d’alcohol i en la mitjana de la quantitat consumida en persones de 50 a 64 anys a Europa.

Les sous-produits de désinfection (SPDs) se forment lorsque la matière organique dissoute (MOD) réagit avec des désinfectants, générant des composés réglementés comme les trihalométhanes (THMs) et les acides haloacétiques (HAAs). Cependant, les SPDs non réglementés, tels que les THMs/HAAs iodés et les sous-produits azotés comme les haloacétonitriles (HANs) et haloacétamides (HAMs), présentent des risques sanitaires plus élevé, comme l'ont montré des études sur des cellules d'ovaire de hamster chinois. De nombreuses études fractionnent la MOD avec des membranes ou des résines pour identifier quelles fractions réagissent à la chloration, mais les résultats restent variables. Cette thèse présente une méta-analyse comparant la réactivité des fractions de MOD vis-à-vis des SPDs (non)réglementés. La méta-analyse montre que les composés hydrophobes sont 10-20% plus réactifs que les hydrophiles pour la formation de THMs et HAAs dans les eaux à forte absorption UV à 254nm (&gt;2). Dans les eaux à faible SUVA254, les réactivités sont similaires. Cependant, les composés hydrophiles sont 20-80% plus réactifs vis-à-vis des SPDs non réglementés. Ni la durée de la chloration ni la dose ne modifient ce ratio, mais une augmentation du facteur de capacité de la colonne le fait. Les fractionnements membranaire d'ultrafiltration ne peuvent pas toujours séparer clairement les fractions, entraînant des résultats incohérents pour les différents groupes de SPDs. Pour résoudre cela, une nouvelle méthode de fractionnement par membrane a été développée, validée par chromatographie d'exclusion de taille (HPSEC-TOC). Le HPSEC-TOC montre une fiabilité accrue avec des limites de détection de 19.0 µgC L-1 et une conservation des échantillons optimisée (maximum deux semaines à 4°C). La méthode HPSEC-TOC s'est avérée fiable pour analyser les fractions de MOD dans des eaux (non) traitées. La MOD a été fractionnée en trois poids moléculaires (PM) : élevé (&gt;20kDa), moyen (0.3-20kDa) et faible (&lt;0.3kDa). Un outil mathématique a été développé pour optimiser le protocole membranaire et garantir des résultats constants. Appliqué à des eaux de surface sur trois saisons, le fractionnement a produit des fractions contenant jusqu'à 50% de composés à PM élevé, plus de 80% de PM moyen et des composés à PM faible. Des tests de chloration et chloramination (24h, 1mgCl2 L-1) ont été effectués pour évaluer la formation de THMs, HAAs, HANs, HAMs et nitrosamines. Les résultats montrent que la fraction de PM moyen est globalement la plus réactive. Cependant, la fraction de PM faible est très réactive vis-à-vis des THMs di-iodés et voit sa réactivité augmenter avec le degré de chloration dans les familles HAAs, HANs et HAMs. La fraction à PM élevé est la moins réactive, sauf pour l'acide iodoacétique et le chloroacétonitrile. La spectroscopie de fluorescence a révélé que les propriétés chimiques des précurseurs varient selon les fractions et les méthodes de désinfection, suggérant des mécanismes complexes. Une approche spécifique à chaque site est recommandée pour identifier les SPDs les plus préoccupants selon leur toxicité et concentration. Enfin, cette thèse explore l'impact des espèces réactives de l'oxygène sur les voies de l'inflammation et du stress oxydatif induites par les HAAs et HAMs. Dans les cellules d'adénocarcinome colorectal humain (Caco-2), les concentrations létales varient de 12µM pour l'iodoacétamide et l'acide iodoacétique à 47mM pour le dichloroacétamide. Des cellules intestinales de patients atteints de cancer colorectal, de Crohn et de témoins sains ont aussi été exposées. Les HAAs ont induit des réponses inflammatoires et du stress oxydatif dans les cellules proches des tissus cancéreux, tandis que les HAMs ont induit ces effets dans tous les types de cellules. Ces résultats suggèrent un lien potentiel entre les SPDs et le développement de maladies inflammatoires de l'intestin, bien que des validations supplémentaires via le séquençage ARN soient nécessaires<br>Disinfection by-products (DBPs) form when dissolved organic matter (DOM) in water reacts with disinfectants, leading to regulated compounds such as trihalomethanes (THMs) and haloacetic acids (HAAs). However, unregulated DBPs like iodinated THMs/HAAs, and nitrogenous DBPs, such as haloacetonitriles (HANs) and haloacetamides (HAMs), pose higher health risks, as studies with Chinese Hamster Ovary cells have shown. To control DBP formation in tap water, researchers focus on identifying DBP precursors by fractionating DOM using resins or membranes, though results vary widely. In this thesis, a meta-analysis compares the reactivity of DOM fractions towards (un)regulated DBPs. The meta-analysis reveals that hydrophobic compounds exhibit 10-20% higher reactivity to both THM and HAA formation compared to hydrophilic compounds in waters with high specific ultraviolet absorbance at 254nm (SUVA254 &gt;2). In waters with low SUVA254, both hydrophobic and hydrophilic compounds have equal reactivity. However, hydrophilic compounds are 20-80% more reactive towards unregulated DBPs. Neither chlorination time nor dose alters this reactivity ratio, but an increase in column capacity factor does. Additionally, dead-end ultrafiltration membranes may not always separate fractions sharply, leading to inconsistent results for DBP formation across groups. To address this, a novel membrane fractionation method was developed. This method was first validated using a size exclusion chromatographic approach (HPSEC) to ensure reliability, considering key factors such as detection limits (19.0µgC dm-3) and the importance of preserving samples for a maximum of two weeks at 4°C. Inorganic carbon removal was achieved by acidifying the sample to pH 6 and purging it with N2. The HPSEC-TOC method proved reliable for DOM fraction analysis in both treated and untreated water sources. Using this method, DOM was separated into three molecular weight (MW) fractions: high (&gt;20kDa), medium (0.3-20kDa), and low (&lt;0.3kDa). A mathematical tool was developed to optimize the protocol and predict the diafiltration factor for each fraction, ensuring consistent results. The method was applied to surface water across three seasons, yielding a fraction up to 50% high MW compounds, a fraction over 80% medium MW compounds, and a fraction containing only low MW compounds. Chlorination and chloramination tests (24h, 1mgCl2 L-1 residual) on these fractions assessed the formation of THMs, HAAs, HANs, HAMs, and nitrosamines. Results showed that the medium MW fraction had the highest overall reactivity. However, the low MW fraction was highly reactive toward di-iodinated THMs, and its reactivity increased with increasing chlorine atoms in the HAA, HAN, and HAM families. The high MW fraction showed the lowest reactivity towards most DBPs, except iodoacetic acid and chloroacetonitrile. Fluorescence spectroscopy further revealed that DBP precursors' chemical properties vary by fraction and disinfection method, suggesting complex reaction mechanisms. A site-specific strategy is recommended to identify the most concerning DBPs, considering both their toxicity and concentration. Finally, the thesis explores the impact of reactive oxygen species on inflammation and oxidative stress pathways induced by HAAs and HAMs. In human colorectal adenocarcinoma (Caco-2) cells, lethal concentrations ranged from 12µM for iodoacetamide and iodoacetic acid to 47mM for dichloroacetamide. Primary intestinal epithelial cells from donors with colorectal cancer, Crohn's disease, and healthy controls were also exposed to HAAs and HAMs. HAAs triggered oxidative stress and inflammatory responses in cells adjacent to cancerous tissue, while HAMs induced these effects across all cell types. These findings suggest a potential link between DBP exposure and inflammatory bowel disease development, although further validation through RNA sequencing is needed

Corrosion of drinking water distribution systems can cost water utilities and homeowners tens of billions of dollars each year in infrastructure damage, adversely impacting public health and causing water loss through leaks. Often, seemingly innocuous choices made by utilities, plumbers, and consumers can have a dramatic impacts on corrosion and pipeline longevity. This work demonstrated that brass pipe connectors used in partial lead service line replacements (PLSLR) can significantly influence galvanic corrosion between lead and copper pipes. Galvanic crevice corrosion was implicated in a fourfold increase in lead compared to a traditional direct connection, which was previously assumed to be a worst-case connection method. In field sampling conducted in two cities, a new sampling method designed to detect particulate lead risks demonstrated that the choice of flow rate has a substantial impact on lead-in-water hazards. On average, lead concentrations detected in water at high flow without stagnation were at least 3X-4X higher than in traditional regulatory samples with stagnation, demonstrating a new 'worst case' lead release scenario due to detachment of lead particulates. Although galvanized steel was previously considered a minor lead source, it can contain up to 2% lead on the surface, and elevated lead-in-water samples from several cities were traced to galvanized pipe, including the home of a child with elevated blood lead. Furthermore, if both galvanized and copper pipe are present, as occurs in large buildings, deposition corrosion is possible, leading to both increased lead exposure and pipe failures in as little as two years. Systematic laboratory studies of deposition corrosion identified key factors that increase or decrease its likelihood; soluble copper concentration and flow pattern were identified as controlling factors. Because of the high copper concentrations and continuous flow associated with mixed-metal hot water recirculating systems, these systems were identified as a worst-case scenario for galvanic corrosion. Deposition corrosion was also confirmed as a contributing mechanism to increased lead release, if copper pipe is placed before a lead pipe as occurs in partial service line replacements. Dump-and-fill tests confirmed copper solubility as a key factor in deposition corrosion impacts, and a detailed analysis of lead pipes from both laboratory studies and field tests was consistent with pure metallic copper deposits on the pipe surface, especially near the galvanic junction with copper. Finally, preliminary experiments were conducted to determine whether nanoparticles from novel water treatment techniques could have a negative impact on downstream drinking water pipeline infrastructure. Although increases in the corrosion of iron, copper, and stainless steel pipes in the presence of silver and carbon nanomaterials were generally small or non-existent, in one case the presence of silver nanoparticles increased iron release from stainless steel by more than 30X via a localized corrosion mechanism, with pitting rates as high as 1.2 mm/y, implying serious corrosion consequences are possible for stainless steel pipes if nanoparticles are present.<br>Ph. D.

Made available in DSpace on 2014-10-09T12:43:07Z (GMT). No. of bitstreams: 0<br>Made available in DSpace on 2014-10-09T14:08:03Z (GMT). No. of bitstreams: 0<br>Tese (Doutoramento) - IPEN Apendices<br>IPEN/T<br>Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Made available in DSpace on 2014-10-09T12:43:07Z (GMT). No. of bitstreams: 0<br>Made available in DSpace on 2014-10-09T14:05:39Z (GMT). No. of bitstreams: 0<br>Tese (Doutoramento) - IPEN<br>IPEN/T<br>Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Research Doctorate - Doctor of Philosophy (PhD)<br>Background: Risky drinking is a leading contributor to the global disease burden for adolescents. The nature and degree of influence of parental behaviour on their children’s alcohol use is unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating: (1) whether parental supply of alcohol is associated with later adolescent risky drinking; and (2) whether the rules parents make about alcohol affect the likelihood that their adolescent children become risky drinkers. Furthermore, we used a longitudinal cohort of parent-child dyads to investigate: (3) what parent characteristics predict approval of adolescent drinking from ages 13 to 16 years; and (4) the association between parental hazardous drinking and the development and/or worsening of hazardous drinking in their children after adjusting for potential confounders. Methods: Using the PRISMA guidelines for studies 1 and 2, we searched eight electronic databases for relevant terms without imposing restrictions on publication year; including only English language peer-reviewed journal articles. We assessed the risk of bias in primary studies and conducted meta-analyses. For studies 3 and 4, we utilized four waves of parent-child dyad data and assessed outcomes annually when children were 13, 14, 15 and 16 years old. We measured parent (score ≥5) and adolescent (score ≥3) hazardous drinking with the AUDIT-C scale. Results: Studies 1 and 2 showed that: (1) parental supply of alcohol in childhood was associated with increased risky drinking in mid-adolescence [Odds ratio (OR) 2.00; 95% confidence interval: 1.72 to 2.32]; and 2) when parents set strict rules concerning alcohol, their children were less likely to become risky drinkers (OR 0.64; 0.48 to 0.86). However, the risk of bias we identified in the existing studies warrants a high level of confidence in the estimates. Study 3 demonstrated that parents of older children (4.6% at 13 years; 13% at 16 years), of daughters (OR 1.62; 1.23 to 2.12), on low-incomes (OR 2.67; 1.73 to 4.12), with less education (OR 1.54; 1.07 to 2.22), single parents (OR 1.62; 1.17 to 2.25), and parents (OR 1.17; 1.09 to 1.25) and parents’ partners (OR 1.17; 1.11 to 1.23) who drank alcohol, were more approving of their children’s alcohol use. Study 4 showed that children whose parents or their partners were hazardous drinkers were at higher risk of being hazardous drinkers at age 15 and 16 (adjusted ORs between 1.5 and 2). Conclusion: Taken together, the results highlight some of the mechanisms by which parents may be able to influence their children’s drinking behaviour. Our findings add to the empirical basis for guidelines and inform the design of future research to underpin public policy and intervention strategies.

碩士<br>國防醫學院<br>公共衛生學研究所<br>91<br>Objective：This study was aiming to examine the all-cause mortality and life expectancy in relation to different habitual patterns of cigarette smoking, alcohol drinking, and betel-nut chewing in Taiwan. Methods：The present study was based on study populations from two prospective studies conducted in 19 townships in Taiwan including 25,188 men and 15,445 women aged above 30 years. The vital status of study subjects was assessed by data linkage with National Death Certification System during the follow-up period between 1982 and 2001. Cox proportional hazards model was used to calculate relative risks (RRs) and 95% confidence intervals (CIs). Results：During the follow-up period, 4,700 men and 1,289 women died. The statistical analyses showed that the adjusted RR for all-cause mortality between smokers and nonsmokers was 1.34 (95% CI: 1.22-1.52) for men and 1.48 (95% CI: 1.07-2.03) for women. The adjusted RR between drinkers and nondrinkers was 1.3 (95% CI: 1.17-1.45) for men and 0.87 (95% CI: 0.61-1.24) for women. The adjusted RR between betel nut chewers and non-chewers was 1.17 (95% CI: 1.01-1.37) for men and 0.53 (95% CI: 0.20-1.44) for women. In men, as compared to subjects who were non-smoking, non-drinking, and non-betel nut chewing, individuals who were smoking, drinking, and betel nut chewing had 2.16 times (95% CI: 1.72-2.70) higher risk of all-cause mortality. In terms of life expectancy, compared with nonsmokers, smokers at age 30 had a 17% shorter life expectancy. Compared with nondrinkers, drinkers at age 30 had a 9% shorter life expectancy. Compared with betel nut non-chewers, chewers at age 30 had a 5% shorter life expectancy. Conclusions：The study results indicate a more deleterious health effect of cigarette smoking than alcohol drinking and betel-nut chewing. From public health viewpoint, smoking cessation would prevent smoking-attributable premature deaths.