Auditory Outcomes in Adolescents with Prenatal Alcohol Exposure.

The aim of the study was to investigate three aspects of auditory function (auditory acuity, cochlear dysfunction, and auditory processing) in adolescents with fetal alcohol exposure without phenotypic changes. Fifty-one adolescents with and without intrauterine exposure to alcohol were selected from a cohort study. The summons, evaluation, and analysis of the results were carried out blindly regarding the respective exposure to alcohol. The auditory tests were pure-tone audiometry, transient otoacoustic emissions, and behavioral assessment of auditory processing (speech-in-noise, dichotic digits, and gap-in-noise). After testing, 45 adolescents were included in the evaluation and were divided into exposed (n = 22) and non-exposed (n = 23) groups. Hearing loss was identified in one subject in the exposed group (4.5%). In the absence of hearing loss, there were no significant differences in tonal thresholds or in the magnitudes of the sensory (cochlear) responses between groups (p > 0.05). There was also no difference between the two groups regarding performance on the processing tests (speech-in-noise p = 0.71, dichotic p = 0.94, and gap-in-noise p = 0.33). However, the exposed group had more cases of hearing disorders (hearing loss plus auditory processing disorders) than the non-exposed group (22.7% vs. 4.3%).

Auditory hyper-responsiveness in autism spectrum disorder, terminologies and physiological mechanisms involved: systematic review. / Hiper-responsividade auditiva no transtorno do espectro autista, terminologias e mecanismos fisiológicos envolvidos: revisão sistemática.

PURPOSE: this paper aims to identify the most used terminologies to designate the disproportional behavior to sounds in the autism spectrum disorder (ASD) and its relationship with the respective tools for its investigation, as well as its occurrence and outcomes. RESEARCH STRATEGIES: the databases used were PubMed, PsycINFO, Web of Science, Scielo and Lilacs. The keywords used were "autism", "hyperacusis" and "auditory perception", with the following combinations: "autism AND hyperacusis" and "autism AND auditory perception". SELECTION CRITERIA: individuals diagnosed with ASD of any age group; available abstract; papers in English, Spanish and Brazilian Portuguese; case series, prevalence and incidence studies, cohort and clinical trials. DATA ANALYSIS: we analyzed studies with individuals diagnosed with ASD of any age group; reference in the title and/or summary of the occurrence of disproportional behavior to sounds, accepting the terms hyper-responsiveness, hypersensitivity and hyperacusis; summary available; papers in English, Spanish and Brazilian Portuguese; series of cases, prevalence and incidence studies, cohort and clinical trials. RESULTS: Of the 692 studies resulting from the consultation, 13 studies could achieve the established requirements. CONCLUSION: The term auditory hypersensitivity was the most commonly used to designate disproportional behavior to sounds, followed by hyperacusis. There was no relationship between the terms and the respective research tool, and the questionnaires were the most used to designate the referred behavior, whose reported frequency was from 42.1% to 69.0%. The auditory behavior tests when performed showed the involvement of the auditory, afferent and efferent neural pathways.

OBJETIVO: identificar as terminologias mais utilizadas para designar o comportamento desproporcional a determinados sons (CDS) no TEA e sua relação com as respectivas ferramentas para sua investigação, assim como sua ocorrência e desfechos. ESTRATÉGIA DE PESQUISA: Foram utilizadas as bases de dados: PubMed, PsycINFO, Web of Science, Scielo e Lilacs. As palavras-chave utilizadas foram "autism", "hyperacusis" e "auditoryperception", com as seguintes combinações: "autism AND hyperacusis" e "autism AND auditoryperception". CRITÉRIOS DE SELEÇÃO: Foram incluídos os trabalhos com diagnóstico de TEA, de qualquer faixa etária; resumo disponível; Artigos em inglês, espanhol e português brasileiro; série de casos, estudos de prevalência e incidência, coorte e ensaios clínicos. ANÁLISE DOS DADOS: Foram analisados estudos com sujeitos com diagnóstico de TEA de qualquer faixa etária; referência no título e/ou resumo da ocorrência do CDS, aceitando os termos hiper-responsividade, hipersensibilidade e hiperacusia; resumo disponível; artigos em inglês, espanhol e português brasileiro; série de casos, estudos de prevalência e incidência, coorte e ensaios clínicos. RESULTADOS: Dos 692 estudos resultantes da consulta, foram identificados 13 que atendiam aos requisitos estabelecidos. CONCLUSÃO: O termo hipersensibilidade auditiva foi o mais empregado para designar o CDS, seguido da hiperacusia. Não houve relação entre os termos e a respectiva ferramenta de investigação, sendo os questionários os mais utilizados para designar o referido comportamento, cuja frequência relatada foi de 42,1% a 69,0%. Os testes auditivos, quando realizados, mostraram o envolvimento das vias neurais auditivas, aferente e eferente.

Stressful life events and alcohol consumption in pregnant women: A cross-sectional survey.

BACKGROUND: Psychological stress in pregnancy has been related to different adaptations (physical, emotional and social) of the woman's life during this period. Although maternal stress is a common occurrence in pregnancy, studies indicate that the high levels of stressful life events are a predisposing factor to alcohol consumption in pregnant women. Though postnatal maternal emotional distress has been extensively investigated, little is known about the association between stressful life events and maternal risk behaviors during pregnancy. OBJECTIVES: The purpose of this study is to verify the association between stressful life events and alcohol consumption in pregnant women. DESIGN AND PARTICIPANTS: This is a cross-sectional survey using a convenience sample of 449 women in the third trimester of pregnancy. The participants were recruited in a public maternity hospital in the city located in the state of Sao Paulo, Brazil. METHODS: A semi-structured interview was used to assess alcohol use and stressful life events of the respondent's life. The semi-structured interview included the following instruments: a socio-demographic questionnaire, inventory for the evaluation of the stressful life events (Interview for Recent life events -IRLE), the questionnaire Tolerance, Annoyed, Cut-down, Eye-Opener (T-ACE) for the use of alcohol, the International Classification of Diseases (ICD-10) criteria for alcohol-related disorders, and the evaluation of consumption before and during each gestational trimester. RESULTS: Pregnant women diagnosed with alcohol abuse and alcohol dependence according to ICD-10 and with risk consumption, according to T-ACE screening, had a higher occurrence of stressful life events than the group without this diagnosis (p < 0.001). The following stressful life events were more frequent among women with alcohol problems: "Major financial difficulties," "Loss or theft of objects", "Serious argument with non-resident/close family member", "Serious argument with family members," and "Marital separation" with the latter about eight times more common in this group. CONCLUSION: The results suggest an association between stressful life events and dependence or risk consumption of alcohol in pregnant women. The evaluation of stressful life events by the nursing team can help pregnant women to identify or strengthen healthy coping styles in the face of stress, thus intervene, and avoid alcohol consumption during pregnancy.

Prenatal alcohol use as a risk for attention-deficit/hyperactivity disorder.

The objective of the study was to investigate the association between alcohol use during pregnancy and mental disorders in childhood, controlling for confounding risk factors by a longitudinal study of pregnant women and their offspring. The initial cohort comprised pregnant women attending an obstetric service. From the initial sample of 449 pregnant women, 81 mother-child pairs agreed to participate. After 12 years, mother-child pairs were assessed through self-administered questionnaires and semi-structured interviews. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was used to assess the presence of any mental disorders in the children. The mothers were assessed by the Self-Reporting Questionnaire (SRQ) and the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, data on the mother's alcohol use collected during pregnancy were analysed. A logistic regression tested the influence of alcohol consumption in all trimesters and binge drinking on the occurrence of attention-deficit/hyperactivity disorder (ADHD), controlling for covariates. Binge drinking at any time during pregnancy or low-moderate alcohol consumption in all trimesters of pregnancy was associated with a fivefold increased odds of child ADHD. The combination of both patterns of alcohol use added an increase of 19% in the variance of ADHD's occurrence. The episodic use of at least four drinks or the regular use of low-moderate alcohol doses during pregnancy was associated with significantly increased odds of subsequent child ADHD. Reducing binge drinking and regular alcohol use of pregnant women may lead to a significant decrease in their children developing ADHD.

Attitudes of nursing students towards substance users and perceptions about religious/spiritual care.

OBJECTIVE: To evaluate the impact of an educational intervention on the attitudes of Nursing students towards users of psychoactive substances (excluding alcohol and tobacco) and their perceptions about the religious and spiritual care offered within the health services. METHOD: Quasi-experimental study. We applied a questionnaire before and one month after an intervention about the comprehensive care of substance users, containing: sociodemographic information, knowledge, the Treatment Spirituality/Religiosity Scale, and the Drug and Drug Problems Perceptions Questionnaire. For the analyses, we employed the paired Student's t-test and Pearson's Coefficient. RESULTS: 62 students participated in this study. After the intervention, there was improvement in the students' attitudes towards the substance users, but not regarding the perception they already had about the importance of offering religious and spiritual care within the services. CONCLUSION: We verified the effectiveness of the educational intervention on the improvement of attitudes concerning the care of substance users, yet we point out that the students did not show changes in their perception about the inclusion of the religious and spiritual aspects in the care dedicated to this population.

Eating behavior of schizophrenic patients / Comportamento alimentar de pacientes com esquizofrenia

ABSTRACT Objective To assess the eating behavior, food practices, nutritional and metabolic profiles of patients with schizophrenia undergoing treatment. Methods Cross-sectional exploratory descriptive qualitative study used a semi-structured questionnaire on the eating behavior, food practices, and perception of changes after the initiation of drug therapy and a quantitative method using anthropometric and body composition measurements, metabolic parameters, and 5-day dietary records to analyze nutrient ingestion of patients with schizophrenia in an outpatient clinic at a tertiary hospital (n=33). The qualitative data were analyzed and coded by three researchers and quantitative data were analyzed using descriptive exploratory statistics. Results The results of this study showed that schizophrenic patients presented high prevalence of excess weight (71.0%), metabolic syndrome (42.0%), dyslipidemia (62.0%), changes in appetite (76.0%), and increase in energy intake (74.2%), associated with important irregularities in eating behavior and food practices (such as irregularity of meals, emotional intake, high carbohydrate and fat intake, and low energy expenditure) and lifestyle (changes in social and work routines). Conclusion This eating profile may interact synergistically with psychotropic drugs to contribute to weight gain and metabolic changes in schizophrenia. Nutrition education may prevent and monitor the risk of metabolic and nutrition problems, irrespective of the medications used.

RESUMO Objetivo Avaliar o comportamento e as práticas alimentares, o perfil nutricional e metabólico de pacientes com esquizofrenia em tratamento ambulatorial de um hospital terciário. Métodos Trata-se de estudo descritivo exploratório transversal com abordagem qualitativa utilizando questionário semi-estruturado sobre comportamentos alimentares, práticas alimentares e percepção de mudanças após o início da terapia medicamentosa e abordagem quantitativa usando medidas antropométricas e de composição corporal, parâmetros metabólicos e registros alimentares por cinco dias para analisar a ingestão de nutrientes em pacientes com esquizofrenia (n=33). Os dados qualitativos foram analisados e codificados por três pesquisadores e os dados quantitativos foram analisados utilizando estatísticas exploratórias descritivas. Resultados Os resultados deste estudo mostraram que os pacientes com esquizofrenia apresentaram uma alta prevalência de excesso de peso (71,0%), síndrome metabólica (42,0%) e dislipidemia (62,0%), com alterações no apetite (76,0%), consumo excessivo de energia (74,2%), associado à irregularidades no comportamento alimentar e nas práticas alimentares (como a irregularidade das refeições, o consumo emocional, a ingestão elevada de carboidratos e gorduras e o baixo gasto de energia) e o estilo de vida (mudanças nas rotinas sociais e de trabalho). Conclusão Esse perfil alimentar pode interagir sinergicamente com às drogas psicotrópicas utilizadas o tratamento de esquizofrenia contribuindo com o ganho de peso e alterações metabólicas após o diagnóstico da doença. Nesse sentido, acredita-se que a educação nutricional pode prevenir e monitorar o risco de problema metabólico e nutricional, independentemente dos medicamentos utilizados.

Attitudes of nursing students towards substance users and perceptions about religious/spiritual care / Actitudes de estudiantes de enfermería ante el adicto a sustancias y percepciones acerca del cuidado religioso/espiritual / Atitudes de estudantes de enfermagem frente ao usuário de substâncias e percepções sobre o cuidado religioso/espiritual

ABSTRACT Objective: To evaluate the impact of an educational intervention on the attitudes of Nursing students towards users of psychoactive substances (excluding alcohol and tobacco) and their perceptions about the religious and spiritual care offered within the health services. Method: Quasi-experimental study. We applied a questionnaire before and one month after an intervention about the comprehensive care of substance users, containing: sociodemographic information, knowledge, the Treatment Spirituality/Religiosity Scale, and the Drug and Drug Problems Perceptions Questionnaire. For the analyses, we employed the paired Student's t-test and Pearson's Coefficient. Results: 62 students participated in this study. After the intervention, there was improvement in the students' attitudes towards the substance users, but not regarding the perception they already had about the importance of offering religious and spiritual care within the services. Conclusion: We verified the effectiveness of the educational intervention on the improvement of attitudes concerning the care of substance users, yet we point out that the students did not show changes in their perception about the inclusion of the religious and spiritual aspects in the care dedicated to this population.

RESUMEN Objetivo: Evaluar el impacto de una intervención educativa acerca de las actitudes de estudiantes de Enfermería ante el usuario de sustancias psicoactivas (excluyéndose el alcohol y el tabaco) y las percepciones acerca del cuidado religioso y espiritual ofrecido en los servicios sanitarios. Método: estudio cuasi-experimental. Se aplicó un cuestionario antes y un mes después de la realización de una intervención acerca del cuidado integral con el adicto a sustancias, conteniendo: informaciones sociodemográficas, conocimientos, Treatment Spirituality/Religiosity Scale y el Drug Problems Perceptions Questionnaire. Para los análisis, se utilizó la prueba de t de Student pareada y el coeficiente de Pearson. Resultados: Participaron 62 estudiantes. Después de la aplicación de la intervención hubo mejora de las actitudes de los estudiantes ante el adicto a sustancias, pero no con relación a la percepción que ya tenían sobre la importancia de la oferta de cuidado religioso y espiritual en los servicios. Conclusión: Se verificó la efectividad de la intervención educativa en la mejora de las actitudes con relación al cuidado del adicto a sustancias, pero se llama la atención al hecho de que los estudiantes no presentaron cambios en su percepción sobre la inclusión de los aspectos religiosos y espirituales en el cuidado dedicado a dicha población.

RESUMO Objetivo: Avaliar o impacto de uma intervenção educativa sobre as atitudes de estudantes de Enfermagem frente ao usuário de substâncias psicoativas (excluindo-se álcool e tabaco) e as percepções sobre o cuidado religioso e espiritual oferecido nos serviços de saúde. Método: estudo quase-experimental. Aplicou-se um questionário antes e 1 mês após a realização de uma intervenção sobre cuidado integral ao usuário de substâncias, contendo: informações sociodemográficas, conhecimentos, Treatment Spirituality/Religiosity Scale e o Drug and Drug Problems Perceptions Questionnaire. Para as análises, utilizou-se do teste t de Student pareado e o coeficiente de Pearson. Resultados: Participaram 62 estudantes. Depois da aplicação da intervenção houve melhora das atitudes dos estudantes diante do usuário de substâncias, mas não em relação à percepção que já tinham sobre a importância da oferta de cuidado religioso e espiritual nos serviços. Conclusão: Verificou-se efetividade da intervenção educativa na melhora das atitudes em relação ao cuidado do usuário de substâncias, mas se alerta ao fato de que os estudantes não apresentaram mudanças em sua percepção sobre a inclusão dos aspectos religiosos e espirituais no cuidado dedicado a essa população.

What we know of the central auditory disorders in children exposed to alcohol during pregnancy? Systematic review. / O que sabemos das alterações auditivas centrais em crianças expostas ao álcool na gestação? Revisão sistemática.

PURPOSE: To identify the effects of alcohol intake during pregnancy on the central auditory nervous system in relation to their possible diagnosis, Fetal Alcohol Syndrome, partial Fetal Alcohol Syndrome, Alcohol-Related Birth Defects and Alcohol-Related Neurodevelopmental Disorder, his extension and the hearing assessment method. RESEARCH STRATEGY: Systematic and integrative review searched the databases PubMed, LILACS and SciELO, with terms in Portuguese and English "fetal alcohol syndrome", "alcohol-related disorders" associated with "hearing". Selection criteria: We identified 123 abstracts, six were selected and published until May 2015. DATA ANALYSIS: Were listed topics to be answered, characterization of the sample; the diagnosis result of fetal exposure; method of hearing assessment and described results. RESULTS: Among the behavioral assessments, Verbal Dichotic Tests with syllables and sentences and Speech in Noise Test, were used. Among the electrophysiological tests, the Brainstem Auditory Evoked Potential was detected change neural synchrony, and Long-Latency Auditory Evoked Potential - P300, early latency values. CONCLUSION: There is evidence that children exposed to alcohol in utero present central auditory nervous system involvement signals, but it was not possible to identify the influence of different subtypes and their losses. Cortical auditory pathways were the most investigated and the electrophysiological method as used with an unexpected result in two of them, early N2 and P300 latency.

O que sabemos das alterações auditivas centrais em crianças expostas ao álcool na gestação? Revisão sistemática / What we know of the central auditory disorders in children exposed to alcohol during pregnancy? Systematic review

RESUMO Objetivo Identificar os efeitos da ingestão de álcool na gestação sobre o sistema nervoso auditivo central em relação aos seus possíveis diagnósticos, Síndrome Fetal do Álcool, Síndrome Fetal do Álcool Parcial, Distúrbios ao Nascimento Relacionados ao Álcool e Distúrbio do Neurodesenvolvimento Relacionado ao Álcool, sua extensão e o método de avaliação auditiva. Estratégia de pesquisa Busca sistemática e integrativa nas bases de dados PubMed, LILACS e SciELO, com os termos em português e inglês “síndrome fetal do álcool”, “desordens relacionadas ao uso do álcool” associadas a “audição”. Critérios de seleção Dos 123 resumos identificados, foram seis selecionados, publicados até maio de 2015. Análise dos dados Foram elencados tópicos a serem respondidos, caracterização da casuística; o diagnóstico decorrente da exposição fetal nas crianças; método de avaliação auditiva; e resultados descritos. Resultados Entre as avaliações comportamentais, foram utilizados os testes dicóticos verbais com sílabas e com sentenças e o teste fala com ruído. Entre os testes eletrofisiológicos, no Potencial Evocado Auditivo de Tronco Encefálico, foi detectada alteração de sincronia neural, e no Potencial Evocado Auditivo de Longa Latência – P300, valores de latência precoces. Conclusão Existem evidências de que as crianças e adultos jovens expostos ao álcool na gestação apresentam sinais de comprometimento do sistema nervoso auditivo central, mas não foi possível caracterizar essas alterações nos diferentes subtipos diagnósticos do espectro. As vias auditivas corticais foram as mais investigadas e o método eletrofisiológico o mais utilizado, com um resultado inesperado em dois deles, a latência precoce da N2 e da P300.

ABSTRACT Purpose To identify the effects of alcohol intake during pregnancy on the central auditory nervous system in relation to their possible diagnosis, Fetal Alcohol Syndrome, partial Fetal Alcohol Syndrome, Alcohol-Related Birth Defects and Alcohol-Related Neurodevelopmental Disorder, his extension and the hearing assessment method. Research strategy Systematic and integrative review searched the databases PubMed, LILACS and SciELO, with terms in Portuguese and English “fetal alcohol syndrome”, “alcohol-related disorders” associated with “hearing”. Selection criteria: We identified 123 abstracts, six were selected and published until May 2015. Data analysis Were listed topics to be answered, characterization of the sample; the diagnosis result of fetal exposure; method of hearing assessment and described results. Results Among the behavioral assessments, Verbal Dichotic Tests with syllables and sentences and Speech in Noise Test, were used. Among the electrophysiological tests, the Brainstem Auditory Evoked Potential was detected change neural synchrony, and Long-Latency Auditory Evoked Potential – P300, early latency values. Conclusion There is evidence that children exposed to alcohol in utero present central auditory nervous system involvement signals, but it was not possible to identify the influence of different subtypes and their losses. Cortical auditory pathways were the most investigated and the electrophysiological method as used with an unexpected result in two of them, early N2 and P300 latency.

Inattention and impulsivity associated with prenatal alcohol exposure in a prospective cohort study with 11-years-old Brazilian children.

This paper aimed to examine prenatal alcohol exposure and neuropsychological parameters and its relationship to impulsivity and inattention. Longitudinal prospective case-control cohort study starting with the risk drinking assessment of 449 third-trimester pregnant women, and a follow-up phase with 56 mother-child pairs (28 alcohol-exposed versus 28 non-exposed), with 11-12 years old children. The cohort study was followed up for 11 years. Quantity-frequency structured questions as well as AUDIT and T-ACE questionnaires were used to assess maternal alcohol consumption. A comprehensive set of neuropsychological testing instruments was used, including d2 Test, RCFT, RAVLT, WISC-III, among others. To control low IQ effects and intellectual disability diagnoses, as well differences in school skills biasing the neuropsychological comparison assessment, children with IQ <70 or learning disabilities were excluded of the sample. The two groups showed to be very comparable regarding sex, age, schooling, global IQ, laterality and maternal and social risk factors. Significant statistical differences were found for higher speed processing, total errors, and number of omission errors in the d2 Test. Likewise, there were differences found on RCFT test (lower scores for copy, immediate and delayed recall), and on semantic verbal fluency tests with a lower score. Prenatal alcohol-exposed children seems to be more inattentive and impulsive; they have poorer skills in verbal fluency, visuospatial working memory, and executive processing when compared to non-exposed children who were part of the same cohort sample.

Identifying maternal risk factors associated with Fetal Alcohol Spectrum Disorders: a systematic review.

To identify the demographic, psychological, and social maternal risk factors associated with the development of Fetal Alcohol Spectrum Disorders (FASD). A bibliographic search was conducted in PubMed, SciELO, Lilacs, Web of Knowledge, and PsycINFO. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of the studies with case-control design. Articles were selected based on their relevance and presentation of data related to statistical comparisons of at least one or more demographic, psychological, or social maternal risk factors for FASD. 738 references were identified, of which 15 met the criteria to be included in the present review. Mothers of FASD children tend to: be older at the time of birth of the affected child, present lower educational level, have other family relatives with alcohol abuse, have other children with FASD, present a pattern of little prenatal care and a distinguishing pattern of alcohol consumption (alcohol use before and during pregnancy, failure to reduce alcohol use during pregnancy, and frequent episodes of binge drinking). Application of the NOS scale of methodological quality indicated that 8 studies (53 %) met the criterion for selection, 4 (27 %) were suitable for the criterion for comparability and only 4 studies were suitable for the exposition criterion. Mothers of FASD children have a distinctive pattern of drinking and accumulate several social risk factors. Maternal age at birth of the child seems to accentuate the risk. There are, however, few controlled studies that are adequate according to the NOS requirements for methodological quality. Fewer are based on the verification of a theoretical model. Clinicians should be aware of the relevance of preventive assessment of FASD risk mothers.

Uso de álcool e expectativas do beber entre universitários: uma análise das diferenças entre os sexos / Alcohol use and drinking expectations among college students: an analysis of sex differences

O estudo analisou comparativamente o consumo de álcool e expectativas do beber de homens e mulheres, verificando a relação entre as variáveis. Contou-se com uma amostra de 238 universitários, que responderam aos instrumentos AUDIT e AEQ-A. Homens apresentaram prevalência significativamente maior de uso de álcool no ano, uso problemático e binge. Expectativas de transformações globais positivas e de melhora no desempenho sexual foram maiores entre os homens. Houve correlação positiva entre expectativas e a gravidade de problemas associados ao consumo de álcool para ambos os sexos, no entanto, essa relação foi significativa apenas para os homens. Resultados indicam que diferenças das expectativas do beber entre os sexos podem ter um importante papel em ações de prevenção mais precisas e eficazes sobre o uso de álcool de homens e mulheres.(AU)

Alcohol use and drinking expectations of men and women were compared, verifying the relationship between variables. A sample of 238 college students responded to the AUDIT and AEQ-A. Men showed significantly higher prevalence of yearly alcohol use, problematic use and binge drinking. Expectations of global positive changes and sexual enhancement were greater among men. A positive correlation was found between expectations and severity of problems associated with alcohol consumption for both sexes, however, this relationship was significant only for men. Results indicated that differences of drinking expectations between the sexes may have an important role in more precise and effective preventive actions on alcohol use of men and women.(AU)

Uso de álcool e expectativas do beber entre universitários: uma análise das diferenças entre os sexos / Alcohol use and drinking expectations among college students: an analysis of sex differences

O estudo analisou comparativamente o consumo de álcool e expectativas do beber de homens e mulheres, verificando a relação entre as variáveis. Contou-se com uma amostra de 238 universitários, que responderam aos instrumentos AUDIT e AEQ-A. Homens apresentaram prevalência significativamente maior de uso de álcool no ano, uso problemático e binge. Expectativas de transformações globais positivas e de melhora no desempenho sexual foram maiores entre os homens. Houve correlação positiva entre expectativas e a gravidade de problemas associados ao consumo de álcool para ambos os sexos, no entanto, essa relação foi significativa apenas para os homens. Resultados indicam que diferenças das expectativas do beber entre os sexos podem ter um importante papel em ações de prevenção mais precisas e eficazes sobre o uso de álcool de homens e mulheres.

Alcohol use and drinking expectations of men and women were compared, verifying the relationship between variables. A sample of 238 college students responded to the AUDIT and AEQ-A. Men showed significantly higher prevalence of yearly alcohol use, problematic use and binge drinking. Expectations of global positive changes and sexual enhancement were greater among men. A positive correlation was found between expectations and severity of problems associated with alcohol consumption for both sexes, however, this relationship was significant only for men. Results indicated that differences of drinking expectations between the sexes may have an important role in more precise and effective preventive actions on alcohol use of men and women.

[Women in outpatient treatment for alcohol abuse: sociodemographic and clinical characteristics]. / Mulheres em tratamento ambulatorial por abuso de álcool: características sociodemográficas e clínicas.

Quantitative and descriptive study aimed to identify sociodemographic and clinical characteristics of women undergoing outpatient treatment for alcohol abuse. Data were collected from medical records of women with alcohol-related disorders who were treated at a psychiatric outpatient service We performed a reading and descriptive analysis of such data. The sample was composed of 27 medical records, the average age of women was 50 years, mostly married (59.6%), not working (70.4%) with incomplete primary education (70.4%), with an alcoholic family (81.5%) and other psychiatric diagnoses (70.3%). Losses physical, social and emotional was the most common symptoms resulting from alcohol withdrawal syndrome (66.7%), family conflicts (72%) and "sadness" (79.2%). Family violence was recorded in 11 records (40.7%). There was low education, unemployment, psychiatric comorbidities and the presence of other family members with alcohol abuse as common characteristics. We emphasize the importance of professional knowledge about the peculiarities of female alcoholism for health activities more effective.

Mulheres em tratamento ambulatorial por abuso de álcool: características sociodemográficas e clínicas / Women in outpatient treatment for alcohol abuse: sociodemographic and clinical characteristics / Las mujeres sometidas a tratamiento ambulatorio por abuso de alcohol: características sociodemográficas y clínicas

Estudo quantitativo e descritivo, com o objetivo de identificar características sociodemográficas e clínicas de mulheres em tratamento ambulatorial por abuso de álcool. Os dados foram coletados em prontuários de mulheres com transtornos relacionados ao álcool, atendidas em serviço psiquiátrico ambulatorial. Foi realizado levantamento, leitura e análise descritiva. A amostra foi composta por 27 prontuários, a média de idade das mulheres foi 50 anos, maioria casada (59,6%), não trabalhava (70,4%), com ensino fundamental incompleto (70,4%), com familiar alcoolista (81,5%) e outros diagnósticos psiquiátricos (70,3%). Prejuízos físicos, sociais e emocionais mais frequentes foram: sintomas advindos da síndrome de abstinência alcoólica (66,7%), conflitos familiares (72%) e "tristeza" (79,2%). A violência familiar foi registrada em 11 prontuários (40,7%). Verificaram-se baixa escolaridade, desemprego, comorbidades psiquiátricas e presença de outro familiar com abuso de álcool como características comuns. Destaca-se a importância do conhecimento profissional sobre as peculiaridades do alcoolismo feminino para ações de saúde mais efetivas.

Quantitative and descriptive study aimed to identify sociodemographic and clinical characteristics of women undergoing outpatient treatment for alcohol abuse. Data were collected from medical records of women with alcohol-related disorders who were treated at a psychiatric outpatient service. We performed a reading and descriptive analysis of such data. The sample was composed of 27 medical records, the average age of women was 50 years, mostly married (59.6%), not working (70.4%) with incomplete primary education (70.4%), with an alcoholic family (81.5%) and other psychiatric diagnoses (70.3%). Losses physical, social and emotional was the most common symptoms resulting from alcohol withdrawal syndrome (66.7%), family conflicts (72%) and "sadness" (79.2%). Family violence was recorded in 11 records (40.7%). There was low education, unemployment, psychiatric comorbidities and the presence of other family members with alcohol abuse as common characteristics. We emphasize the importance of professional knowledge about the peculiarities of female alcoholism for health activities more effective.

El estudio cuantitativo y descriptivo tuvo como objetivo identificar las características sociodemográficas y clínicas de las mujeres sometidas a tratamiento ambulatorio por abuso de alcohol. Los datos fueron obtenidos de las historias clínicas de mujeres con trastornos relacionados con el alcohol que fueron tratadas en un servicio psiquiátrico ambulatorio. Se realizó un análisis descriptivo y lectura de estos datos. La muestra se compone de 27 historias clínicas, la edad promedio de las mujeres era de 50 años, casadas (59,6%), sin trabajar (70,4%), con educación primaria incompleta (70,4%), con una familia alcohólica (81,5%) y otros diagnósticos psiquiátricos (70,3%). Las pérdidas físicas, sociales y emocionales fueron los síntomas más comunes que resultan de síndrome de abstinencia de alcohol (66,7%), conflictos familiares (72%) y "tristeza" (79,2%). La violencia familiar se registró en 11 registros (40,7%). Hubo baja escolaridad, el desempleo, las comorbilidades psiquiátricas y la presencia de miembros de la familia con el abuso de alcohol como características comunes. Hacemos hincapié en la importancia del conocimiento profesional acerca de las peculiaridades del alcoholismo femenino para actividades de salud más eficaces.

Diferenças de gênero sobre expectativas do uso de álcool / Gender differences in alcohol expectancies

CONTEXTO: Estudos indicam que expectativas sobre o uso de álcool podem contribuir para o início e a manutenção do consumo da droga e modular de forma diferente o comportamento do beber de homens e de mulheres. OBJETIVOS: Descrever e analisar diferenças de gênero sobre expectativas relacionadas ao uso de álcool em artigos da literatura indexada. MÉTODOS: Foram pesquisados artigos empíricos originais no período de 2000 a 2011 nos indexadores PubMed, SciELO, Lilacs e PsycInfo. RESULTADOS: Foram selecionados 32 estudos, sendo apenas dois de origem latino-americana. Expectativa de facilitação social foi a mais observada para ambos os gêneros. Homens apresentaram maior diversidade de expectativas sobre os efeitos do uso de álcool. Intervenções baseadas na redução de expectativas positivas parecem mais eficazes entre os homens. CONCLUSÃO: Expectativas são um importante fator de risco para o uso de álcool, independentemente do gênero. A consideração das diferenças de gênero sobre expectativas pode beneficiar o manejo clínico de problemas associados ao consumo de álcool e direcionar ações preventivas para o risco de abuso e dependência.

BACKGROUND: Previous studies have shown, that expectancies about the consumption of alcohol can contribute to the onset and maintenance of alcohol use and modulate in different ways the drinking behaviour of men and women. OBJECTIVES: To describe and analyse gender differences in alcohol expectancies based on indexed literature. METHODS: The research was conducted via the electronic databases PubMed, SciELO, Lilacs and PsycInfo, considering original articles published between 2000 and 2011. RESULTS: Thirty two studies were found, whereby only 2 were from Latin America. Social facilitation was the most frequent expectancy in both genders. Men showed more variety of expectancies associated to alcohol use. Preventive measures with the aim to reduce positive expectancies were more effective in male. DISCUSSION: Regardless of gender, alcohol expectancies are an important risk factor for alcohol use. The consideration of gender differences in alcohol expectancies can enhance clinical monitoring of problems associated with alcohol use and direct preventive efforts against the risk of abuse and dependence.

Revisão sistemática sobre fatores de risco associados à depressão pós-parto / A systematic review on risk factors associated to postpartum depression

Este estudo teve como objetivo investigar fatores de risco relacionados à depressão pós-parto. Foi realizada uma revisão sistemática nas bases PubMed, Scielo e Lilacs. Descritores: postpartum depression, risk factors, epidemiological studies. Critérios de inclusão: artigos publicados nos últimos cinco anos, idiomas inglês, português ou espanhol, amostra de mulheres acima de 18 anos, avaliação da depressão pós-parto realizada, no mínimo, 15 dias pós-parto. Foram selecionados 35 artigos e encontrados 70 fatores de risco para depressão pós-parto. Os fatores de risco mais frequentemente citados pertenciam ao agrupamento de fatores psicológicos/psiquiátricos. A evolução das investigações sobre depressão pós-parto tem privilegiado o estudo dos fatores psicossociais. Fatores hormonais/genéticos aparecem com baixa representatividade nesses estudos. Mulheres em situação de risco podem ser identifi cadas nas consultas pré-natais permitindo ações preventivas para a depressão pós-parto.(AU)

This study sought to investigate risk factors associated to postpartum depression. A systematic review of the literature was conducted on the databases PubMed, Scielo and Lilacs, with the keywords postpartum depression, risk factors and epidemiological studies. Inclusion criteria: articles published in the last fi ve years in the following languages: English, Portuguese or Spanish; the sampling consisted of women above 18 years of age, with the postpartum depression assessment undertaken at least fifteen days after birth. There were 35 articles selected. From those, 70 risk factors were associated to postpartum depression. The risk factors that appear more frequently were psychological/psychiatric ones. The development of the investigations about postpartum depression has privileged the knowledge about psychosocial risk factors. A low frequency of hormonal/genetic factors appeared in these studies. The conclusion points out to the need of pregnant women in risk situation to be identified in the prenatal care in order to allow preventive actions for postpartum depression.(AU)

Revisão sistemática sobre fatores de risco associados à depressão pós-parto / A systematic review on risk factors associated to postpartum depression

Este estudo teve como objetivo investigar fatores de risco relacionados à depressão pós-parto. Foi realizada uma revisão sistemática nas bases PubMed, Scielo e Lilacs. Descritores: postpartum depression, risk factors, epidemiological studies. Critérios de inclusão: artigos publicados nos últimos cinco anos, idiomas inglês, português ou espanhol, amostra de mulheres acima de 18 anos, avaliação da depressão pós-parto realizada, no mínimo, 15 dias pós-parto. Foram selecionados 35 artigos e encontrados 70 fatores de risco para depressão pós-parto. Os fatores de risco mais frequentemente citados pertenciam ao agrupamento de fatores psicológicos/psiquiátricos. A evolução das investigações sobre depressão pós-parto tem privilegiado o estudo dos fatores psicossociais. Fatores hormonais/genéticos aparecem com baixa representatividade nesses estudos. Mulheres em situação de risco podem ser identifi cadas nas consultas pré-natais permitindo ações preventivas para a depressão pós-parto.

This study sought to investigate risk factors associated to postpartum depression. A systematic review of the literature was conducted on the databases PubMed, Scielo and Lilacs, with the keywords postpartum depression, risk factors and epidemiological studies. Inclusion criteria: articles published in the last fi ve years in the following languages: English, Portuguese or Spanish; the sampling consisted of women above 18 years of age, with the postpartum depression assessment undertaken at least fifteen days after birth. There were 35 articles selected. From those, 70 risk factors were associated to postpartum depression. The risk factors that appear more frequently were psychological/psychiatric ones. The development of the investigations about postpartum depression has privileged the knowledge about psychosocial risk factors. A low frequency of hormonal/genetic factors appeared in these studies. The conclusion points out to the need of pregnant women in risk situation to be identified in the prenatal care in order to allow preventive actions for postpartum depression.

Consumo de álcool e atenção primária no interior da Amazônia: sobre a formação de médicos e enfermeiros para assistência integral / Alcohol abuse and primary care in the Amazon: training nurses and physicians for comprehensive care

O uso problemático de álcool (UPA) é um dos principais problemas de saúde pública na lista de prioridades da Estratégia de Saúde da Família (ESF). Este artigo objetiva investigar a visão de enfermeiros e médicos de Saúde da Família sobre o UPA, focando a compreensão que trazem sobre esta temática e o modo como é trabalhada no dia a dia dos serviços da região amazônica. Trata-se de um estudo qualitativo, com 14 trabalhadores da ESF, médicos e enfermeiros recém-formados de um município do interior do Amazonas. Foram utilizados dois grupos focais. Os dados foram analisados por meio de análise temática, a partir dos princípios do SUS e da formação de recursos humanos em saúde. Os profissionais identificaram os fatores de risco para o UPA, mostraram conhecer as consequências para o indivíduo e para a sociedade, e descreveram os critérios utilizados pelos sistemas de classificação de doenças, mas não sabiam como atuar sobre esta questão, indicando problemas na formação universitária.

Alcohol abuse is one of the main public health problems on the list of priorities in Brazil's Family Health Strategy. The objectives of this study were to learn the views of family health nurses and physicians concerning alcohol abuse, focusing on their understanding of this issue and the way it is handled routinely by health services in the Amazon. This was a qualitative study with 14 recently graduated nurses and physicians from the Family Health Strategy in a county in the interior of the State of Amazonas. Two focus groups were used. The data were analyzed through thematic analysis, based on the principles of the Unified National Health System (SUS) and human resources training. The health professionals identified risk factors for alcohol abuse, were aware of the consequences for the individual and society, and described the criteria used by disease classification systems, but they did not know how to act on this issue, thus revealing gaps in the respective university training.

Avaliação do funcionamento familiar no contexto da saúde mental / Family functioning assessment in the context of mental health

OBJETIVO: Verificar quais instrumentos têm sido utilizados na avaliação do funcionamento familiar no âmbito da saúde mental. MÉTODO: Revisão sistemática da literatura de acordo com as normas Cochrane nas bases de dados Medline, PubMed e PsycInfo, no período de janeiro de 1990 a julho de 2009. Foram considerados artigos nos idiomas inglês, português e espanhol que apresentassem a utilização de escalas, questionários e entrevistas na avaliação da relação familiar no contexto da saúde mental. Os resumos deveriam especificar o nome do instrumento utilizado, com aplicação em pelo menos dois membros da família, e apresentar objetivo, metodologia e resultados. As palavras-chave utilizadas foram: "family functioning" e "assessment" e "psychiatry". RESULTADOS: A partir de 1.162 artigos, foram selecionados 20. Os instrumentos encontrados foram: Family Assessment Device (FAD), Family Environment Scale (FES), Family Assessment Measure (FAM) e Family Adaptability Cohesion Evaluation Scale III (FACES III). Os aspectos mais relacionados com disfunção familiar foram: desempenho de papéis, valores e normas, comunicação, envolvimento afetivo e resolução de problemas. A melhora do funcionamento familiar foi associada à recuperação do paciente com transtorno mental. CONCLUSÃO: A utilização de instrumentos de avaliação familiar pode contribuir para o planejamento de intervenções terapêuticas e na reabilitação em saúde mental.

OBJECTIVE: To determine which instruments have been used in the assessment of family functioning in the context of mental health. METHOD: Systematic review according to Cochrane standards in databases: Medline, PubMed and PsycInfo from January 1990 to July 2009. We considered articles in English, Portuguese and Spanish who presented the use of scales, questionnaires and interviews in the assessment of family relationship in the context of mental health. The abstract should specify the name of the instrument, applying at least two family members, to present objective, methodology and results. The keywords used were: family functioning and assessment and psychiatry. RESULTS: This study found 1,162 articles and 20 were selected. The instruments cited were: Family Assessment Device (FAD), Family Environment Scale (FES), Family Assessment Measure (FAM) Family Adaptability and Cohesion Evaluation Scale III (FACES III). The most families dysfunctions were related to: the performance of roles, norms and values, communication, affective involvement and problem resolution. The improvement of family functioning was associated with recovery of patients with mental disorders. DISCUSSION: The use of family assessment instruments can contribute to the planning of therapeutic interventions and rehabilitation in mental health.