RESUMEN
OBJECTIVE: Research has demonstrated that alcohol outcome expectancies moderate the relationship between psychological states such as stress and negative affect and alcohol use. This study examined whether the relationship between expectancies and alcohol problems would be moderated by gender and ethnicity. METHOD: Using a household survey format, personal interviews were conducted with Puerto Rican and Irish American men and women. The final sample consisted of 412 (231 male) Puerto Ricans and 476 (252 male) Irish Americans. Alcohol expectancies were measured with the Effects of Drinking Alcohol Scale. All subjects resided in the New York metropolitan area. The original study was designed to compare the drinking behaviors and alcohol-related beliefs of groups with varied drinking practices and distinct drinking beliefs. RESULTS: Both gender and ethnicity moderated the links between aggressive and self-control expectancies and drinking problems. For example, anticipated loss of control from drinking was more negatively related to Puerto Rican and female alcohol problems than it was to Irish and male problems. CONCLUSIONS: The present findings suggest that whether an outcome expectancy is associated with more alcohol problems depends upon the particular meaning of the outcome. This meaning, in turn, depends upon an individual's particular sociocultural perspective which is associated with such personal characteristics as gender and ethnicity.
Asunto(s)
Consumo de Bebidas Alcohólicas/etnología , Trastornos Relacionados con Alcohol/etnología , Actitud Frente a la Salud/etnología , Comparación Transcultural , Adulto , Anciano , Agresión , Consumo de Bebidas Alcohólicas/psicología , Trastornos Relacionados con Alcohol/psicología , Síntomas Conductuales/psicología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Irlanda/etnología , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Puerto Rico/etnología , Análisis de Regresión , Factores Sexuales , Valores Sociales/etnologíaRESUMEN
AIM: This study tested mediator, moderator and main effects models to determine the pattern of relationships between ethnicity, gender, temperament, and alcohol use. DESIGN: A large-scale survey was employed. Respondents were interviewed in their homes. Participants were 523 Puerto Rican and 490 Irish American adults residing in the New York metropolitan area. MEASURES: Quantity and frequency of alcohol consumption were assessed with standard measures, and recent drinking problems with the substance abuse module of the Composite International Diagnostic Instrument. FINDINGS: Rather than supporting a complex, nested model, the findings supported a main effects model and indicated that each of the three predictors was related to one or more drinking measure. While gender strongly influenced each drinking behavior, ethnicity only influenced frequency, and temperament only influenced recent drinking problems. CONCLUSIONS: The results support previous studies indicating consistent male-female drinking differences while highlighting a statistical strategy for comparing competing models of ethnic drinking behavior.
Asunto(s)
Consumo de Bebidas Alcohólicas/etnología , Adulto , Femenino , Humanos , Irlanda/etnología , Masculino , Modelos Teóricos , New York/epidemiología , Puerto Rico/etnología , Factores Sexuales , TemperamentoRESUMEN
The intraesophageal acid perfusion (Bernstein) test was evaluated as a provocative test for nonspecific chest pain in children with esophagitis. Sixty patients with atypical chest pain were studied. None of the patients had heartburn or other characteristic symptoms of esophagitis. Forty-five patients had esophagitis; in 18 (40%) of these patients, pain replicating their usual symptoms developed during esophageal acid perfusion, whereas in 15 patients without esophagitis, chest pain did not develop during esophageal acid perfusion. In three patients with esophagitis, esophageal manometric abnormalities and chest pain developed as a result of esophageal acid perfusion. Treatment with either ranitidine or antacids had equivalent effectiveness. We conclude that a positive Bernstein test result in children with nonspecific chest pain indicates that the pain is likely associated with esophageal disease.
Asunto(s)
Dolor en el Pecho/etiología , Esofagitis/diagnóstico , Ácido Clorhídrico , Adolescente , Antiácidos/uso terapéutico , Dolor en el Pecho/inducido químicamente , Niño , Esofagitis/complicaciones , Esofagitis/tratamiento farmacológico , Humanos , Ácido Clorhídrico/administración & dosificación , Manometría , Ranitidina/uso terapéuticoRESUMEN
We retrospectively evaluated the utility of hepatobiliary scintigraphy and various clinical factors in differentiating intrahepatic cholestasis from biliary atresia in 28 consecutive infants with neonatal cholestasis. One millicurie of technetium-labeled diisopropyliminodiacetic acid (DISIDA) was administered intravenously, and images were obtained for up to 24 hours or until gastrointestinal excretion was noted. Nine separate studies in seven infants with biliary atresia were correctly interpreted as showing no gastrointestinal excretion of radionuclide. Of the 21 patients with intrahepatic cholestasis, only nine had gastrointestinal excretion on the first study; in eight without excretion, a second study was done, and five of these showed gut excretion. All infants with either neonatal hepatitis (six) or inspissated bile syndrome (three) had demonstrable gastrointestinal excretion either on the first or second DISIDA study. However, five of six infants with paucity of intrahepatic bile ducts, two of six infants with cholestasis secondary to total parenteral nutrition, and one infant with cholangiolitis did not show evidence of gastrointestinal excretion. The mean birth weight, mean gestational age, and mean weight at study were significantly greater (P less than 0.005) for infants with biliary atresia without excretion than for infants with intrahepatic cholestasis without excretion. The mean direct bilirubin concentration was 6.0 mg/dL for both infants with biliary atresia and infants with intrahepatic cholestasis without excretion; however, infants with excretion had a significantly lower (P less than 0.02) mean direct bilirubin value of 3.4 mg/dL. Excretion was noted in four infants with total bilirubin values greater than 10.0 mg/dL. The absence of gut excretion on the first DISIDA study was 100% sensitive but only 43% specific for biliary atresia. In infants without gut excretion of DISIDA, birth weight greater than 2200 g was 100% sensitive and 92% specific for biliary atresia. We conclude that DISIDA scanning, together with clinical data, is useful in differentiating extrahepatic from intrahepatic cholestasis. The absence of gut excretion on the first DISIDA study does not necessarily indicate extrahepatic obstruction; the study should be repeated if the diagnosis is not clear.