El articulo presenta una discusion teorica sobre el impacto del alcoholismo en la poblacion mapuche. Desde una perspectiva interdisciplinaria se analiza como el colonialismo y el trauma historico han ...influido en el kvme mongen (salud holistica y buena vida) en personas, familias y el lof (territorio mapuche), como tambien la relacion que este efecto ha tenido en el consumo problematico de alcohol. Se destaca la importancia de la interculturalidad y el mapuche kvmvn para abordar la superacion del alcoholismo en el marco de estrategias colectivas para la reparacion del trauma historico. Se concluye que para abordar el alcoholismo que afecta a la poblacion mapuche se requiere de una comprension critica de las consecuencias del pasado colonial y la necesidad de metodologias descolonizadoras para la produccion de contribuciones teorico-practicas que vayan en la linea de una transformacion radical de las relaciones de poder coloniales y la construccion de nuevas formas de autodeterminacion y soberania.
Alcohol use disorders Carvalho, Andre F; Heilig, Markus; Perez, Augusto ...
The Lancet (British edition),
08/2019, Letnik:
394, Številka:
10200
Journal Article
Recenzirano
Alcohol use disorders consist of disorders characterised by compulsive heavy alcohol use and loss of control over alcohol intake. Alcohol use disorders are some of the most prevalent mental disorders ...globally, especially in high-income and upper-middle-income countries; and are associated with high mortality and burden of disease, mainly due to medical consequences, such as liver cirrhosis or injury. Despite their high prevalence, alcohol use disorders are undertreated partly because of the high stigma associated with them, but also because of insufficient systematic screening in primary health care, although effective and cost-effective psychosocial and pharmacological interventions do exist. Primary health care should be responsible for most treatment, with routine screening for alcohol use, and the provision of a staggered treatment response, from brief advice to pharmacological treatment. Clinical interventions for these disorders should be embedded in a supportive environment, which can be bolstered by the creation of alcohol control policies aimed at reducing the overall level of consumption.
Rationale: A promising pharmacotherapy for alcohol use disorders has been positive allosteric modulators (PAMs) of the gamma -aminobutyric acid receptor B (GABA sub(B) R) since GABA sub(B) R PAMs ...reduce ethanol drinking and self-administration in rodents. Objective: The current studies investigated a novel, selective GABA sub(B) R PAM, ADX71441, in comparison to naltrexone in a protocol of ethanol binge-like drinking, drinking-in-the-dark (DID), and in a model of long-term, excessive drinking, intermittent access to ethanol (IA). Methods: Male C57BL/6 J mice were given doses of ADX71441 (3, 10, 30 mg/kg, p.o.) before the fourth test day of repeated DID access to 20 % ethanol. Another group of mice had a history of 4 weeks of IA before ADX71441 (3, 10, 17 mg/kg, p.o.) treatment. The opioid antagonist, naltrexone (0.1, 1, 10 mg/kg, i.p.), was administered to different groups of mice in both protocols as a positive control. Results: In both DID and IA protocols, ADX71441 showed a selective and potent reduction of ethanol drinking, but not water drinking, while naltrexone had a more modest and transient effect on reducing ethanol drinking. The long-lasting effect of ADX71441 agrees with its plasma pharmacokinetics in showing peak concentrations at 2 h followed by a slow decay lasting well beyond 8 h. Conclusions: These findings support previous studies demonstrating that GABA sub(B) R PAMs decrease voluntary ethanol intake without altering water intake. ADX71441 may be a worthwhile candidate for developing a treatment of alcoholism, yet its site of action in the brain and long-term pharmacological effects require further exploration.
The relationship between violent behavior against women and other members of the family and alcohol consumption is currently a social problem with legal repercussions. The most frequent is to see an ...alcoholic man execute violent actions against women; data at the global level show that this is not a problem that covers all countries, regardless of their economic or technological development. That being the case, there are many studies that affirm that, it is the family nucleus, the place where the greatest number of aggressions against women occur, regardless of age, condition, race, culture and economic condition.
Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact ...of this approach with a 10-year comparison of public endorsement of treatment and prejudice.
The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma.
In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection.
More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.