Czechs spend more on tobacco, alcohol than on health - report

23 June 2008

Prague- Czechs spend more on tobacco, alcohol and other unhealthy habits than on the protection of their health, according to a report on health care worked out within the Round table project and released.

Czechs do not like cash payments in health care apart from their health insurance.

"People expect that all their health problems to be solved by somebody else and desirably for free if they pay health insurance," Stanislav Vachek, analyst of the Round table on the future of the health care system's funding project.

In EU countries, households spend two to five percent of their budget on health.

Czech households spent 1.5 times more on tobacco, alcohol and other unhealthy habits than on health.

. . . . . . .

Read Full Article

________________________________________________________________

Substance Use Among Women: Associations with Pregnancy, Parenting, and Race/Ethnicity
Maternal and Child Health Journal Online First 20 June 2008


To examine the association of pregnancy and parenting (0- to 2-year-old child) statuses with past 30-day use of alcohol, cigarettes and marijuana, psychotherapeutics and cocaine among American women aged 18–44, overall and by race/ethnicity.

Five years of data (2002–2006) from the National Survey on Drug Use and Health (NSDUH) were pooled. Binary logistic regression analyses stratified by race/ethnicity were performed to examine the relationships adjusting for age, marital status, education and family income.

Overall, past 30-day alcohol, cigarette, marijuana, psychotherapeutic or cocaine use was substantially lower among pregnant women, particularly in their second or third trimesters, than among their parenting or non-pregnant counterparts. Logistic regression analysis suggested a strong negative association between pregnancy status and substance use, with no considerable variations in the magnitude of the relationship by race/ethnicity for most measures. The relationship between parenting status and substance use was in the same direction, but relatively weak, and not statistically significant for non-Hispanic (NH) blacks for any measures except for alcohol use. Regardless of pregnancy and parenting statuses, NH white women reported substance use at the highest rates, followed by Hispanics and NH blacks.

There is indirect evidence of postpregnancy resumption in substance use. Pregnant and parenting women, regardless of race/ethnicity, could benefit from prevention efforts focusing on cessation rather than temporary abstinence from substance use.

Read Full Abstract

Request Reprint E-Mail: pradip.muhuri@samhsa.hhs.gov
_________________________________________________________________

Alcohol policies must target majority to reduce the toll of death and disease

Monday, 23rd June 2008

With alcohol-related deaths in Scotland almost doubling in the past decade and one of the fastest growing alcoholic liver disease rates in the world, it's hard to believe that some people still argue that harmful alcohol use in Scotland is a minority problem (Platform, 20 June).

The truth is that many of us, young and old alike, are drinking at levels that put our health and wellbeing at risk. More harm is associated with the much bigger group of risky drinkers than the smaller group of dependent drinkers. Policies need to target the whole population rather than just the heaviest drinkers.

Effective action to reduce alcohol consumption in the population means controls on price and availability. . . . . . . .

Read Full Article
________________________________________________________

French police to fine "Le binge drinkers"

By Henry Samuel in Paris

22/06/2008

Paris police have imposed an acohol ban in the park surrounding the Eiffel Tower because it has become a drunken "battlefield".

Selling or drinking alcohol is now forbidden from 4pm to 7am in the Champ-de-Mars, the green area around the tower leading up to the Trocadero. Drinkers face a £30 fine, while anyone caught selling alcohol must pay £595.

The French are increasingly worried about the rise of "le binge drinking," particularly among the younger generation, in a country long proud of avoiding Anglo-Saxon "drink-to-get-drunk" culture.
. . . . . . .

Read Full Article

__________________________________________________________________

A framework for studying the neurobiology of value-based decision making

Nature Reviews Neuroscience 9, 545-556 (July 2008)

Neuroeconomics is the study of the neurobiological and computational basis of value-based decision making. Its goal is to provide a biologically based account of human behaviour that can be applied in both the natural and the social sciences.

This Review proposes a framework to investigate different aspects of the neurobiology of decision making. The framework allows us to bring together recent findings in the field, highlight some of the most important outstanding problems, define a common lexicon that bridges the different disciplines that inform neuroeconomics, and point the way to future applications.

Read Full Abstract

Request Reprint E-Mail: rangel@hss.caltech.edu __________________________________________________________________

A survey of local health promotion initiatives for older people in Wales
BMC Public Health 2008, 8:217

As the demographic profile of the UK changes, policy makers and practitioners have to respond to health challenges presented by a progressively ageing population. The health promotion plan for older people, aged over 50 years, in Wales included eight key areas: physical activity, healthy eating, home safety and warmth, emotional health, health protection, smoking, alcohol and sexual health. The aim of this study was to describe the extent, content and regional variation of existing health promotion initiatives for older people in Wales, provided by statutory, voluntary and private sector agencies.

A questionnaire was sent to senior health promotion specialists employed in the 22 local authority areas in Wales to ascertain details of all projects promoting health and wellbeing in the eight key areas where the priority population was aged over 50, or the majority of users were older people. Additional information was sought from project leads and websites.

Eighteen questionnaires were returned; not all were fully completed. Four areas did not return a questionnaire. Additional information was obtained from internet searches but this mainly concerned national initiatives rather than local projects. In all, 120 projects were included, 11 were throughout Wales. Best provision was for physical activity, with 3 national and 42 local initiatives, but local provision was patchy. Healthy eating, and home safety and warmth had far fewer initiatives, as did health protection, which comprised two national immunisation campaigns. Smoking and alcohol misuse were poorly provided for, and there was no provision for older peoples sexual health. Evaluation arrangements were poorly described. Half of those who responded identified unmet training needs.

The reasons for patchy provision of services were not clear. Increased efforts to improve the coverage of interventions known to be effective should be made. Rigorous evaluation of projects is needed to ascertain the most effective and appropriate interventions, especially for alcohol misuse and sexual health. These conclusions are relevant to the other countries of the United Kingdom (UK), and more widely across Europe.

Read Full Text (PDF)

_____________________________________________________________

Alcohol dose effects on brain circuits during simulated driving: An fMRI study

Human Brain Mapping Published Online: 20 Jun 2008


Driving while intoxicated remains a major public health hazard. Driving is a complex task involving simultaneous recruitment of multiple cognitive functions.

The investigators studied the neural substrates of driving and their response to different blood alcohol concentrations (BACs), using functional magnetic resonance imaging (fMRI) and a virtual reality driving simulator.

GLM analysis revealed significant dose-related functional differences, complementing ICA data. Driving behaviors including opposite white line crossings and mean speed independently demonstrated significant dose-dependent changes. Behavior-based factors also predicted a frontal-basal-temporal circuit to be functionally impaired with alcohol dosage across baseline scaled, good versus poorly performing drivers.

We report neural correlates of driving behavior and found dose-related spatio-temporal disruptions in critical driving-associated regions including the superior, middle and orbito frontal gyri, anterior cingulate, primary/supplementary motor areas, basal ganglia, and cerebellum.

Overall, results suggest that alcohol (especially at high doses) causes significant impairment of both driving behavior and brain functionality related to motor planning and control, goal directedness, error monitoring, and memory.


Read Full Abstract

Request Reprint E-Mail: smeda01@harthosp.org
__________________________________________________________________

Chronic Alcohol Consumption Increases the Severity of Murine Influenza Virus Infections
The Journal of Immunology, 2008, 181: 641-648.


Respiratory infections with both seasonal as well as potential pandemic Influenza viruses represent a significant burden on human health. Furthermore, viruses such as Influenza are increasingly recognized as important etiologic agents in community acquired pneumonia. Within the U.S. alone, 12.9 million people are heavy drinkers and chronic abuse of alcohol is known to increase the risk and severity of community acquired pneumonia.

Given the lack of knowledge regarding Influenza disease in this population, we determined the effects of chronic alcohol consumption on Influenza virus infection.

Herein, we report that mice exposed to chronic ethanol have sharp increases in morbidity, mortality, and pulmonary virus titers relative to controls. These increases in influenza severity correspond with inhibited pulmonary influenza-specific CD8 T cell responses. Further, chronic ethanol consumption results in an enhanced pulmonary lesion severity, similar to that recently described for pandemic influenzas.

Together, our results suggest that chronic alcohol consumption may increase the risk for severe influenza virus infections by altering the pulmonary inflammatory environment and CD8 T cell response.

<sup>Read Full Abstract

Request Repint E-Mail:</sup> kevin-legge@uiowa.edu
^{____________________________________________________________________________}

The day that 'binge' became a dirty word

Michael Bachelard


June 22, 2008

A WEEK after the National Health and Medical Research Council said its "definition of binge drinking will drop" to the equivalent of four pots of beer, or three glasses of wine, the group issued a statement saying new alcohol-consumption guidelines "do not use the term 'binge drinking'".

Alcohol experts have accused the NHMRC of a "stuff-up", saying its handling of the guidelines debate has threatened the credibility of health researchers and obscured a crucially important message.
. . . . . . .

Read Full Article

_______________________________________________________________

Abstinence following Alcohol Drinking Produces Depression-Like Behavior and Reduced Hippocampal Neurogenesis in Mice
Neuropsychopharmacology advance online publication 18 June 2008;


Alcoholism and depression show high degrees of comorbidity. Clinical evidence also indicates that depression that emerges during abstinence from chronic alcohol use has a greater negative impact on relapse than pre-existing depression. Although no single neurobiological mechanism can account for the behavioral pathologies associated with these devastating disorders, converging evidence suggests that aspects of both alcoholism and depression are linked to reductions in hippocampal neurogenesis.

Here, we report results from a novel preclinical behavioral model showing that abstinence from voluntary alcohol drinking leads to the emergence of depression-like behavior and reductions in neurogenesis.

After 14 days, but not 1 day of abstinence from alcohol drinking, mice showed a significant increase in depression-like behavior. The significant increase in depression-like behavior during abstinence was associated with a reduction in proliferating cell nuclear antigen (PCNA) and doublecortin (DCX) immunoreactivity in the dentate gyrus of the hippocampus indicating that both the number of proliferating neural progenitor cells (NPC) and immature neurons were reduced, respectively.

The number of NPCs that were labeled with bromo-deoxyuridine (BrdU) at the beginning of alcohol exposure was not altered indicating that survival of NPCs is not linked to abstinence-induced depression.

Chronic treatment (14 days) with the antidepressant desipramine during abstinence prevented both the emergence of depression-like behavior and the reduction in hippocampal neurogenesis indicating that abstinence-induced depression is associated with structural plasticity in the hippocampus.

Overall, the results of this study support the conclusion that profound functional (ie behavioral) and structural changes occur during abstinence from alcohol use and suggest that antidepressant treatment may alleviate some of these pathological neurobehavioral adaptations.

Read Full Abstract

Request Reprint E-Mail: chodge@med.unc.edu
___________________________________________________________________

Enhanced Negative Emotion and Alcohol Craving, and Altered Physiological Responses Following Stress and Cue Exposure in Alcohol Dependent Individuals
Neuropsychopharmacology advance online publication 18 June 2008;


Chronic alcohol abuse is associated with changes in stress and reward pathways that could alter vulnerability to emotional stress and alcohol craving.

This study examines whether chronic alcohol abuse is associated with altered stress and alcohol craving responses.

Alcohol patients showed significantly elevated basal heart rate and salivary cortisol levels. Stress and alcohol cue exposure each produced a significantly enhanced and persistent craving state in alcohol patients that was marked by increased anxiety, negative emotion, systolic blood pressure responses, and, in the case of alcohol cue, behavioral distress responses, as compared to SDs. Blunted stress-induced cortisol responses were observed in the AD compared to the SD group.

These data are the first to document that stress and cue exposure induce a persistent negative emotion-related alcohol craving state in abstinent alcoholics accompanied by dysregulated HPA and physiological arousal responses.

As laboratory models of stress and negative mood-induced alcohol craving are predictive of relapse outcomes, one implication of the current data is that treatments targeting decreases in stress and alcohol cue-induced craving and regulation of stress responses could be of benefit in improving alcohol relapse outcomes.

Read Full Abstract


Request Reprint E-Mail: rajita.sinha@yale.edu
_______________________________________________________________

SNP alcohol policy could give UK government a Brussels hangover

By Colin Donald, Business Editor

Minimum pricing branded a competition law minefield

MEASURES PROPOSED by the Scottish government to establish minimum prices for alcohol carry a "significant risk" of exposing the UK government to a European legal challenge, lawyers have warned.

English and Scottish competition law specialists say that proposals for minimum retail pricing contained in the SNP government's alcohol strategy document contain potential legal snares, infringement of which would make a Westminster government answerable to European law courts.
. . . . . . .

Read Full Article

_________________________________________________________________

Our booze blues

June 22, 2008

We know it brings chaos to our city streets, we know it destroys families, we know it's responsible for violence and domestic abuse, we know it's killing us, so why do we still love to drink? Ian Bell looks at our love affair with alcohol

There are certain cherished sayings we could probably live without. And by "live" I mean exactly that. Here's one redolent, supposedly, of the Scottish national character: Freedom and whisky gang thegither. What's wrong with that sentiment? Perhaps the fact that it is only slightly less egregious, muddled and downright dangerous than asserting that alcopops and human dignity combine nicely.

. . . . . . .

Read Full Article
________________________________________________________________

Editorial: Binge rules could drive you to drink

June 21, 2008

It is not difficult to see why Kevin Rudd's Government is alarmed about young Australians' abuse of alcohol. A report published this month in the Australian and New Zealand Journal of Public Health found that the number of women aged 18 to 24 who had to go to hospital after binge drinking had more than doubled in less than a decade. About half were diagnosed with acute intoxication.

Such statistics persuaded Mr Rudd to embark on a national strategy which, among other things, included a 70 per cent rise in the tax on alcopops. Now, far less persuasively, there is a proposed new set of guidelines on what constitutes binge drinking. So severe are these that not only are they likely to be disregarded, but they also risk devaluing the whole strategy.
. . . . . . .

Read Full Article

________________________________________________________________

Maturation-Dependent Alcohol Resistance in the Developing Mouse: Cerebellar Neuronal Loss and Gene Expression During Alcohol-Vulnerable and -Resistant Periods
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 19 June 2008

Alcohol abuse during pregnancy injures the fetal brain. One of alcohol’s most important neuroteratogenic effects is neuronal loss. Rat models have shown that the cerebellum becomes less vulnerable to alcohol-induced neuronal death as it matures.

We determined if maturation-dependent alcohol resistance occurs in mice and compared patterns of gene expression during the alcohol resistant and sensitive periods.

Purkinje and granule cells were vulnerable to alcohol-induced death at PD2 to 4, but not at PD8 to 10. Acquisition of maturation-dependent alcohol resistance coincided with changes in the expression of neurodevelopmental genes. The vulnerability of cerebellar neurons to alcohol toxicity declined in parallel with decreasing levels of Math1 and Cyclin D2, markers of immature granule cells. Likewise, the rising resistance to alcohol toxicity paralleled increasing levels of GABA α-6 and Wnt-7a, markers of mature granule neurons. Expression of growth factors and genes with survival promoting function (IGF-1, BDNF, and cyclic AMP response element binding protein) did not rise as the cerebellum transitioned from alcohol-vulnerable to alcohol-resistant. All 3 were expressed at substantial levels during the vulnerable period and were not expressed at higher levels later. Acute alcohol exposure altered the expression of neurodevelopmental genes and growth factor genes when administered either during the alcohol vulnerable period or resistant period. However, the patterns in which gene expression changed varied among the genes and depended on timing of alcohol administration.

Mice have a temporal window of vulnerability in the first week of life, during which cerebellar neurons are more sensitive to alcohol toxicity than during the second week. Expression of genes governing neuronal maturation changes in synchrony with the acquisition of alcohol resistance. Growth factors do not rise as the cerebellum transitions from alcohol-vulnerable to alcohol-resistant. Thus, a process intrinsic to neuronal maturation, rather than rising levels of growth factors, likely underlies maturation-dependent alcohol resistance.

Read Full Abstract

Request Reprint E-Mail: bahri-karacay@uiowa.edu

____________________________________________________________________

Role of Major NMDA or AMPA Receptor Subunits in MK-801 Potentiation of Ethanol Intoxication
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 19 June 2008

The glutamate system plays a major role in mediating EtOH’s effects on brain and behavior, and is implicated in the pathophysiology of alcohol-related disorders. N-methyl-D-aspartate receptor (NMDAR) antagonists such as MK-801 (dizocilpine) interact with EtOH at the behavioral level, but the molecular basis of this interaction is unclear.

MK-801 markedly potentiated the ataxic effects of 1.75 g/kg EtOH and the sedative/hypnotic effects of 3.0 g/kg EtOH, but not the hypothermic effects of 3.0 g/kg EtOH, in C57BL/6J and 129/SvImJ mice. Phencyclidine potentiated EtOH-induced sedation/hypnosis in both inbred strains. Neither NR2A nor GluR1 KO significantly altered basal EtOH-induced ataxia, hypothermia, or sedation/hypnosis. Ro 25-6981 modestly increased EtOH-induced sedation/hypnosis. The ability of MK-801 to potentiate EtOH-induced ataxia and sedation/hypnosis was unaffected by GluR1 KO or NR2B antagonism. NR2A KO partially reduced MK-801 + EtOH-induced sedation/hypnosis, but not ataxia or hypothermia.

Data confirm a robust and response-specific potentiating effect of MK-801 on sensitivity to EtOH’s intoxicating effects. Inactivation of three major components of glutamate signaling had no or only partial impact on the ability of MK-801 to potentiate behavioral sensitivity to EtOH. Further work to elucidate the mechanisms underlying NMDAR × EtOH interactions could ultimately provide novel insight into the role of NMDARs in alcoholism and its treatment.

Read Full Abstract

Request Reprint E-Mail: holmesan@mail.nih.gov

____________________________________________________________________

Inhibition of 5α-Reduced Steroid Biosynthesis Impedes Acquisition of Ethanol Drinking in Male C57BL/6J Mice
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 19 June 2008

Allopregnanolone (ALLO) is a physiologically relevant neurosteroid modulator of GABA_A receptors, and it exhibits a psychopharmacological profile that closely resembles the post-ingestive effects of ethanol. The 5α-reductase inhibitor finasteride (FIN), which inhibits biosynthesis of ALLO and structurally related neurosteroids, was previously demonstrated to reduce the maintenance of limited-access ethanol consumption.

The primary aim of the current work was to determine whether FIN would reduce the acquisition of drinking in ethanol-naïve mice.

FIN dose-dependently blocked the acquisition of 10E drinking and prevented the development of ethanol preference, thereby suggesting that the GABAergic neurosteroids may be important in the establishment of stable drinking patterns. FIN-elicited reductions in 10E intake were primarily attributable to selective and marked reductions in bout frequency, as no changes were observed in bout size, duration, or lick rates following FIN treatment. FIN-treated mice continued to exhibit attenuated ethanol consumption after 2 weeks post-treatment, despite a full recovery in brain ALLO levels. A second study confirmed the rightward and downward shift in the acquisition of ethanol intake following 7 daily FIN injections. While there were no significant group differences in brain ALLO levels following the seventh day of ethanol drinking, ALLO levels were decreased by 28% in the FIN-50 group.

Although the exact mechanism is unclear, FIN and other pharmacological interventions that modulate the GABAergic system may prove useful in curbing ethanol intake acquisition in at-risk individuals.

Read Full Abstract

Request Reprint E-Mail: fordma@ohsu.edu

___________________________________________________________

Decision Making in Alcohol Dependence: Insensitivity to Future Consequences and Comorbid Disinhibitory Psychopathology
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 19 June 2008


Alcohol dependence (AD) is often comorbid with other disinhibitory disorders that are characterized by poor decision making and evidenced by disadvantageous strategies on laboratory tasks such as the Iowa Gambling Task (IGT).

In this study, a variant of the IGT is used to examine specific mechanisms that may account for poor decision making on the task in AD both with and without comorbid psychopathology.

Both AD and CCD were associated with greater IFC but not greater PLvS. Structural equation models (SEMs) indicated that IFC was associated with higher scores on a latent dimensional “disinhibitory disorders” factor representing the covariance among all lifetime measures of disinhibitory psychopathology, but was not directly related to any one disinhibitory disorder. SEMs also suggested that adult antisocial behavior was uniquely associated with a greater PLvS.

Disadvantageous decision making on the IGT in those with AD and related disinhibitory disorders may reflect an IFC that is common to the covariance among these disorders but not unique to any one disorder.

Read Full Abstract


Request Rep[rint E-Mail: finnp@indiana.edu
_________________________________________________

Peptidergic Agonists of Activity-Dependent Neurotrophic Factor Protect Against Prenatal Alcohol-Induced Neural Tube Defects and Serotonin Neuron Loss
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 19 June 2008

Prenatal alcohol exposure via maternal liquid diet consumption by C57BL/6 (B6) mice causes conspicuous midline neural tube deficit (dysraphia) and disruption of genesis and development of serotonin (5-HT) neurons in the raphe nuclei, together with brain growth retardation.

The current study tested the hypothesis that concurrent treatment with either an activity-dependent neurotrophic factor (ADNF) agonist peptide [SALLRSIPA, (SAL)] or an activity-dependent neurotrophic protein (ADNP) agonist peptide [NAPVSIPQ, (NAP)] would protect against these alcohol-induced deficits in brain development.

Prenatal alcohol exposure resulted in abnormal openings along the midline and delayed closure of ventral canal in the brainstem. This dysraphia was associated with reductions in the number of 5-HT neurons both in the rostral raphe nuclei (that gives rise to ascending 5-HT projections) and in the caudal raphe (that gives rise to the descending 5-HT projections). Concurrent treatment of the alcohol-consuming dams with SAL prevented dysraphia and protected against the alcohol-induced reductions in 5-HT neurons in both the rostral and caudal raphe. NAP was less effective in protecting against dysraphia and did not protect against 5-HT loss in the rostral raphe, but did protect against loss in the caudal raphe.

These findings further support the potential usefulness of these peptides for therapeutic interventions in pregnancies at risk for alcohol-induced developmental deficits. Notably, the ascending 5-HT projections of the rostral raphe have profound effects in regulating forebrain development and function, and the descending 5-HT projections of the caudal raphe are critical for regulating respiration. Protection of the rostral 5-HT-system may help prevent structural and functional deficits linked to abnormal forebrain development, and protection of the caudal systems may also reduce the increased risk for sudden infant death syndrome associated with prenatal alcohol exposure.

Read Full Abstract

Request Reprint E-Mail: imce100@iupui.edu

____________________________________________________________________

Prediction of Serotonergic Treatment Efficacy Using Age of Onset and Type A/B Typologies of Alcoholism
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 19 June 2008

Previously, we reported that ondansetron was efficacious at treating early-onset (≤25-years old) but not late-onset (≥26-years old) alcoholics in a double-blind, randomized, placebo-controlled clinical trial (n = 321 enrolled patients, 271 of them randomized). Randomized participants underwent 11 weeks of treatment with ondansetron (1, 4, or 16 μg/kg twice daily; n = 67, 77, and 71, respectively) or identical placebo (n = 56), plus weekly standardized group cognitive behavioral therapy.

For this study, we reanalyzed the original sample to determine whether the Type A/B typological classification predicts ondansetron treatment response. In this comparative analysis, k-means clustering was applied to 19 baseline measures of drinking behavior, psychopathology, and social functioning, similar to those used by Babor in the original typological derivation. A 2-factor solution described robustly 2 groups phenomenologically consistent with Type A/B classification. Subjects were subdivided into early- and late-onset alcoholics.

Seventy-two percent of Type B subjects had early-onset alcoholism (EOA); 67% of Type A subjects had late-onset alcoholism (LOA). The A/B typology better discriminated 2 clusters based upon baseline severity of alcoholism. There was a significant effect (p < 0.05) for Type B alcoholics to respond to ondansetron (4 μg/kg); however, Type A alcoholics receiving ondansetron showed no beneficial effect. Early-onset vs. late-onset classification predicted ondansetron response substantially better than Type A/B classification, which did not add to the prediction of treatment outcome. Further analyses showed that ondansetron was effective in the 33% of Type A alcoholics with EOA but ineffective in the 28% of Type B alcoholics with LOA.

Type A/B classification best discriminates alcoholic subtypes based upon baseline severity. Early- vs. late-onset classification is, however, a better predictor of response to ondansetron treatment because it might be more closely related to fundamental neurobiological processes associated with the underlying pathophysiology of alcoholism.

Read Full Abstract

Request Reprint E-Mail: roache@uthscsa.edu

__________________________________________________________________