To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.


Saturday, September 25, 2010

Age Differences in Long-Term Patterns of Change in Alcohol Consumption Among Aging Adults

To estimate patterns of long-term, within-person, changes in alcohol consumption among adults of different ages and assess key predictors of alcohol-use patterns over time.
Data came from 3,617 adults, interviewed up to four times between 1986 and 2002. Multilevel multinomial logit models estimated the odds of abstinence and heavy drinking relative to moderate drinking.
The odds of abstinence increased and the odds of heavy drinking decreased during the study period. Older adults experienced faster increases in abstinence than younger adults. However, data extrapolations suggest that current younger adults are more likely to be abstinent and less likely to be heavy drinkers during late life than current older adults. Time-varying health, social, and lifestyle factors account for some of these patterns.
Drinking behavior in our aging population appears to be on a relatively promising course, perhaps reflecting the effectiveness of public health efforts. 

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Tightening The Genotype-Phenotype Gap: From Genetic Variation to Gene Function

Event:Ancillary Symposium entitled "Tightening The Genotype-Phenotype Gap: From Genetic Variation to Gene Function"
Location:60th Annual Meeting of the American Society of Human Genetics (ASHG) at the Walter E. Washington Convention Center, 801 Mount Vernon Place, NW, Washigton, DC 20001-3614.
Start Date:11/2/2010 8:00 AM
End Date:11/2/2010 5:30 PM

Program         Agenda 
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Friday, September 24, 2010

The Potential of Recovery Capital

This short paper outlines the concept of recovery capital and discusses the impact that the accumulation of individual success has on groups and communities. 

It seeks to define recovery capital, to capture its flavour and principles, and to look at the intrinsically social forces that are at play in shaping change and in growing communities of recovery.

It also outlines how we will be taking forward these ideas in our action research.

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The effect of risky alcohol use and smoking on suicide risk: findings from the German MONICA/KORA-Augsburg Cohort Study

Smoking and heavy alcohol use predicts suicidal behaviour. Whether the simultaneous presentation of both conditions induces an amplified effect on risk prediction has not been investigated so far.
In a community-based cohort study, a total of 12,888 subjects (6,456 men, 6,432 women; age range of 25–74 years at assessment) from three independent population-based cross-sectional MONICA surveys (conducted in 1984/85, 1989/90, and 1994/95), representative for the Southern German population, was followed up until 31 December 2002. Standardized mortality ratios (SMR) for deaths from suicide using German population rates were calculated for smoking and high alcohol consumption. 
After a mean follow-up time of 12.0 (SD 4.4) years and 154,275 person-years at risk, a total of 1,449 persons had died from all causes and 38 of them from suicide. Compared to the general population, mortality from suicide was increased for risky alcohol consumption (SMR = 2.37; 95% CI 1.14–4.37) and for smoking (SMR = 2.30; 95% CI 1.36–3.63). A substantial increase in suicide mortality (SMR = 4.80; 95% CI 2.07–9.46) was observed for smokers with risky alcohol consumption. 
The approximately fourfold increased relative risk for completed suicide in subjects with smoking and risky alcohol consumption indicates a synergistic effect which deserves an increased alertness. 
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Cognitive Performance in Treatment-Naïve Active Alcoholics

Most studies reporting cognitive deficits in chronic alcoholics have relied on treatment samples (predominantly men) from inpatient or outpatient treatment facilities. However, the majority of chronic alcoholics have never been in treatment and there is increasing evidence that treated and non-treatment-seeking alcoholic samples come from different populations with regard to alcohol use and other factors related to the severity of disease. 

Accordingly, in the present study, we assessed a broad range of cognitive functions in 55 treatment-naïve alcohol-dependent (TNAD) individuals and 55 nonalcoholic controls (NAC) matched for age and education. 

In addition, a goal of the present study was to assess potential differential effects of alcohol dependence on cognitive performance in TNAD men and women.
Comprehensive neuropsychological assessment was conducted on TNAD and NAC. The following 9 performance domains, each consisting of multiple measures, were examined: attention, auditory working memory, verbal processing, abstraction/cognitive flexibility, psychomotor function, immediate memory, delayed memory, reaction time, and spatial processing.
Analysis revealed no cognitive deficits in TNAD, relative to NAC, in any of the 9 cognitive domains. TNAD performed better than NAC in the attention domain. In addition, while men performed better than women in the spatial domain, there were no TNAD versus NAC group by gender interactions for any domain.
Our results extend findings that TNAD show minimal behavioral effects of chronic heavy alcohol use and are consistent with the contention that TNAD are relatively cognitively intact. 

Differences between our findings and those often reported for alcoholics recruited from treatment settings may be understood in terms of differences in alcohol use, along with genetic, psychiatric, and nutritional factors. 

In addition, the lack of differential effects of alcohol dependence on male and female cognitive performance in our study suggests that TNAD men and women do not differ in the severity of cerebral consequences of alcohol dependence.

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Acupuncture Inhibits GABA Neuron Activity in the Ventral Tegmental Area and Reduces Ethanol Self-Administration

Withdrawal from chronic ethanol enhances ventral tegmental area (VTA) GABA neuron excitability and reduces mesolimbic dopamine (DA) neurotransmission, which is suppressed by acupuncture at Shenmen (HT7) points (Zhao et al., 2006). 

The aim of this study was to evaluate the effects of HT7 acupuncture on VTA GABA neuron excitability, ethanol inhibition of VTA GABA neuron firing rate, and ethanol self-administration. A role for opioid receptors (ORs) in ethanol and acupuncture effects is also explored.
Using electrophysiological methods in mature rats, we evaluated the effects of HT7 stimulation and opioid antagonists on VTA GABA neuron firing rate. Using behavioral paradigms in rats, we evaluated the effects of HT7 stimulation and opioid antagonists on ethanol self-administration using a modification of the sucrose-fading procedure.
HT7 stimulation produced a biphasic modulation of VTA GABA neuron firing rate characterized by transient enhancement followed by inhibition and subsequent recovery in 5 minutes. HT7 inhibition of VTA GABA neuron firing rate was blocked by systemic administration of the nonselective μ-opioid receptor antagonist naloxone. 

HT7 stimulation significantly reduced ethanol suppression of VTA GABA neuron firing rate, which was also blocked by naloxone. HT7 acupuncture reduced ethanol self-administration without affecting sucrose consumption. 

Systemic administration of the δ-opioid receptor (DOR) antagonist naltrindole blocked ethanol suppression of VTA GABA neuron firing rate and significantly reduced ethanol self-administration without affecting sucrose consumption.
These findings suggest that DOR-mediated opioid modulation of VTA GABA neurons may mediate acupuncture’s role in modulating mesolimbic DA release and suppressing the reinforcing effects of ethanol.

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Area of residence and alcohol-related mortality risk: a five-year follow-up study

To examine differences in alcohol-related mortality risk between areas, while adjusting for the characteristics of the individuals living within these areas.

A 5-year longitudinal study of individual and area characteristics of those dying and not dying from alcohol-related deaths.

The Northern Ireland Mortality study.
A total of 720 627 people aged 25–74, enumerated in the Northern Ireland 2001 Census, not living in communal establishments.
Five hundred and seventy-eight alcohol-related deaths.
There was an increased risk of alcohol-related mortality among disadvantaged individuals, and divorced, widowed and separated males. The risk of an alcohol-related death was significantly higher in deprived areas for both males [hazard ratio (HR) 3.70; 95% confidence interval (CI) 2.65, 5.18] and females (HR 2.67 (95% CI 1.72, 4.15); however, once adjustment was made for the characteristics of the individuals living within areas, the excess risk for more deprived areas disappeared. Both males and females in rural areas had a reduced risk of an alcohol-related death compared to their counterparts in urban areas; these differences remained after adjustment for the composition of the people within these areas.
 Alcohol-related mortality is higher in more deprived, compared to more affluent areas; however, this appears to be due to characteristics of individuals within deprived areas, rather than to some independent effect of area deprivation per se. Risk of alcohol-related mortality is lower in rural than urban areas, but the cause is unknown.

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Thursday, September 23, 2010

Challenges in Developing Evidence-Based Recommendations Using the GRADE Approach: The Case of Mental, Neurological, and Substance Use Disorders

The World Health Organization (WHO) has been criticized recently for recommendations based on systematic reviews of the best available evidence and for the quality of some of its guidelines [1][3]

In 2007, WHO put in place procedures for developing transparent, evidence-based guidelines based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology [4],[5]

This methodology, developed by an international network of methodologists with an interest in grading quality of evidence and strength of recommendations (Box 1), has now been used to produce WHO guidelines for several topics. These include rapid advice guidelines for the pharmacological management of human H5N1 virus infection [6],[7] and guidelines on a single specific clinical topic such as psychosocially assisted pharmacological treatment of opioid dependence [8]

However, the GRADE approach has not yet been applied to develop recommendations that cover a broad range of conditions and interventions.

WHO is in the process of developing a model intervention guide within its mental health Gap Action Programme (mhGAP) [9]. The model intervention guide provides recommendations to facilitate care at first and second level facilities by the non-specialist health care providers in low- and middle-income countries (Box 2). These recommendations will be based on the GRADE approach. 

To our knowledge, this is the first exercise involving a systematic evaluation of evidence in this area. Other initiatives, for example the recently published reviews of evidence for packages of care for mental, neurological, and substance use disorders in low- and middle-income countries, did not use GRADE methodology [10]

This paper describes the use and adaptation of the GRADE approach in developing the guidelines for the mhGAP model intervention guide.

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Electrophysiological evidence of alcohol-related attentional bias in social drinkers low in alcohol sensitivity.

Low sensitivity to the acute effects of alcohol is a known risk factor for alcoholism. However, little is known concerning potential information-processing routes by which this risk factor might contribute to increased drinking. 

We tested the hypothesis that low-sensitivity (LS) participants would show biased attention to alcohol cues, compared with their high-sensitivity (HS) counterparts. 

Participants performed a task in which alcoholic and nonalcoholic beverage cues were presented bilaterally followed by a target that required categorization by color. 

Response times were faster for targets appearing in alcohol-cued than non–alcohol-cued locations for LS but not for HS participants. 

Event-related potential markers of early attention orienting (P1 amplitude) and subsequent attention reorienting (ipsilateral invalid negativity amplitude) indicated preferential selective attention to alcohol-cued locations among LS individuals. 

Controlling for recent drinking and family history of alcoholism did not affect these patterns, except that among HS participants, relatively heavy recent drinking was associated with difficulty reorienting attention away from alcohol-cued locations. 

These findings suggest a potential information-processing bias through which low sensitivity could lead to heavy alcohol involvement. 

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Press Statement - The College of Emergency Medicine Calls for Policy-Makers to Take Action Against Alcohol-Related Harm

The College of Emergency  Medicine (CEM) is today calling for measures to tighten up control over the marketing of alcohol, in order to tackle alcohol-related harm and the
impact on Emergency Departments (EDs). 

Healthcare professionals operating in EDs and the wider hospital environment are confronted with the result of alcohol misuse on a daily basis, and vital resources are being drained treating and managing the problem.
Set to coincide with Freshers’ Week, during which time alcohol-related admissions to EDs rise significantly, the CEM is calling for co-ordinated action from all stakeholders to reduce the harms from alcohol. 

Shockingly, the recently published Local Alcohol Profiles for England (LAPE 2010) indicated a statistic of 945,469 admissions to hospital for alcohol related harm in 2008/9 – 825 a day more than five years ago – costing the NHS and other public services around £20 billion per year.

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Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review

We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact.

We searched 12 databases, along with articles’ reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates.

We identified 50 articles, containing 340 estimates. Meta-estimates were r=–0.347 for alcohol-related disease and injury outcomes, –0.022 for violence, –0.048 for suicide, –0.112 for traffic crash outcomes, –0.055 for sexually transmitted diseases, –0.022 for other drug use, and –0.014 for crime and other misbehavior measures. All except suicide were statistically significant.

Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%.

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Combined Impact of Lifestyle-Related Factors on Total and Cause-Specific Mortality among Chinese Women: Prospective Cohort Study Findings from the Shanghai Women's Health Study confirm those derived from other, principally Western, cohorts regarding the combined impact of lifestyle-related factors on mortality.

Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. 

The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women.

We used data from the Shanghai Women's Health Study, an ongoing population-based prospective cohort study in China. Participants included 71,243 women aged 40 to 70 years enrolled during 1996–2000 who never smoked or drank alcohol regularly. A healthy lifestyle score was created on the basis of five lifestyle-related factors shown to be independently associated with mortality outcomes (normal weight, lower waist-hip ratio, daily exercise, never exposed to spouse's smoking, higher daily fruit and vegetable intake). The score ranged from zero (least healthy) to five (most healthy) points. 

During an average follow-up of 9 years, 2,860 deaths occurred, including 775 from cardiovascular disease (CVD) and 1,351 from cancer. Adjusted hazard ratios for mortality decreased progressively with an increasing number of healthy lifestyle factors. Compared to women with a score of zero, hazard ratios (95% confidence intervals) for women with four to five factors were 0.57 (0.44–0.74) for total mortality, 0.29 (0.16–0.54) for CVD mortality, and 0.76 (0.54–1.06) for cancer mortality. 

The inverse association between the healthy lifestyle score and mortality was seen consistently regardless of chronic disease status at baseline. The population attributable risks for not having 4–5 healthy lifestyle factors were 33% for total deaths, 59% for CVD deaths, and 19% for cancer deaths.

In this first study, to our knowledge, to quantify the combined impact of lifestyle-related factors on mortality outcomes in Chinese women, a healthier lifestyle pattern—including being of normal weight, lower central adiposity, participation in physical activity, nonexposure to spousal smoking, and higher fruit and vegetable intake—was associated with reductions in total and cause-specific mortality among lifetime nonsmoking and nondrinking women, supporting the importance of overall lifestyle modification in disease prevention.

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Experimental effect of positive urgency on negative outcomes from risk taking and on increased alcohol consumption.


The current pair of experimental studies sought to further validate the role of positive urgency (acting rashly when in an extreme positive emotional state) as a risk factor for impulsive and maladaptive behavior. 

Previous research has supported the use of emotion-based dispositions to rash action in predicting a wide range of maladaptive acts. However, that research was conducted in the field and relied on self-reported behavior, thus lacking tight experimental controls and direct observation of risky behaviors.

In the 2 experimental studies described here, we found that among college students (1) positive urgency significantly predicted negative outcomes on a risk-taking task following a positive mood manipulation (n = 94), and (2) positive urgency significantly predicted increases in beer consumption following positive mood induction (n = 33).

Positive urgency's role was above and beyond previously identified risk factors; these findings, combined with prior cross-sectional and longitudinal field studies, provide support for the role of positive urgency in rash action.

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Is it beneficial to have an alcoholics anonymous sponsor?.

Alcoholics Anonymous (AA) attendance is predictive of increased abstinence for many problem drinkers and treatment referral to AA is common. Strong encouragement to acquire an AA sponsor is likewise typical, and findings about the benefits associated with social support for abstinence in AA support this practice, at least indirectly. Despite this widespread practice, however, prospective tests of the unique contribution of having an AA sponsor are lacking. 

This prospective study investigated the contribution of acquiring an AA sponsor using a methodologically rigorous design that isolated the specific effects of AA sponsorship. 

Participants were recruited from AA and outpatient treatment. Intake and follow-up assessments included questionnaires, semi-structured interviews, and urine toxicology screens. Eligibility criteria limited prior treatment and AA histories to clarify the relationship of interest while, for generalizability purposes, broad substance abuse criteria were used. 

Of the 253 participants, 182 (72%) provided complete data on measures central to the aims of this study. Overall reductions in alcohol, marijuana, and cocaine use were found over 12-months and lagged analyses indicated that AA attendance significantly predicted increased abstinence. 

During early AA affiliation but not later logistic regressions showed that having an AA sponsor predicted increased alcohol-abstinence and abstinence from marijuana and cocaine after first controlling for a host of AA-related, treatment, and motivational measures that are associated with AA exposure or are generally prognostic of outcome.

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Parental alcohol involvement and adolescent alcohol expectancies predict alcohol involvement in male adolescents.

Current models of adolescent drinking behavior hypothesize that alcohol expectancies mediate the effects of other proximal and distal risk factors. 

This longitudinal study tested the hypothesis that the effects of parental alcohol involvement on their children's drinking behavior in mid-adolescence are mediated by the children's alcohol expectancies in early adolescence. 

A sample of 148 initially 9–11 year old boys and their parents from a high-risk population and a contrast group of community families completed measures of drinking behavior and alcohol expectancies over a 6-year interval. We analyzed data from middle childhood (M age = 10.4 years), early adolescence (M age = 13.5 years), and mid-adolescence (M age = 16.5 years).  The sample was restricted only to adolescents who had begun to drink by mid-adolescence. 

Results from zero-inflated Poisson regression analyses showed that 1) maternal drinking during their children's middle childhood predicted number of drinking days in middle adolescence; 2) negative and positive alcohol expectancies in early adolescence predicted odds of any intoxication in middle adolescence; and 3) paternal alcoholism during their children's middle childhood and adolescents' alcohol expectancies in early adolescence predicted frequency of intoxication in middle adolescence. 

Contrary to predictions, child alcohol expectancies did not mediate the effects of parental alcohol involvement in this high-risk sample. Different aspects of parental alcohol involvement, along with early adolescent alcohol expectancies, independently predicted adolescent drinking behavior in middle adolescence. 

Alternative pathways for the influence of maternal and paternal alcohol involvement and implications for expectancy models of adolescent drinking behavior were discussed. 

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Risky Decisions and Their Consequences: Neural Processing by Boys with Antisocial Substance Disorder Adolescents with conduct and substance problems (

Adolescents with conduct and substance problems (“Antisocial Substance Disorder” (ASD)) repeatedly engage in risky antisocial and drug-using behaviors. We hypothesized that, during processing of risky decisions and resulting rewards and punishments, brain activation would differ between abstinent ASD boys and comparison boys.

We compared 20 abstinent adolescent male patients in treatment for ASD with 20 community controls, examining rapid event-related blood-oxygen-level-dependent (BOLD) responses during functional magnetic resonance imaging. In 90 decision trials participants chose to make either a cautious response that earned one cent, or a risky response that would either gain 5 cents or lose 10 cents; odds of losing increased as the game progressed. We also examined those times when subjects experienced wins, or separately losses, from their risky choices. We contrasted decision trials against very similar comparison trials requiring no decisions, using whole-brain BOLD-response analyses of group differences, corrected for multiple comparisons. During decision-making ASD boys showed hypoactivation in numerous brain regions robustly activated by controls, including orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate, basal ganglia, insula, amygdala, hippocampus, and cerebellum. While experiencing wins, ASD boys had significantly less activity than controls in anterior cingulate, temporal regions, and cerebellum, with more activity nowhere. During losses ASD boys had significantly more activity than controls in orbitofrontal cortex, dorsolateral prefrontal cortex, brain stem, and cerebellum, with less activity nowhere.

Adolescent boys with ASD had extensive neural hypoactivity during risky decision-making, coupled with decreased activity during reward and increased activity during loss. These neural patterns may underlie the dangerous, excessive, sustained risk-taking of such boys. The findings suggest that the dysphoria, reward insensitivity, and suppressed neural activity observed among older addicted persons also characterize youths early in the development of substance use disorders.

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Even low alcohol concentrations affect obstacle avoidance reactions in healthy senior individuals

Alcohol is a commonly used social drug and driving under influence is a well-established risk factor for traffic accidents. To improve road safety, legal limits are set for blood alcohol concentration (BAC) and driving, usually at 0.05% (most European countries) or 0.08% (most US states, Canada and UK). Alcohol, even at these low concentrations, affects brain function and increases fall risk. An increased fall risk has been associated with impaired obstacle avoidance skills. Low level BACs are likely to affect obstacle avoidance reactions during gait, since the brain areas that are presumably involved in these reactions have been shown to be influenced by alcohol.

Therefore we investigated the effect of low to moderate alcohol consumption on such reactions. Thirteen healthy senior individuals were subjected to an obstacle avoidance task on a treadmill after low alcohol consumption. Fast stepping adjustments were required to successfully avoid suddenly appearing obstacles. Response times and amplitudes of the m. biceps femoris, a prime mover, as well as avoidance failure rates were assessed.

After the first alcoholic drink, 12 of the 13 participants already had slower responses. Without exception, all participants' biceps femoris response times were delayed after the final alcoholic drink.

The present results clearly show that even with BACs, considered to be safe for driving, obstacle avoidance reactions are inadequate, late, and too small. This is likely to contribute to an increased fall risk. Therefore we suggest that many of the alcohol-related falls are the result of the disruptive effects of alcohol on the online corrections of the ongoing gait pattern when walking under challenging conditions.

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Derivation and Characterization of Replicate High- and Low-Alcohol Preferring Lines of Mice and a High-Drinking Crossed HAP Line

Selectively breeding lines of mice and rats to differ in alcohol intake has proven useful for defining which traits correlate with high alcohol drinking behavior, as well as for creating animal models of alcoholism.

This study reports the derivation of two novel sets of selected lines, High Alcohol Preferring (HAP) and Low Alcohol Preferring (LAP) replicate 2 and 3 lines.

Mice were mass-selected using the same procedure as in the replicate 1 lines: using HS/Ibg as a progenitor, mice were selected for differences in 2-bottle choice intake of 10% alcohol during a 4-week testing period.

In addition, another high-drinking line, the crossed HAP (cHAP) line was selectively bred from a progenitors that were a cross of replicate 1 (S27) × replicate 2 (S21) HAP lines.

All lines were characterized for saccharin intake. Overall, the response to selection of the HAP and LAP replicate 2 and 3 lines was quite similar.

As anticipated, following selection, the cHAP line drank more than either parent HAP line (consuming 26.0 g/kg per day of alcohol by S11), suggesting that this method of crossing replicate lines and selecting from that cross captures more alleles than any single selected line, as well as producing a line with exceptionally high voluntary alcohol intake.
As expected, saccharin consumption was highly associated with alcohol consumption; data from 7 lines (HAP 1, 2, and 3, LAP 1, 2, and 3, and cHAP) indicated a genetic correlation between 10% alcohol and 0.32% saccharin intake of 0.91.

Overall, these findings show the practicality of developing replicate lines divergent in alcohol preference, and validate a novel procedure for generating very high-drinking mouse populations.

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Alcohol News - 38/2010

YLE News (Finland) - Finns Less Tolerant of Alcohol Consumption
Attitudes towards alcohol consumption and binge drinking in Finland have hardened significantly, with a majority of Finns agreeing on the need for restraint in alcohol use.

Helsinkin Sanomat (Finland) - Nearly 70% would reduce blood-alcohol threshold for drink-driving cases
Finnish attitudes towards binge-drinking are becoming increasingly strict. Bans and restrictions are accepted these days with more relish than in earlier years. (Denmark) - Carlsberg puts alcohol locks on beer trucks
Workers will need to breathe into breathalysers to start their vehicles Brewery giant Carlsberg’s promise to equip their beer trucks with alcohol ignition locks went into force today, and 300 vehicles have been fitted with the devices, reported TV2 News....

The Local (Sweden) - Swedish team targets addict relapse molecule
People who have used cocaine are at a greater risk of becoming addicted even after long drug-free periods, researchers at Linköping University have discovered.

Truck News (Sweden) - Swedes spec'ing alcolocks to prevent impaired truck driving
Volvo has announced that 25% of the trucks it sells in Sweden now come with a factory-fitted alcolock to prevent impaired driving.

ERR News (Estonia) - Alcohol Proves a Factor in 58% of Drownings
In the first eight months of this year, 85 people drowned in Estonia, of whom 72 were men and 49 were under the influence of alcohol.

TopNews United States (Scotland) - New Study: Native Scots Run Twice the Risk of Giving in Due to Alcohol Related Reasons
As per a novel study, native Scots have twofold risk of dying be cause of alcohol related troubles, in comparison to those people from Scotland, who belong the southern border. (USA) - Colleges Try To Discourage Binge Drinking Among Freshmen
Most colleges have intensive programs designed to educate students about alcohol and drug abuse and to inform them about campus resources to help. For many, including Quinnipiac, UConn and Trinity College, that educational process begins in the summer before freshman year with an online class that also provides administrators with an overall assessment of students' alcohol use before they come to campus.,0,394524.story

Helium - Links between alcohol and depression
Serotonin is a neurotransmitters been indicated as a contributing factor in mood disorders. Neurotransmitters are brain chemical that cause an effect in the brain.

Co-Operative News (UK) – Call for UK-wide action on alcohol sales
The Co-operative Group has called on the UK Government to work closely with the Scottish Government after the SNP administration announced plans to introduce minimum pricing for alcohol in an attempt to curb the nation’s drink-related problems.

London Free Press (UK) - Courts must always take drunk driving seriously
Impaired driving has been a scourge on Canadian roads for decades. While campaigns have been waged, warnings issued and laws tightened, drinking and driving is not going away.

The Nation, Pakistan - Alcohol, diabetes, hepatitis up liver cancer risk: study
Heavy alcohol use, diabetes, and viral hepatitis combine synergistically to raise the risk of developing liver cancer, according to a new report.

Science AAAS (USA) - Advisers Say NIH Should Merge Alcohol, Drug Abuse Institutes
A group of outside advisers to National Institutes of Health Director Francis Collins has recommended merging the two NIH institutes that study alcoholism and drug abuse.

Sify (Russia) - Alcohol unaffected by recession in Russia
Production of alcohol such as vodka, beer and wine in Russia has not been affected by the global economic crisis, according to the federal statistics bureau Rosstat.

Medical News Today - Alcohol Consumption After Breast Cancer Diagnosis May Increase Recurrence Risk
In the Life After Cancer Epidemiology (LACE) study, 1,897 participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited on average 2 years post-breast cancer diagnosis were evaluated for the association between alcohol intake and breast cancer recurrence and death.

Wall Street Journal (Thailand) - Global Liquor Makers Fight Graphic Labels in Thailand
Alcohol companies world-wide are lining up to fight a Thai plan to require graphic warning labels about alcohol on the country's domestic and imported beer, wine and liquor bottles.

ABC Online (Australia) - Concern over alcohol related violence
There is concern over alcohol-related crime in the New South Wales south east, with assault and under-age drinking at alarming high levels.

TopNews United Kingdom (UK) - 90% of Youngsters Try Alcohol by 15
It has been revealed by the data gathered by the Australian Secondary Students Drug and Alcohol Survey that by the time young people turn 15, 90% of them try alcohol.

The Press Association (Scotland) - Caffeinated alcohol ban considered
The Scottish Government will "carefully consider" Labour calls to ban caffeinated alcoholic drinks such as Buckfast, Deputy First Minister Nicola Sturgeon has said.

ABC Online - Alcohol linked to early onset dementia
New research suggests that up to a fifth of all cases of early onset dementia are alcohol related.

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National Survey of Drinking and Driving attitudes and Behaviors

Twenty percent of the public 16 and older had in the past year driven a motor vehicle within two hours of drinking alcohol.

About two-thirds of these, or 13% of the total population 16 and older had done so in the past 30 days. The survey produced an estimate of 85.5 million past-month drinking-driving trips, up from 73.7 million trips in 2004 and reversing a declining trend in such trips since 1995. More than three-fourths (78%) of the trips were made by males.

Those who reported driving within two hours of drinking in the past year tended to be more frequent drinkers than did other drivers who drink but do not drive afterwards.

More than one in four (28%) drinking drivers usually consumed alcoholic beverages 3 or more days a week, compared to 10% of drivers who drink but do not drink and drive.

While few 16- to 20-year-olds reported drinking and driving, those that did averaged 5.7 drinks per sitting during the times they drink alcohol (inclusive of all drinking occasions, not just drinking and driving).

For 21- to 24-year-old drinking drivers, their average alcohol intake was 4.2 drinks per sitting.

The average number of drinks dropped sharply again for 25- to 34-year-old drinking drivers (3.0), then declined more slowly across ensuing age groups

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Pregnancy and complex social factors

The NICE guideline ‘Antenatal care: routine care for the healthy pregnant woman’ (NICE clinical guideline 62). The guideline has been developed in collaboration with the Social Care Institute for Excellence.

It is for professional groups who are routinely involved in the care of pregnant women, including midwives, GPs and primary care professionals who may encounter pregnant women with complex social factors in the course of their professional duties. It is also for those who are responsible for commissioning and planning healthcare and social services.

In addition, the guideline will be of relevance to professionals working in social services and education/childcare settings, for example school nurses, substance misuse service workers, reception centre workers and domestic abuse support workers. outlines the care that women should be offered during pregnancy. However, pregnant women with complex social factors may have additional needs.

This guideline sets out what health care professionals as individuals, and antenatal services as a whole, can do to address these needs and improve pregnancy outcomes in this group of women.

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