Is It My Job? Alcohol Brief Interventions: Knowledge and Attitudes among Future Health-care Professionals in Scotland

To document knowledge and perceptions relating to the professional role in the -area of alcohol misuse within a sample of first year (n = 278) and final year (n = 527) medical, nursing and allied health professional (NAHP) students in Scotland. 

A cross sectional survey design involving self-completed questionnaires administered in autumn 2008 (first year students) and spring 2009 (final year students) through course websites and lectures.

 

Gaps in the knowledge relating to current UK health guidelines were identified but more so among NAHP students than medical students. Exploration of the perceived role in this area of practice identified three broad groups of students: those clear about their role (medical and nursing students), those advocating a role but not identified by fellow students (occupational therapy and pharmacy) and those uncertain of their role (radiographers, speech and language therapists/audiologists and physiotherapy).

 

Higher education institutions should address the gaps in the knowledge around guidance for alcohol consumption. The effectiveness of brief interventions may depend on it. Additionally, through inter-professional teaching and in collaboration with the relevant professional bodies, more could be done to promote the contribution of practitioners other than those traditionally linked (i.e. medical and nursing) to this important clinical role. 

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Request Reprint E-Mail:   jgill@qmu.ac.uk 

Neurocognitive Determinants of Novelty and Sensation-Seeking in Individuals with Alcoholism

Sober alcoholic abusers exhibit personality traits such as novelty-seeking (NS) and sensation-seeking, which overlap to a limited extent. In parallel, they also show impaired executive and decision-making processes. However, little is known about the specific and common cognitive processes associated with NS and sensation-seeking personality traits in detoxified sober alcoholic abusers.

In these present studies, we have investigated the relationships between executive functioning/central executive of working memory (pre-potent response inhibition, manipulation stored in working memory), and decision-making under uncertainty and NS/sensation-seeking traits in such alcoholics. 

Compared with healthy controls (n = 30, mean age = 40.2), and in agreement with previous studies, alcoholics (n = 30, mean age = 40.4) showed higher levels of both NS and sensation-seeking traits. Alcoholics were also disadvantaged with respect to (a) gambling tasks, as reported previously, and (b) a poor ability to manipulate information stored in working memory and inhibit pre-potent responses. Most importantly, regression analyses and mediation analyses measures showed that poor response inhibition and decision-making were associated with high NS behaviour. In addition, impaired decision-making and manipulation of stored information in working memory were associated with a high sensation-seeking trait. 

Overall, these results support the existence of specific links between cognitive executive functioning, decision-making under uncertainty and NS/sensation-seeking personality traits in individuals with alcoholism. 

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Request Reprint E-Mail:   xnoel@ulb.ac.be 

Diversification of the ADH1B Gene during Expansion of Modern Humans

A variant allele, ADH1B*48His, also known as ADH1B*2, at the human Alcohol Dehydrogenase 1B gene (ADH1B) is strongly associated with alcoholism in some populations and has an unusual geographic distribution. 

Strong evidence implies selection has increased the frequency of this allele in some East Asian populations but does not fully explain its geographic pattern. 

We have studied haplotypes of 10 single nucleotide polymorphisms (SNPs) and two short tandem repeat polymorphisms (STRPs) in the ADH1B region in 2,206 individuals from a worldwide set of populations. These SNPs and STRPs define nine common haplogroups most of which have distinct geographic patterns. 

The haplogroups H5 and H6, both with the derived ADH1B*48His allele, appear restricted to the Middle East and East Asia, respectively. The positively selected H7 is derived from H6 by a new regulatory region variant defining SNP rs3811801 restricted to East Asia. 

Age estimates of the haplogroups based on the STRPs also agree with the time of the migration events estimated by other studies. H7 is estimated to have expanded recently, around 2,800 years ago, and ancient DNA samples from North China confirm its presence about that time. 

The dating of the H7 expansion may help understand the selective force on the ADH1B gene.

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Request Reprint E-Mail:  Kenneth.Kidd@Yale.edu 

Developing effective alcohol legislation

The purpose of the legislation guide is to assist government agencies and ministries in developing country-level legislation to implement, monitor and enforce effective alcohol policies. 

The guide provides advice on approaches to alcohol regulation to support development of effective legislation appropriate to each country. It provides practical advice based on international experience about the implications of legislative options, steps to be taken to implement legislation and best practice on how to enforce legislation and support compliance.

> > > >  Read More

Alcohol tax among bill signings today

In a little over a month, Marylanders will be digging deeper into their pockets to pay for beer, wine and liquor, after Gov. Martin O'Malley today signs into law the first tax increase on alcohol in at least a generation.

The sales tax on alcohol will rise from 6 to 9 percent July 1, a move expected to generate $85 million in the next fiscal year.   > > > >   Read More

Alcohol Consumption During Pregnancy Among Women in Israel

Fetal alcohol spectrum disorder (FASD) is a range of disabilities caused by gestational exposure of the fetus to alcohol. Alcohol consumption in Israel has increased dramatically in the last decades. Our previous study revealed limited knowledge among Israeli medical professionals of the risks and potential long-term effects of FASD.

To evaluate the awareness and knowledge of women regarding the current recommendations on alcohol consumption during pregnancy, evaluate how many of the women received information regarding alcohol consumption during pregnancy from medical professionals, and their personal drinking habits during pregnancy.

 
A cross-sectional sample of new mothers in 3 large hospitals in Israel were asked to complete an ad hoc questionnaire on aspects of alcohol consumption during pregnancy.

 
A total of 3815 women of mean age 30.4 years participated in the study; 82% were Jewish. Alcohol consumption during pregnancy was reported by 14.1%, including more than 17% of the Jewish women, 11.1% of the Christian women, and none of the Muslim women. Rates were higher among nonsecular and younger women and first-time mothers. 71.6% of the sample claimed that women should not drink alcohol at all during pregnancy, and 21.4% thought that it was permissible if limited to 2 drinks per week. Seventy-five percent had received no formal information from medical professionals regarding alcohol consumption during pregnancy.

 
Alcohol consumption is frequent among pregnant women in Israel, especially young secular Jewish women with first pregnancies. Improved educational programs on the dangers of FASD are needed for both professionals and the general public.

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Inefficacy of self-regulation of alcohol advertisements: a systematic review of the literature.

The most recent scientific literature indicates that alcohol advertising influences behavior, particularly early and higher alcohol consumption by children and adolescents. From a public health perspective, alcohol advertising should be restricted. In many countries, as well as in Brazil, limits to alcohol advertising are established by industry self-regulation (e.g. controlled by the advertising community itself). We examined in this review all papers on the subject of industry self-regulation of alcohol advertising published in the international literature

 

A systematic literature review was realized on papers investigating the effectiveness of self-regulation of alcohol advertisings. The search was conducted in Medline, SciELO, Camy and Google Scholar, between the years of 1991 and 2010. In addition, the "snowball" technique for the indication of the main authors on the subject was employed. From the papers found, 11 focused on the subject discussed here

The set of papers obtained indicates that industry self-regulation of alcohol advertising does not show evidence of efficacy. In other words, such a regulation does not prevent, for instance, alcohol advertising directed at children and adolescents.  

Further measures should be considered for the control and the broadcast of alcohol advertising, such as independent monitoring, legal control.


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Alcohol screening instruments in elderly male: a population-based survey in metropolitan São Paulo, Brazil.

This study compares the efficacy of the AUDIT (gold standard) with the more easily and quickly applied instruments CAGE, TWEAK, and T-ACE for men aged > 60 using data from a representative stratified sample of the general population of metropolitan São Paulo.

 

The GENACIS questionnaire was administered to a total sample of 2,083 people aged over 18, with a response rate of 74.5%. The elderly male sample consisted of 169 men. Sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve, and confidence intervals were calculated for each instrument (95% CI).

 

Respondents were predominantly married (81.7%), had up to 11 years of education (61.3%) and a monthly per capita income of up to 300 US dollars. Current abstinence rate was high (61.6%) and 38% reported being former drinkers. There were no statistically significant differences among the instruments tested; however, the TWEAK had a higher area under the receiver operating characteristic curve (95% CI; 0.90-0.99).

Research in the general population with screening instruments is scarce, especially among the elderly. However, it can provide specific information concerning this age group and be useful in the formulation of policies and prevention strategies.

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Global Actions China Marks Launch of UN “Decade of Action” for Road Safety

Global Actions China is participating today in a national launch event for the United Nations Decade of Action for Road Safety. China is one of 18 countries where initiatives are underway as part of Global Actions on Harmful Drinking (www.global-actions.org), and one of six countries wherethese efforts focus on drink driving.
 
“While there is a generally high awareness of the ‘Decade of Action’ and its importance, part of our challenge is raising public awareness about the dangers of drink driving to similar levels, and we are proud to be a partner in that effort,” said James Yu, China Country Manager for the International Center for Alcohol Policies (ICAP), the lead implementing organization for Global Actions on Harmful Drinking (www.global-actions.org).
 
China Ministry of Public Security statistics show that in 2009, alcohol-related road traffic crashes resulted in 2,665 fatalities in China, and 6,626 injuries. As part of a collaborative effort to deter and reduce drink driving, ICAP and the China Center for Health Education (CCHE) of the Ministry of Health signed a Memorandum of Understanding to collaborate on enhancing drink driving programs in target areas in China.  > > > >    Read More

Global Actions Colombia Marks Launch of UN “Decade of Action” for Road Safety

Global Actions Colombia is participating in landmark events this week to mark the national launch of the United Nations Decade of Action for Road Safety. Colombia is one of 18 countries where initiatives are underway as part of Global Actions on Harmful Drinking (www.global-actions.org), and one of six countries where these efforts focus on drink driving.
 
“Drink Driving is a significant contributing factor in road traffic crashes,” said Mario Lleras, Country Manager for the International Center for Alcohol Policies (ICAP), the lead implementing organization for Global Actions on Harmful Drinking (www.global-actions.org). “We are pleased to be working alongside our local partners in collaborative efforts to help reduce alcohol-related traffic deaths and injuries in Colombia.”
 
As the Decade of Actions is marked in regions around the world, Global Actions is working in partnership with the Road Prevention Fund (Fondo de Prevencion Vial) in Colombia and is supporting the PACTOS initiatives of the Ministry of Social Protection and the United Nations Office on Drugs and Crime (UNODC).   > > > >   Read More

Global Actions Mexico Marks Launch of UN “Decade of Action” for Road Safety

Global Actions Mexico is participating in landmark events this week to mark the national launch of the United Nations Decade of Action for Road Safety. Mexico is one of 18 countries where initiatives are underway as part of Global Actions on Harmful Drinking (www.global-actions.org), and one of six countries where these efforts focus on drink driving.
 
This week has been designated Road Safety Week (Semana de la Seguridad Vial, or SSV) in Mexico, and Global Actions representatives will take part in key road safety activities in the coming days. “At the federal and regional levels, we have been working in collaboration with other stakeholders to address drink driving in Mexico,” said Mariana Guerra Rendon, Country Manager for the International Center for Alcohol Policies (ICAP), the lead implementing organization for Global Actions on Harmful Drinking (www.global-actions.org). “We are pleased to be a part of this effort and to be taking actions that can lead to sustainable improvements in road safety.”   > > > >  Read More

Hazardous alcohol use interventions with emergency patients: Self-reported practices of nurses, and predictors of behaviour

The present study examined Australian ED nurses' practices in asking patients about alcohol and assisting them to manage their alcohol consumption. It also investigated strategies to support ED nurses in these interventions.

A two-stage survey was administered to ED nurses. The first questionnaire measured theoretical and organizational predictors of behaviour, and underlying beliefs, and the subsequent questionnaire explored rates of asking and assisting patients.

A total of 125 nurses returned the first questionnaire. Participants held generally positive attitudes, perceived norms, feelings of legitimacy and perceived ability to ask about and intervene for alcohol, but lower role adequacy. The 71 ED nurses who completed the second questionnaire had intervened with almost 500 patients concerning alcohol in the previous week. Participants asked approximately one in four patients about alcohol (median = 26.3% of patients, 1095/4279 total patients asked). 

The Theory of Planned Behaviour did not predict rates of asking or assisting patients. Several strategies were identified that might increase rates: identify environmental factors that prevent nurses acting on their intentions to ask and intervene, raise confidence and skills, make asking about alcohol part of routine assessment, make supports such as drug and alcohol units or nurses available, and implement organizational policies on alcohol.
 

Nurses appear positively disposed to engage with patients in regard to alcohol. However, greater support is needed to achieve the considerable significant public health benefits from this engagement. The findings point to several practical strategies that could be pursued to provide this support.



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Request Reprint E-Mail: toby.freeman@flinders.edu.au 

Big spike recorded in older drug, alcohol addicts

They go around this room at the Hanley Center telling of their struggles with alcohol and drugs. They tell of low points and lapses, brushes with death and pain caused to families. And silently, through the simple fact that each is in their 60s or beyond, they share one more secret: Addiction knows no age.

"I retired, I started drinking more," one man said. "I lost my father, my mother, my dog, and it gave me a good excuse," said another.

A remarkable shift in the number of older adults reporting substance abuse problems is making this scene more common. Between 1992 and 2008, treatment admissions for those 50 and older more than doubled in the U.S. That number will continue to grow, experts say, as the massive baby boom generation ages.   > > > >  Read More

Experts Say Alcohol Marketing Encourages Harmful Drinking

Efforts by alcoholic beverage makers to boost sales by appealing to younger drinkers contribute to drinking patterns that are harmful to health, said experts at a panel discussion on “Alcohol, Chronic Noncommunicable Diseases and Public Health,” held this week at the Pan American Health Organization (PAHO).

While alcoholic beverage makers say their ads are aimed only at consumers who are at or over the legal purchase age, research shows that viewing of alcohol ads by under-age youths has increased by nearly 70 percent over the past decade, said David Jernigan, associate professor at the Johns Hopkins Bloomberg School of Public Health. 

In addition, some of the fastest-selling categories of alcoholic beverages—such as “alcopops,” alcohol energy drinks, and whipped cream alcohol drinks—are purchased disproportionately by younger drinkers. Some of these drinks contain the equivalent of as much as five servings of alcohol in a single can. At the same time, younger drinkers are much more likely than older drinkers to consume large quantities of alcohol over short periods of time, a pattern that significantly increases the risk of injuries and ill health effects.

> > > >  Read More

Dose-dependent increase and decrease in active glucose uptake in jejunal epithelium of broilers after acute exposure to ethanol

Little is known about the effects of ethanol on gastrointestinal tract of chicken. In this study, we investigated the effects of low levels of ethanol on electrophysiological variables of jejunal epithelium of commercial broilers.

Jejunal tissues from 35- to 39-day-old broilers were exposed to either 0 or 0.1% ethanol in Ussing chambers, and electrophysiological variables were monitored for 40min. After 40 and 60min of incubation, glucose (20mM) and carbamoylcholine (200μM), respectively, were introduced into the chambers. The absolute and percent increase in short-circuit current (Isc) and potential difference (Vt) induced by glucose were increased significantly with 0.1% ethanol. 

There was no significant effect of 0.1% ethanol on carbamoylcholine-induced electrophysiological variables. To investigate if higher levels of ethanol have similar effects, we tested the effects of 0, 0.33, and 0.66% ethanol under similar experimental conditions until the glucose-addition step. 

Contrary to 0.1% ethanol, both the 0.33 and 0.66% ethanol levels significantly decreased the basal and glucose-induced Isc and Vt. Tissue conductivity remained unaffected in all cases. 

These results indicate that intestinal epithelia of chicken may be more sensitive to the effects of ethanol as compared with other species. 

This is the first report indicating dose-dependent increase and decrease in active glucose absorption in intestinal epithelia in the presence of ethanol.

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Request Reprint E-Mail:  josef.boehm@vetmeduni.ac.at

Changes in extracellular levels of glutamate in the nucleus accumbens after ethanol-induced behavioral sensitization in adolescent and adult mice

Repeated administration of low doses of ethanol gradually increases locomotor responses to ethanol in adult Swiss mice. This phenomenon is known as behavioral sensitization.

However, we have shown that adolescent Swiss mice show either behavioral tolerance or no sensitization after repeated ethanol injections. Although the mesolimbic dopamine system has been extensively implicated in behavioral sensitization, several studies have demonstrated an important role of glutamatergic transmission in this phenomenon. In addition, relatively few studies have examined the role of developmental factors in behavioral sensitization to ethanol. 

To examine the relationship between age differences in behavioral sensitization to ethanol and the neurochemical adaptations related to glutamate within nucleus accumbens (NAc), in vivo microdialysis was conducted in adolescent and adult Swiss mice treated with ethanol (1.8g/kg) or saline for 15 days and subsequently challenged with an acute dose (1.8g/kg) of ethanol 6 days later. 

Consistent with previous findings, only adult mice demonstrated evidence of behavioral sensitization. 

However, ethanol-treated adolescent mice demonstrated a 196.1±40.0% peak increase in extracellular levels of glutamate in the NAc after ethanol challenge in comparison with the basal values, whereas ethanol-treated adult mice demonstrated a 52.2±6.2% reduction in extracellular levels of glutamate in the NAc after ethanol challenge. 

These observations suggest an age-dependent inverse relationship between behavioral and glutamatergic responses to repeated ethanol exposure.

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Request Reprint E-Mail:    camarini@icb.usp.br  

Universal school-based prevention programs for alcohol misuse in young people

Alcohol misuse in young people is cause of concern for health services, policy makers, prevention workers, criminal justice system, youth workers, teachers, parents. 

This is one of three reviews examining the effectiveness of (1) school-based, (2) family-based, and (3) multi-component prevention programs.

To review evidence on the effectiveness of universal school-based prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age.

  Relevant evidence (up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO.

  Randomized trials evaluating universal school-based prevention programs and reporting outcomes for alcohol use in students 18 years of age or younger were included. 



Two reviewers screened titles/abstracts and full text of identified records.

  Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed.53 trials were included, most of which were cluster-randomised. The reporting quality of trials was poor, only 3.8% of them reporting adequate method of randomisation and program allocation concealment. Incomplete data was adequately addressed in 23% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively.

Six of the 11 trials evaluating alcohol-specific interventions showed some evidence of effectiveness compared to a standard curriculum. In 14 of the 39 trials evaluating generic interventions, the program interventions demonstrated significantly greater reductions in alcohol use either through a main or subgroup effect. Gender, baseline alcohol use, and ethnicity modified the effects of interventions. Results from the remaining 3 trials with interventions targeting cannabis, alcohol, and/or tobacco were inconsistent.

  This review identified studies that showed no effects of preventive interventions, as well as studies that demonstrated statistically significant effects. There was no easily discernible pattern in characteristics that would distinguish trials with positive results from those with no effects. 



Most commonly observed positive effects across programs were for drunkenness and binge drinking. 



Current evidence suggests that certain generic psychosocial and developmental prevention programs can be effective and could be considered as policy and practice options. These include the Life Skills Training Program, the Unplugged program, and the Good Behaviour Game. A stronger focus of future research on intervention program content and delivery context is warranted.









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Request Reprint E-Mail:    david.foxcroft@brookes.ac.uk.  

The Association Between the SLC6A3 VNTR 9-Repeat Allele and Alcoholism—A Meta-Analysis

Dopamine transporter gene (SLC6A3) represents a promising candidate involved in the development of alcoholism. 



This study aimed to explore the association between the 9-repeat allele (A9) of a 40-bp variable number tandem repeat (VNTR) polymorphism in the 3′ un-translated region (3′ UTR) of the SLC6A3 gene and alcoholism.

The SLC6A3 VNTR was genotyped by PCR in unrelated Mexican Americans including 337 controls and 365 alcoholics. Pearson’s chi-square test or Fisher’s exact test was used to compare the genotype and allele distribution.



Meta-analyses were performed for population-based case–control association studies of the SLC6A3 VNTR polymorphism with alcoholism. Data were analyzed under random effect models with the Comprehensive Meta-analysis (v.2) statistical software package.

In Mexican Americans, no significant difference was found in allele and genotype distribution between controls and alcoholics or between controls and alcoholics with alcohol withdrawal seizure (AWS) or delirium tremens (DT) (unadjusted p > 0.05). A total of 13 research articles were included in the meta-analyses.



No significant difference of the SLC6A3 VNTR A9 was noted between controls and alcoholics at the genotypic and allelic level when all ethnic populations, only Caucasian populations, or only Asian populations were considered (p > 0.05). 



Significant associations were observed between SLC6A3 VNTR A9 and alcoholics with AWS or DT at the genotypic as well as allelic level when all ethnic populations or only Caucasian populations were considered (p < 0.05, OR 1.5–2.1).

Meta-analyses suggest a possible association between the SLC6A3 VNTR A9 and alcoholic subgroup with AWS or DT.







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Request Reprint E-Mail: ywan@kumc.edu    

How should addiction-related research at the national institutes of health be reorganized?

The decades-old debate about the optimum organizational structure of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute on Drug Abuse (NIDA) has reached a crescendo with the recent deliberations of the Scientific Management Review Board, which, despite the lack of a crisis, proposed a structural reorganization that would dissolve the two institutes and create a new institute for substance use, abuse, and addiction, in hope of new scientific and public health advances (Collins, 2010). For a new institute to succeed, a multitude of potential challenges need to be negotiated effectively.

Notably, new funds will be needed, even in the current difficult national economic climate, to coalesce the infrastructure of NIAAA and NIDA and incorporate addiction-related research currently conducted by other National Institutes of Health (NIH) institutes. To succeed, the new institute would also require an enormous amount of cooperation from other institutes as the portfolios of research in the areas of alcohol, tobacco, and other drug abuse are transferred to it. Thus, in the near term, a structural reorganization would be less efficient and more costly than the individual institutes are currently. Only with careful strategic planning would it be possible to increase efficiency and reduce costs over time.  > > > >  Read More

Type 1 Equilibrative Nucleoside Transporter Regulates Ethanol Drinking Through Accumbal N-Methyl-D-Aspartate Receptor Signaling

Mice lacking type 1 equilibrative nucleoside transporter (ENT1−/−) exhibit increased ethanol-preferring behavior compared with wild-type littermates. This phenotype of ENT1−/− mice appears to be correlated with increased glutamate levels in the nucleus accumbens (NAc). However, little is known about the downstream consequences of increased glutamate signaling in the NAc.

To investigate the significance of the deletion of ENT1 and its effect on glutamate signaling in the NAc, we employed microdialysis and iTRAQ proteomics. We validated altered proteins using Western blot analysis. We then examined the pharmacological effects of the inhibition of the N-methyl-D-aspartate (NMDA) glutamate receptor and protein kinase Cγ (PKCγ) on alcohol drinking in wild-type mice. In addition, we investigated in vivo cyclic adenosine monophosphate response element binding activity using cyclic adenosine monophosphate response element-β-galactosidase mice in an ENT1−/− background.

We identified that NMDA glutamate receptor-mediated downregulation of intracellular PKCγ-neurogranin-calcium-calmodulin dependent protein kinase type II signaling is correlated with reduced cyclic adenosine monophosphate response element binding activity in ENT1−/− mice. Inhibition of PKCγ promotes ethanol drinking in wild-type mice to levels similar to those of ENT1−/− mice. In contrast, an NMDA glutamate receptor antagonist reduces ethanol drinking of ENT1−/− mice.

These findings demonstrate that the genetic deletion or pharmacological inhibition of ENT1 regulates NMDA glutamate receptor-mediated signaling in the NAc, which provides a molecular basis that underlies the ethanol-preferring behavior of ENT1−/− mice.

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Request Reprint E-Mail:   choids@mayo.edu 

The Association Between the SLC6A3 VNTR 9-Repeat Allele and Alcoholism—A Meta-Analysis

Dopamine transporter gene (SLC6A3) represents a promising candidate involved in the development of alcoholism. 



This study aimed to explore the association between the 9-repeat allele (A9) of a 40-bp variable number tandem repeat (VNTR) polymorphism in the 3′ un-translated region (3′ UTR) of the SLC6A3 gene and alcoholism.

The SLC6A3 VNTR was genotyped by PCR in unrelated Mexican Americans including 337 controls and 365 alcoholics. Pearson’s chi-square test or Fisher’s exact test was used to compare the genotype and allele distribution.



Meta-analyses were performed for population-based case–control association studies of the SLC6A3 VNTR polymorphism with alcoholism. Data were analyzed under random effect models with the Comprehensive Meta-analysis (v.2) statistical software package.

In Mexican Americans, no significant difference was found in allele and genotype distribution between controls and alcoholics or between controls and alcoholics with alcohol withdrawal seizure (AWS) or delirium tremens (DT) (unadjusted p > 0.05). A total of 13 research articles were included in the meta-analyses.



No significant difference of the SLC6A3 VNTR A9 was noted between controls and alcoholics at the genotypic and allelic level when all ethnic populations, only Caucasian populations, or only Asian populations were considered (p > 0.05). 



Significant associations were observed between SLC6A3 VNTR A9 and alcoholics with AWS or DT at the genotypic as well as allelic level when all ethnic populations or only Caucasian populations were considered (p < 0.05, OR 1.5–2.1).

Meta-analyses suggest a possible association between the SLC6A3 VNTR A9 and alcoholic subgroup with AWS or DT.







Read Full Abstract 



Request Reprint E-Mail: ywan@kumc.edu    

Incorporating Genetics into Your Studies: A Guide for Social Scientists

There has been a surge of interest in recent years in incorporating genetic components into on-going longitudinal, developmental studies and related psychological studies. 

While this represents an exciting new direction in developmental science, much of the research on genetic topics in developmental science does not reflect the most current practice in genetics. 

This is likely due, in part, to the rapidly changing landscape of the field of genetics, and the difficulty this presents for developmental scientists who are trying to learn this new area. 

In this review, we present an overview of the paradigm shifts that have occurred in genetics and we introduce the reader to basic genetic methodologies. 

We present our view of the current stage of research ongoing at the intersection of genetics and social science, and we provide recommendations for how we could do better. 

We also address a number of issues that social scientists face as they integrate genetics into their projects, including choice of a study design (candidate gene versus genome-wide association versus sequencing), different methods of DNA collection, and special considerations involved in the analysis of genotypic data. 

Through this review, we hope to equip social scientists with a deeper understanding of the many considerations that go into genetics research, in an effort to foster more meaningful cross-disciplinary initiatives.

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Beyond the ubiquitous relapse curve: a data-informed approach

Relapse to alcohol and other substances has generally been described by curves that resemble one another. 

However, these curves have been generated from the time to first use after a period of abstinence without regard to the movement of individuals into and out of drug use. 

Instead of measuring continuous abstinence, we considered post-treatment functioning as a more complicated phenomenon, describing how people move in and out of drinking states on a monthly basis over the course of a year. 

When we looked at time to first drink we observed the ubiquitous relapse curve. When we classified clients (N = 550) according to drinking state however, they frequently moved from one state to another with both abstinent and very heavy drinking states as being rather stable, and light or moderate drinking and heavy drinking being unstable. 

We found that clients with a family history of alcoholism were less likely to experience these unstable states.

When we examined the distribution of cases crossed by the number of times clients switched states we found that a power function explained 83% of that relationship. 

Some of the remainder of the variance seems to be explained by the stable states of very heavy drinking and abstinence acting as attractors.

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The High Cost of Cheap Alcohol

Each year alcohol claims 79,000 lives. It is the third leading lifestyle-related cause of death. In 2005, 1.6 million hospitalizations and 4 million emergency room visits occurred due to alcohol. To put these figures in perspective, almost 6,000 military personnel have lost their lives in the Iraq and Afghanistan wars and an estimated 3,000 people die each year due to food borne illness. 

Alcohol is related to crime, disease and other social problems. It threatens to rob the potential of our youth who continue to drink at high levels. Problems with alcohol touch many Americans. When asked in a Gallup poll, “Has drinking ever been a cause of trouble in your family?” 31% said “Yes.” 

Clearly the cost of alcohol misuse is very high. This suggests we need to do whatever we can to minimize the devastating impact the figures imply. A substantial body of research points to the effectiveness of restricting “affordability, availability and accessibility.” 

But regulations that embody these principles are being eroded as alcohol price policies are changed, alcohol outlets are allowed to sell more types of products, hours and days of sale are increased, and the total number of alcohol outlets is increased beyond the need for population growth. Eroding these policies is often sold to the public on the basis of increasing tax revenue and improving customer convenience. However, the only way this would work is if a lot more people buy and drink a lot more alcohol. While surveys usually find public support for alcohol policies to be high, the public doesn’t always understand the impact of changes to single regulations. 

This report is designed to educate the public about the alcohol regulatory system and how it works. It focuses on one of the most powerful tools available to control alcohol problems: price. Time and again, research has shown that when prices go up, alcohol consumption and its attendant social problems go down. To be effective, pricing policies must impact the entire marketplace and be related to availability. The reason is that cheap alcohol is primarily a problem when large quantities of inexpensive products flood the marketplace; a few cheap bottles in a remote location do not lead to overall social harm. Our regulatory systems were originally designed with great care by people who knew the dangers of an unregulated marketplace.  > > > >  Read More

Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: results from the Youth Smoking Survey

Despite the high prevalence of smoking among Aboriginal youth, there is a paucity of research related to tobacco use and other risk behaviours among Aboriginal youth living off-reserve in Canada. We used data from the national Youth Smoking Survey to characterize non-traditional tobacco use, exposure to second-hand smoke, and alcohol and drug use among Aboriginal youth living off-reserve. We examined whether these youth were at increased health risk compared with non-Aboriginal youth.

We examined cigarette smoking behaviour, use of other tobacco products, use of alcohol and other drugs, and exposure to second-hand smoke among 2620 Aboriginal youth living off-reserve and 26 223 non-Aboriginal youth in grades 9 to 12 who participated in the 2008/09 Youth Smoking Survey.

The prevalence of current smoking among the Aboriginal youth was more than double that among non-Aboriginal youth (24.9% v. 10.4%). Aboriginal youth also had a higher prevalence of regular exposure to second-hand smoke at home (37.3% v. 19.7%) and in cars (51.0% v. 30.3%). Aboriginal youth were more likely than non-Aboriginal youth to be current smokers, to be regularly exposed to second-hand smoke, to have tried marijuana and other illicit drugs, and to engage in binge drinking. They were less likely than non-Aboriginal youth to have tried to quit smoking.

Current national estimates of smoking, and alcohol and illicit drug use among youth underestimate the prevalence of these behaviours among Aboriginal youth living offreserve. Our findings highlight the need for culturally appropriate prevention and cessation policies and programs for this at-risk population.







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The Association Between the SLC6A3 VNTR 9-Repeat Allele and Alcoholism—A Meta-Analysis

Dopamine transporter gene (SLC6A3) represents a promising candidate involved in the development of alcoholism. 



This study aimed to explore the association between the 9-repeat allele (A9) of a 40-bp variable number tandem repeat (VNTR) polymorphism in the 3′ un-translated region (3′ UTR) of the SLC6A3 gene and alcoholism.

The SLC6A3 VNTR was genotyped by PCR in unrelated Mexican Americans including 337 controls and 365 alcoholics. Pearson’s chi-square test or Fisher’s exact test was used to compare the genotype and allele distribution.



Meta-analyses were performed for population-based case–control association studies of the SLC6A3 VNTR polymorphism with alcoholism. Data were analyzed under random effect models with the Comprehensive Meta-analysis (v.2) statistical software package.

In Mexican Americans, no significant difference was found in allele and genotype distribution between controls and alcoholics or between controls and alcoholics with alcohol withdrawal seizure (AWS) or delirium tremens (DT) (unadjusted p > 0.05). A total of 13 research articles were included in the meta-analyses.



No significant difference of the SLC6A3 VNTR A9 was noted between controls and alcoholics at the genotypic and allelic level when all ethnic populations, only Caucasian populations, or only Asian populations were considered (p > 0.05). 



Significant associations were observed between SLC6A3 VNTR A9 and alcoholics with AWS or DT at the genotypic as well as allelic level when all ethnic populations or only Caucasian populations were considered (p < 0.05, OR 1.5–2.1).

Meta-analyses suggest a possible association between the SLC6A3 VNTR A9 and alcoholic subgroup with AWS or DT.







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Heavy Drinking Is Associated with Poor Blood Pressure Control in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Alcohol intake has been shown to have a J-shaped association with blood pressure (BP). However, this association has not been examined in mixed race populations or in people with diabetes where tighter blood pressure control is recommended.

Participants in the REGARDS study who were 45 years or older (n = 30,239) were included. Medical history (including self-reported alcohol intake) was collected by telephone while blood collection and clinical measurements were done during an in-home visit. We defined diabetes as use of medications and/or fasting glucose ≥ 126 mg/dL and hypertension as use of blood pressure lowering medications and/or BP ≥ 140/90 mmHg or BP ≥ 130/80 mmHg in people with diabetes. 

After adjustment for confounders, heavy drinking was associated with an increased odds of hypertension (OR = 1.59; 95% CI = 1.37, 1.87). Diabetes and gender significantly modified (interaction P < 0.05 for both) the association between alcohol use and hypertension, although heavy drinking remained associated with increased odds of hypertension in sub-group analyses. We did not observe the previously described J-shaped relationship in any sub-group except white females. 

These data suggest heavy alcohol consumption is associated with poor BP control and that heavy drinkers may want to consider limiting alcohol intake in order to manage hypertension.


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Protein Traffic Is an Intracellular Target in Alcohol Toxicity

Eukaryotic cells comprise a set of organelles, surrounded by membranes with a unique composition, which is maintained by a complex synthesis and transport system. Cells also synthesize the proteins destined for secretion. Together, these processes are known as the secretory pathway or exocytosis. In addition, many molecules can be internalized by cells through a process called endocytosis. 

Chronic and acute alcohol (ethanol) exposure alters the secretion of different essential products, such as hormones, neurotransmitters and others in a variety of cells, including central nervous system cells.
 

This effect could be due to a range of mechanisms, including alcohol-induced alterations in the different steps involved in intracellular transport, such as glycosylation and vesicular transport along cytoskeleton elements. 

Moreover, alcohol consumption during pregnancy disrupts developmental processes in the central nervous system. 

No single mechanism has proved sufficient to account for these effects, and multiple factors are likely involved. One such mechanism indicates that ethanol also perturbs protein trafficking. 

The purpose of this review is to summarize our understanding of how ethanol exposure alters the trafficking of proteins in different cell systems, especially in central nervous system cells (neurons and astrocytes) in adult and developing brains.

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Modeling Relations among Discrete Developmental Processes: A General Approach to Associative Latent Transition Analysis

To understand one developmental process, it is often helpful to investigate its relations with other developmental processes. 

Statistical methods that model development in multiple processes simultaneously over time include latent growth curve models with time-varying covariates, multivariate latent growth curve models, and dual trajectory models. These models are designed for growth represented by continuous, unidimensional trajectories. 

The purpose of this article is to present a flexible approach to modeling relations in development among two or more discrete, multidimensional latent variables based on the general framework of loglinear modeling with latent variables called associative latent transition analysis (ALTA). 

Focus is given to the substantive interpretation of different associative latent transition models, and exactly what hypotheses are expressed in each model. 

An empirical demonstration of ALTA is presented to examine the association between the development of alcohol use and sexual risk behavior during adolescence.

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Request Reprint E-Mail:    bcbray@vt.edu