Social capital as norms and resources: Focus groups discussing alcohol

The aim of this article is to analyse the relationship between peer-group social capital and the use of alcohol among young people – as this relationship is expressed in focus group interviews.

The main point to be made is that social capital affects alcohol use in two different ways: it incites some forms of drinking (‘controlled drunkenness’) while restricting others (drinking alone, drinking ‘for the wrong reason’, losing control often).

Furthermore, the idea behind this article is that social capital is both a background factor influencing participants’ relationship to alcohol and an effect of their drinking experience.

We apply Coleman's micro-oriented perspective on local network mechanisms – with a specific focus on collective norms negotiated in the focus groups – in combination with Bourdieu's definition of social capital as resources.

The data used in this article come from focus group interviews with 18–19-year-old Danes.



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Changes in self-reported drinking behaviors among US teenagers associated with the introduction of flavored malt beverages: An interrupted time series

This study sought to examine high school students’ self-reported drinking behaviors following the introduction of flavored malt beverages, also known as alcopops, to the US market.

We hypothesized that adolescents’ reported drinking behaviors would be significantly altered following the introduction of alcopops in the US.

A cross-sectional time series Youth Risk Behavior Survey data set was created from publicly available data collected by the Centers for Disease Control and Prevention (N = 60,426) and used to conduct secondary data analysis, using an interrupted time series quasi-experimental design.

Segmented regression analyses estimated how much the introduction of alcopops in the US affected drinking behaviors, whether the effects were immediate and/or delayed, and whether there may have been other factors than the intervention that could explain the effects.

Respondents aged ≥18 years had statistically significant increases in three drinking behaviors after alcopops were introduced.

Binge drinking increased significantly in the entire study population between 1997 and 2001, remaining steady in 2001–2003.

Drinking on school property increased in some groups between 2001 and 2003.


The statistically significant increases identified for some drinking behaviors and, for most behaviors, in certain population subgroups can be used to develop prevention strategies that are targeted accordingly.


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Telescoping and Gender Differences in Alcohol Dependence: New Evidence From Two National Surveys

The course of alcohol disorders in women is often described as "telescoped" compared to that in men, with a later age at initiation of alcohol use but shorter times from use to dependence and treatment. This study examined evidence for such a telescoping effect in the general population and tested birth cohort effects for gender differences.

Data from two U.S. national surveys conducted 10 years apart (1991–1992 and 2001–2002) using the same diagnostic instrument (the Alcohol Use Disorder and Associated Disabilities Interview Schedule–IV) were used to analyze five birth cohorts. Age at initiation of alcohol use, time from first use to dependence, and time from dependence to first treatment were analyzed. Interaction terms (cohort by gender; cohort by gender by time) were tested in Cox proportional hazards models.

Little evidence was found for a telescoping effect in women. For alcohol use and dependence, cohort and gender interacted, which suggests that gender differences are diminished in more recent cohorts. A three-way interaction of cohort, gender, and time was significant for time from first use to dependence, suggesting that men have a shorter time to dependence, especially in younger cohorts.

A telescoping effect is not evident in the general population. Gender differences in the overall hazard of alcohol use and dependence are decreasing in more recent cohorts, while gender differences in time from first use to dependence are increasing.

These findings challenge the commonly held notion of a gender-specific course of alcohol disorders and suggest the need for a greater clinical focus on problem drinking in women and further research on accelerated time to dependence in men.

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Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors

To estimate the percentage reduction in incidence of dementia that would be obtained if specific risk factors were eliminated.

Prospective seven year cohort study.

General population, Montpellier, France.

1433 people aged over 65 with a mean baseline age of 72.5 (SD 5.1) years.

Diagnosis of mild cognitive impairment or dementia established by a standardised neurological examination.

Cox models were constructed to derive hazard ratios and determine confounding and interaction effects for potentially modifiable risk factors for dementia. Mean percentage population attributable fractions were calculated with 95% confidence intervals derived from bootstrapping for seven year incidence of mild cognitive impairment or dementia. The final model retained crystallised intelligence (population attributable fraction 18.11%, 95% confidence interval 10.91% to 25.42%), depression (10.31%, 3.66% to 17.17%), fruit and vegetable consumption (6.46%, 0.15% to 13.06%), diabetes (4.88%, 1.87% to 7.98%), and apolipoprotein E 4 allele (7.11%, 2.44% to 11.98%).

Increasing crystallised intelligence and fruit and vegetable consumption and eliminating depression and diabetes are likely to have the biggest impact on reducing the incidence of dementia, outweighing even the effect of removing the principal known genetic risk factor. Although causal relations cannot be concluded with certainty, the study suggests priorities that may inform public health programmes.

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Differential Patterns of Alcohol Consumption and Dopamine-2 Receptor Binding in Wistar-Kyoto and Wistar Rats

The Wistar-Kyoto (WKY) rat strain has been described as an animal model of depressive behavior that consumes significantly greater amounts of alcohol compared to the Wistar (WIS) rat strain.

Since the mesolimbic dopamine (DA) type-2 (D2) receptors mediate reward-related behaviors, the present study measured the binding of [¹²⁵I]-Iodosulpiride to D2 receptors in the brains of WKY versus WIS rats following 24 days of voluntary alcohol or water consumption.

Alcohol consuming WKY rats showed a significant increase in D2 receptor binding in several regions of the mesolimbic and nigrostriatal systems.

In contrast, alcohol consuming WIS rats showed a reduction in D2 receptor binding in DA cell body areas.

The differential regulation of D2 receptors by voluntary alcohol consumption in the two rat strains suggests that D2 receptor mediated neurotransmission may be playing a role in the increased alcohol drinking behavior reported in WKY rats.


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The effect of alcohol and tobacco consumption, and apolipoprotein E genotype, on the age of onset in Alzheimer's disease

This study examined the association between a history of heavy alcohol use and smoking, presence of the apolipoprotein-E epsilon 4 allele (APOE 4), and age of disease onset in a community dwelling sample of 685 Alzheimer's disease (AD) patients spanning three ethnic groups.

Cross-sectional study of AD patients evaluated at a University-affiliated outpatient memory disorders clinic.

A clinic-based cohort of white non-Hispanic (WNH; n = 397), white Hispanic (WH; n = 264), and African-American (AA; n = 24) patients diagnosed with possible or probable AD according to NINCDS-ADRDA diagnostic criteria.

The age of onset of AD was obtained from a knowledgeable family member. All patients were assessed for APOE genotype. History of alcohol and tobacco consumption prior to the onset of dementia was obtained via an interview with the patient and the primary caregiver. A history of heavy drinking was defined as >2 drinks per day and a history of heavy smoking was defined as 1 pack per day.

Presence of an APOE 4 allele, a history of heavy drinking, or a history of heavy smoking were each associated with an earlier onset of AD by 2-3 years. Patients with all three risk factors were likely to be diagnosed with AD nearly 10 years earlier than those with none of the risk factors.

The results suggest that APOE 4 and heavy drinking and heavy smoking lower the age of onset for AD in an additive fashion. Read Full Abstract Request Reprint E-Mail: billy@msmc.com

Epidemiologic Trends of Adolescent Use of Alcohol, Tobacco, and Other Drugs

This article provides an overview of drug and alcohol use and risk factors among American adolescents.

Current trends indicate that tobacco, alcohol, and marijuana are the most frequently used substances among this age group.

Further, the greatest risk factors for using these substances are being male, being White, being an older adolescent, engaging in sexual risk behaviors, having a family history of substance abuse, associating with peers who abuse substances, and lacking a sense of school commitment and connectedness.

These findings underscore the need to involve communities, families, schools, and peer groups to effectively prevent and treat this problem.

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Request Reprint E-Mail: wlatimer@jhsph.edu

Alcohol policy enforcement and changes in student drinking rates in a statewide public college system: a follow-up study

Heavy alcohol use among U.S. college students is a major contributor to young adult morbidity and mortality.

The aim of this study was to examine whether college alcohol policy enforcement levels predict changes in student drinking and related behaviors in a state system of public colleges and universities, following a system-wide change to a stricter policy.

Students and administrators at 11 Massachusetts public colleges/universities completed surveys in 1999 (N of students = 1252), one year after the policy change, and again in 2001 (N = 1074). We calculated policy enforcement scores for each school based on the reports of deans of students, campus security chiefs, and students, and examined the correlations between perceived enforcement levels and the change in student drinking rates over the subsequent two year period, after weighting the 2001 data to adjust for

Overall rates of any past-30-days drinking, heavy episodic drinking, and usual heavy drinking among past-30-days drinkers were all lower in 2001 compared to 1999. School-level analyses (N=11) found deans' baseline reports of stricter enforcement were strongly correlated with subsequent declines in heavy episodic drinking (Pearson's r = -0.73, p=0.011). Moreover, consistently high enforcement levels across time, as reported by deans, were associated with greater declines in heavy episodic drinking. Such relationships were not found for students' and security chiefs' reports of enforcement. Marijuana use did not rise during this period of decline in heavy drinking.

Study findings suggest that stronger enforcement of a stricter alcohol policy may be associated with reductions in student heavy drinking rates over time. An aggressive enforcement stance by deans may be an important element of an effective college alcohol policy.

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Simultaneous injuries to both eyes in traffic accidents

In traffic accidents, eye injuries occur as isolated or with polytrauma. They may involve just one eye, but simultaneous injuries to both eyes do happen occasionally.

The aim of our paper was to reveal the risk factors, in an effort to reduce the number of such accidents and to prevent bilateral ocular damage.

All patients hospitalized at the Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, due to traffic accidents with bilateral eye injuries in a period of 9 years from the beginning of 2000 to the end of 2008 were analyzed.

In this 9-year period, a total of 36 patients were hospitalized and treated for bilateral ocular injury (72 eyes). There were 23 males among them, the male-female ratio being 1.8:1. Mean age was 33.9 years. The occupations of injured persons were the following: the most common were workers—15, followed by clerks—seven, while less common were pupils, students, pensioners and housewives—three of each of them, and farmers—two. Front-seat passengers were the most common among the injured—20 (55.6%), then drivers—15 (41.7%), with only one passenger from the back seat on the right side (2.7%). As many as 33 (91.7%) of them failed to fasten their seat belts, while 18 (50.0%) were drunk. Penetrating bulbar injuries or eyeball ruptures were predominant—66.7%, while blunt injuries were found in only two (2.8%) eyes in one single person; but in 22 cases (30.5%) there was adnexal damage, too. Visual acuity at discharge and subsequent controls was as follows: amaurosis in 21 (29.2%), less than 0.3 in nine (5.6%), 0.4 and better in 42 (58.1%), and normal visual acuity of 1.0 in 28 patients (38.3%).

The major risk factors for getting bilateral eye injuries in traffic accidents proved to be: sitting in the front car seats, not fastening the seat belt and alcohol intoxication. Prevention of these risk factors would result in a decrease in such a large number of bilateral eye injuries.


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milosjov@scnet.rs

Are adolescents with high socioeconomic status more likely to engage in alcohol and illicit drug use in early adulthood?

Previous literature has shown a divergence by age in the relationship between socioeconomic status (SES) and substance use: adolescents with low SES are more likely to engage in substance use, as are adults with high SES. However, there is growing evidence that adolescents with high SES are also at high risk for substance abuse.

The objective of this study is to examine this relationship longitudinally, that is, whether wealthier adolescents are more likely than those with lower SES to engage in substance use in early adulthood.

The study analyzed data from the National Longitudinal Survey of Adolescent Health (AddHealth), a longitudinal, nationally-representative survey of secondary school students in the United States. Logistic regression models were analyzed examining the relationship between adolescent SES (measured by parental education and income) and substance use in adulthood, controlling for substance use in adolescence and other covariates.

Higher parental education is associated with higher rates of binge drinking, marijuana and cocaine use in early adulthood. Higher parental income is associated with higher rates of binge drinking and marijuana use. No statistically significant results are found for crystal methamphetamine or other drug use. Results are not sensitive to the inclusion of college attendance by young adulthood as a sensitivity analysis. However, when stratifying by race, results are consistent for white non-Hispanics, but no statistically significant results are found for non-whites. This may be a reflection of the smaller sample size of non-whites, but may also reflect that these trends are driven primarily by white non-Hispanics.

Previous research shows numerous problems associated with substance use in young adults, including problems in school, decreased employment, increases in convictions of driving under the influence (DUI) and accidental deaths. Much of the previous literature is focused on lower SES populations. Therefore, it is possible that teachers, parents and school administrators in wealthier schools may not perceive as great to address substance abuse treatment in their schools. This study can inform teachers, parents, school administrators and program officials of the need for addressing drug abuse prevention activities to this population of students.

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Have We Bottled It? Alcohol Marketing and Young People Conference

Alcohol is one of the most heavily marketed products on our shelves with a total market value of €6 billion in Ireland this year. Alcohol marketing targets young people and influences their drinking.

Alcohol Action Ireland’s conference sets out to explore the question - have we abdicated responsibility when it comes to controlling alcohol marketing? The conference looks at what alcohol marketing actually is, how it works and what can be done to reduce its impact, particularly on young people.

Have We Bottled It? Alcohol Marketing and Young People Conference
Date: Wednesday, September 15, 2010
Venue: Royal College of Physicians of Ireland, No 6 Kildare St, Dublin 2
Time: 9.30- 4pm
Costs: Bookings received before 17 August can avail of our special price of €50 per person. Bookings placed after 17 August will be €70 per person.

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A Polymorphism in GABRA2 Is Associated With the Medial Frontal Response to Alcohol Cues in an fMRI Study

Significant evidence has accumulated to suggest an association between single-nucleotide polymorphisms (SNPs) in the GABRA2 gene and alcoholism. However, research has yet to show an association between these polymorphisms and the human brain's reward system function.

In this study, we stratified subjects who had participated in an fMRI study of alcohol cue responses according to their genotype at a SNP in GABRA2Edenberg et al., 2004).

Genotyping showed 13 subjects to be homozygous for the high-risk allele (AA), and 23 subjects to be heterozygous (AG). In fMRI, subjects were exposed to the aromas of their preferred alcoholic drink odors (AO), as well as to appetitive control odors (ApCO) under both alcohol intoxication and placebo control conditions.

Homozygous AA subjects had a larger [AO > ApCO] response than did AG subjects in medial frontal cortical areas thought to code reward value. However, AG subjects had a larger [AO > ApCO] effect in the ventral tegmental area. Alcohol intoxication did not alter these group differences.

These are the first data to suggest that GABRA2 genotype could affect the brain's responses to cues associated with alcohol.

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Request Reprint E-Mail: dkareken@iupui.edu

Trends in Alcohol Use among Hawai‘i Adolescents

It is important to review trends in youth alcohol use over time in order to effectively tailor prevention programs to address those trends.

This article reviews data on alcohol use behaviors from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey in Hawai‘i from 1993 to 2007.

Five alcohol use indicators were examined and stratified by grade level, from 9th grade through 12th grade.

Significant drops in nearly all indicators are seen among 9th through 11th graders, but not among 12th graders.

This suggests that Hawai‘i youth are responding well to anti-alcohol messaging as young teens, but a different approach may be needed to target older teens.

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Sex Differences in Striatal Dopamine Release in Young Adults After Oral Alcohol Challenge: A Positron Emission Tomography Imaging Study With [11C]Racl

We used a positron emission tomography paradigm with the D2/3 radiotracer [¹¹C]raclopride and an alcohol challenge to examine the magnitude of alcohol-induced dopamine release and compare it between young men and women.

Twenty-one nonalcohol-dependent young social drinkers completed two positron emission tomography scans on separate days following ingestion of a juice mix containing either ethanol (.75 mg/kg body water) or trace ethanol only. The extent of dopamine released after alcohol was estimated by the percentage difference in [¹¹C]raclopride binding potential (ΔBP_ND) between days.

Alcohol administration significantly displaced [¹¹C]raclopride in all striatal subregions, indicating dopamine release, with the largest effect observed in the ventral striatum. Linear mixed model analysis across all striatal subregions of regional ΔBP_ND with region of interest as repeated measure showed a highly significant effect of sex (p < .001). Ventrostriatal dopamine release in men, but not in women, showed a significant positive correlation to alcohol-induced measures of subjective activation. Furthermore, we found a significant negative correlation between the frequency of maximum alcohol consumption per 24 hours and ventrostriatal ΔBP_ND (r = .739, p = .009) in men.

This study provides definitive evidence that oral alcohol induces dopamine release in nonalcoholic human subjects and shows sex differences in the magnitude of this effect. The ability of alcohol to stimulate dopamine release may contribute to its rewarding effects and, thereby, to its abuse liability in humans. Our report further suggests several biological mechanisms that may mediate the difference in vulnerability for alcoholism between men and women.

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Request Reprint E-Mail: nu2118@columbia.edu

Economic and Social Returns on Investment in Open Archiving Publicly Funded Research Outputs

Preliminary modeling suggests that over a transitional period of 30 years from implementation, the potential incremental benefits of the proposed FRPAA archiving mandate might be worth around 8 times the costs. Perhaps two-thirds of these benefits would accrue within the US, with the remainder spilling over to other countries. Hence, the US national benefits arising from the proposed FRPAA archiving mandate might be of the order of 5 times the costs.

Exploring sensitivities in the model we find that the benefits exceed the costs over a wide range of values. Indeed, it is difficult to imagine any plausible values for the input data and model parameters that would lead to a fundamentally different answer.These preliminary estimates are based on the information available to us at the time of writing. They are released in conjunction with an online model, which enables others to explore their own preferred values for the various parameters.

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Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians

The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes.

The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians.

Data were from N=2609 Indigenous Australians who participated in a health screening program in rural far north Queensland in 1999-2000 (44.5% response rate). The individual and interactive effects of metabolic risk and alcohol drinking on elevated serum GGT concentrations ([greater than or equal to] 50 U/L) were analyzed using logistic regression.

Overall, 26% of the population had GGT[greater than or equal to] 50 U/L. Elevated GGT was associated with alcohol drinking (moderate drinking: OR 2.3 [95%CI 1.6 - 3.2]; risky drinking: OR 6.0 [4.4 - 8.2]), and with abdominal obesity (OR 3.7 [2.5 - 5.6]), adverse metabolic risk cluster profile (OR 3.4 [2.6 - 4.3]) and metabolic syndrome (OR 2.7 [2.1 - 3.5]) after adjustment for age, sex, ethnicity, smoking, physical activity and BMI. The associations of obesity and metabolic syndrome with elevated GGT were similar across alcohol drinking strata, but the association of an adverse metabolic risk cluster profile with elevated GGT was larger in risky drinkers (OR 4.9 [3.7 - 6.7]) than in moderate drinkers (OR 2.8 [1.6 - 4.9]) and abstainers (OR 1.6 [0.9 - 2.8]).

In this Indigenous population, an adverse metabolic profile conferred three times the risk of elevated GGT in risky drinkers compared with abstainers, independent of sex and ethnicity. Community interventions need to target both determinants of the population's metabolic status and alcohol consumption to reduce the risk of elevated GGT.

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Alcohol research latest reviews, news and updates: July 2010

Mainly from the drug and alcohol Findings database:

Brief alcohol advice works with psychiatric patients: Will brief alcohol advice work with depressed and/or distressed psychiatric patients at risk from their drinking? From Sweden, an affirmative answer from the first study among psychiatric outpatients to test brief alcohol advice against screening alone. Use of a telephone-based intervention was another innovation.

Probation resources too stretched to adequately tackle huge drink problem: Probation services in England and Wales are creatively grappling with a huge and criminogenic offender drink problem, but their efforts are undermined by lack of evidence about what works and by under-resourcing linked to a dispute over whether health or probation should bear the core funding burden.

Matching alcohol treatments to the patient It was the great hope for alcohol treatment: even if overall one type of therapy was as good as another, surely this was just because certain therapies worked best with certain patients. Getting the match right was seen as a key way to advance effectiveness. Despite major setbacks, it remains a fascinating and fertile research topic. See what you make of it by running the hot topic search.

Alcohol licensing, price and taxation: Market levers not available to curb the illicit drugs market promise to make the greatest difference to alcohol-related harm across the population. The prize - an improvement in public health among the largest achievable by any feasible means - is great, but so too are the obstacles. Run the hot topic search to see what we may be missing if we fail to grasp these opportunities. (Current price and taxation review details here

Fuelling the problem? The sale of alcohol at petrol stations in Wales: An Alcohol Concern survey of petrol stations in eight counties in Wales in May 2010 found that 33 per sold alcohol, a figure that corresponds to previous research undertaken in England and Wales. The survey also highlighted that training for staff on selling alcohol was not consistent. Follow the above link for Alcohol Concern's 5 policy recommendations.

Uganda still leads in alcohol consumption

Uganda has maintained the lead in consumption of harmful alcohol in Africa, experts have revealed. Dr Nazarius Mbona, a senior lecturer at Makerere University Department of Epidemiology and Biostatistics, said Uganda’s per capita consumption of alcohol is 19 litres per year compared to an average four litres in other African countries.

“Although alcohol consumption rate is lowering here now, we are still ranked the highest,” Dr Mbona said. > > >

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Reviewers' Bias Against the Null Hypothesis: the Reproductive Hazard of Binge Drinking

We examined whether scientific reviewers exhibit bias in scoring a simulated “positive” study (i.e. showing adverse fetal effects) as compared to a simulated “negative” study on the fetal effects of binge drinking.

The reviewers of the “negative” study tended to reject it more commonly, to give it lower scores, and there was significantly more variability from the median in their scores.

Scientific journals should make an effort to eliminate this source of bias against negative results.


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Breast Cancer DNA Methylation Profiles Are Associated with Tumor Size and Alcohol and Folate Intake

Although tumor size and lymph node involvement are the current cornerstones of breast cancer prognosis, they have not been extensively explored in relation to tumor methylation attributes in conjunction with other tumor and patient dietary and hormonal characteristics.

Using primary breast tumors from 162 (AJCC stage I–IV) women from the Kaiser Division of Research Pathways Study and the Illumina GoldenGate methylation bead-array platform, we measured 1,413 autosomal CpG loci associated with 773 cancer-related genes and validated select CpG loci with Sequenom EpiTYPER.

Tumor grade, size, estrogen and progesterone receptor status, and triple negative status were significantly associated with altered methylation of 209, 74, 183, 69, and 130 loci, respectively.

Unsupervised clustering, using a recursively partitioned mixture model (RPMM), of all autosomal CpG loci revealed eight distinct methylation classes.

Methylation class membership was significantly associated with patient race.

Using multinomial logistic regression to adjust for potential confounders, patient age and tumor size, as well as known disease risk factors of alcohol intake and total dietary folate, were all significantly associated with methylation class membership.

Breast cancer prognostic characteristics and risk-related exposures appear to be associated with gene-specific tumor methylation, as well as overall methylation patterns.

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