The effectiveness of an intervention in increasing community health clinician provision of preventive care: A study protocol of a non-randomised, mult

The primary behavioural risks for the most common causes of mortality and morbidity in developed countries are tobacco smoking, poor nutrition, risky alcohol use, and physical inactivity. Evidence, guidelines and policies support routine clinician delivery of care to prevent these risks within primary care settings. Despite the potential afforded by community health services for the delivery of such preventive care, the limited evidence available suggests it is provided at suboptimal levels. This study aims to assess the effectiveness of a multi-strategic practice change intervention in increasing clinician's routine provision of preventive care across a network of community health services.

A multiple baseline study will be conducted involving all 56 community health facilities in a single health district in New South Wales, Australia. The facilities will be allocated to one of three administratively-defined groups. A 12 month practice change intervention will be implemented in all facilities in each group to facilitate clinician risk assessment of eligible clients, and clinician provision of brief advice and referral to those identified as being 'at risk'. The intervention will be implemented in a non-random sequence across the three facility groups. Repeated, cross-sectional measurement of clinician provision of preventive care for four individual risks (smoking, poor nutrition, risky alcohol use, and physical inactivity) will occur continuously for all three facility groups for 54 months via telephone interviews. The interviews will be conducted with randomly selected clients who have visited a community health facility in the last two weeks. Data collection will commence 12 months prior to the implementation of the intervention in the first group, and continue for six months following the completion of the intervention in the last group. As a secondary source of data, telephone interviews will be undertaken prior to and following the intervention with randomly selected samples of clinicians from each facility group to assess the reported provision of preventive care, and the acceptability of the practice change intervention and implementation.

The study will provide novel evidence regarding the ability to increase clinician's routine provision of preventive care across a network of community health facilities.

Read Full Article (PDF)

Examining Physical Activity Levels and Alcohol Consumption: Are People Who Drink More Active?

Summarize/categorize current scientific literature examining the association between alcohol consumption (AC) and levels of physical activity (PA).

Electronic databases spanning education, psychology, sociology, medicine, and interdisciplinary reports.

Included studies (n  =  17) must be published in a peer-reviewed, English language journal; measure either AC or PA as an independent/dependent variable; and primarily examine the relationship between AC and PA.

Search terms/phrases included alcohol, alcohol consumption, drinking, physical activity, exercise, and physically active.

The Matrix Method and PRISMA guidelines organized pertinent literature and identified/extracted salient findings.

Alcohol consumers of all ages were more physically active than nondrinking peers. Further, several studies suggest a dose-response relationship between AC and PA, indicating that as drinking increases, so does PA level.

Reviewed studies support a positive association between AC and PA across all ages. Findings were contrary to the hypothesis of the investigators. Future research should place specific emphasis on identifying why alcohol consumers exercise at higher levels than non–alcohol consumers.

Read Full Abstract

Request Reprint E-Mail: akgardner@ufl.edu.

Alcohol consumption and suicide rates in Russia

To estimate the aggregate level effect of alcohol on suicide rates in Russia.

Suicide is one of the main causes of premature mortality in Russia, bringing considerable losses of human lives. There is strong evidence of a crucial role of alcohol in the explanation of the high suicide rate and its profound fluctuations over the past decades in this country.

Trends in alcohol consumption per capita and suicide rates from 1980 to 2005 were analyzed employing autoregressive integrated moving
average (ARIMA) time series analysis.

The overall level of alcohol consumption was significantly associated with both male and female suicide rates. The estimates of the age specific models for men were positive and ranged from 0.029 (75+ age group) to 0.084 (30-44 age group). The estimates for women were positive for the age groups 15-29 (0.036), 30-44 (0.033), 45-59 (0.022) and 60-74 (0.008).

The outcome of this study provides indirect support for the hypothesis that alcohol played a crucial role in the fluctuation in suicide mortality rate in Russia during recent decades.


Read Full Article (PDF)

Adopting Local Alcohol Policies: A Case Study of Community Efforts to Regulate Malt Liquor Sales

To learn how the local context may affect a city's ability to regulate alcohol products such as high–alcohol-content malt liquor, a beverage associated with heavy drinking and a spectrum of nuisance crimes in urban areas.

An exploratory, qualitative case study comparing cities that adopted policies to restrict malt liquor sales with cities that considered, but did not adopt policies.

Nine large U.S. cities in seven states.

City legislators and staff, alcohol enforcement personnel, police, neighborhood groups, business associations, alcohol retailers, and industry representatives.

Qualitative data were obtained from key informant interviews (n  =  56) and media articles (n  =  360). The data were coded and categorized. Similarities and differences in major themes among and across Adopted and Considered cities were identified.

Cities faced multiple barriers in addressing malt liquor–related problems, including a lack of enforcement tools, alcohol industry opposition, and a lack of public and political will for alcohol control. Compared to cities that did not adopt malt liquor sales restrictions, cities that adopted restrictions appeared to have a stronger public mandate for a policy and were less influenced by alcohol industry opposition and lack of legislative authority for alcohol control. Strategies common to successful policymaking efforts are discussed.

Understanding the local context may be a critical step in winning support for local alcohol control policies.

Read Full Abstract

Request Reprint E-Mail: jones010@umn.edu.

Dopamine dysregulation in a mouse model of paroxysmal nonkinesigenic dyskinesia

Paroxysmal nonkinesigenic dyskinesia (PNKD) is an autosomal dominant episodic movement disorder. Patients have episodes that last 1 to 4 hours and are precipitated by alcohol, coffee, and stress. Previous research has shown that mutations in an uncharacterized gene on chromosome 2q33–q35 (which is termed PNKD) are responsible for PNKD.

Here, we report the generation of antibodies specific for the PNKD protein and show that it is widely expressed in the mouse brain, exclusively in neurons. One PNKD isoform is a membrane-associated protein. Transgenic mice carrying mutations in the mouse Pnkd locus equivalent to those found in patients with PNKD recapitulated the human PNKD phenotype.

Staining for c-fos demonstrated that administration of alcohol or caffeine induced neuronal activity in the basal ganglia in these mice. They also showed nigrostriatal neurotransmission deficits that were manifested by reduced extracellular dopamine levels in the striatum and a proportional increase of dopamine release in response to caffeine and ethanol treatment.

These findings support the hypothesis that the PNKD protein functions to modulate striatal neurotransmitter release in response to stress and other precipitating factors.


Read Full Article (PDF)

Dietary intake of folate and alcohol, MTHFR C677T polymorphism, and colorectal cancer risk in Korea

The incidence of colorectal cancer (CRC) is increasing sharply in Korea, and evidence has suggested the role of dietary methyl supply and related polymorphisms on colorectal carcinogenesis.

We investigated the association between folate and alcohol intake, methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, and CRC risk in Koreans.

A total of 787 cases and 656 controls were recruited from 2 university hospitals. Multiple logistic regression models were used to estimate ORs and corresponding 95% CIs.

MTHFR 677T homozygotes were at a lower risk of CRC (OR: 0.60; 95% CI: 0.46, 0.78 for TT compared with CC/CT). High folate intake was associated with reduced CRC risk (OR: 0.64; 95% CI: 0.49, 0.84 for high compared with low intake), and high alcohol consumption was associated with increased risk of CRC (OR: 1.76; 95% CI: 1.26, 2.46 for high compared with low intake). When data were stratified by the amount of dietary methyl (combined intake of folate and alcohol), those with low-methyl diets had higher risk of CRC (OR: 2.32; 95% CI: 1.18, 4.56) than did those with high-methyl diets among CC/CT carriers, whereas the amount of dietary methyl did not affect the CRC risk among carriers with the TT homozygous variant. This association was stronger in patients with colon cancer than in patients with rectal cancer.

We found that the effect of dietary methyl supply on colorectal carcinogenesis may differ according to MTHFR C677T genotype and the subsite of origin in a Korean population.

Read Full Abstract

Request Reprint E-Mail: dhkims@hallym.ac.kr

Alcohol consumption and the risk of colon cancer by family history of colorectal cancer

Individuals with a family history of colorectal cancer may be more susceptible to adverse effects of alcohol consumption.

We investigated whether the association between alcohol consumption and colon cancer risk differed by family history of colorectal cancer.

We conducted prospective studies in women and men in the Nurses’ Health Study and Health Professionals Follow-Up Study, respectively. Alcohol consumption was first assessed in 1980 in women and in 1986 in men.

During a follow-up of 26 y among 87,861 women and 20 y among 47,290 men, we documented 1801 cases of colon cancer (1094 women and 707 men). Higher alcohol consumption was associated with an elevated risk of colon cancer, although the association was significant only for the highest intake category of ≥30 g/d, with no significant linear trend. The association between alcohol consumption and colon cancer risk differed by family history of colorectal cancer; in comparison with nondrinkers, the pooled multivariate RRs for alcohol consumption of ≥30 g/d were 1.23 (95% CI: 0.96, 1.57; NS) among those with no family history and 2.02 (95% CI: 1.30, 3.13) among those with a family history of colorectal cancer (P value test for difference = 0.05). In comparison with nondrinkers with no family history, the RR for colon cancer was 2.80 (95% CI: 2.00, 3.91) for individuals who consumed ≥30 g/d and who had a family history of colorectal cancer.

Reducing alcohol consumption may decrease the incidence of colon cancer, especially among those with a family history of colorectal cancer.

Read Full Abstract

Request Reprint E-Mail: eunyoung.cho@channing.harvard.edu.

Perceptions of low-risk drinking levels among Australians during a period of change in the official drinking guidelines

.In 2009, the National Health and Medical Research Council released a revision of Australia's official low-risk alcohol guidelines, specifying low-risk consumption levels for both short- and long-term consumption. This study aims to assess how the general population's assessment of low-risk drinking levels compares to these guidelines and to examine whether the changes to the official guidelines corresponded with changes in perceptions of low-risk drinking levels in the population.

The study uses two waves of a large, general population survey which was run in 2007 (n = 19 818) and 2010 (n = 26 648), providing before and after measures of respondents' estimates of low-risk drinking levels.

In the 2010 survey, less than 5% of respondents estimated low-risk drinking levels that matched those in the 2009 guidelines. Generally speaking, younger respondents and heavier drinkers provided higher estimates of low-risk drinking thresholds. There was little change in estimates between 2007 and 2010, although there was some evidence that the changes to the guidelines had influenced perceptions of safe drinking.

There is very little knowledge of the official drinking guidelines among the general Australian population. If drinking guidelines are to have any effect on levels of consumption, a more concerted effort to publicise them is necessary.

Read Full Abstract

Request Reprint E-Mail: michaell@turningpoint.org.au

Increased body mass index modifies associations between alcohol intake and blood cholesterol profile

Habitual alcohol drinking influences blood cholesterol profile, and dyslipidaemia often accompanies obesity. The aim of this study was to determine whether obesity modifies relationships between alcohol intake and blood cholesterol profile.

Japanese men aged 35–60 years (n = 23 834) were divided into two groups by body mass index (BMI) (normal BMI: ≥ 18·5 and < 25 kg/m²; high BMI: ≥ 25 kg/m²) and were further divided into four subgroups by alcohol intake [non-, light (< 22 g ethanol/day), heavy (≥ 22 and < 44 g ethanol/day) and very heavy (≥ 44 g ethanol/day) drinkers]. Relationships of alcohol intake with serum LDL cholesterol, HDL cholesterol and LDL/HDL ratio were investigated.

Both in the subject groups with normal and high BMI, alcohol intake was associated with lower risks of high LDL cholesterol, low HDL cholesterol and high LDL/HDL ratio, and these risks tended to decrease as alcohol intake increased. The odds ratios vs. nondrinkers for high LDL cholesterol, low HDL cholesterol and high LDL/HDL ratio tended to be lower in the normal BMI group than in the high BMI group. Significant interactions between alcohol drinking and BMI for high LDL cholesterol, low HDL cholesterol and high LDL/HDL ratio were found in all of the drinker subgroups except for the interaction for high LDL cholesterol in light drinkers.

High BMI status is suggested to attenuate the associations of alcohol intake with lower LDL cholesterol, higher HDL cholesterol and lower LDL/HDL ratio.

Read Full Abstract

Request Reprint E-Mail: wakabaya@hyo-med.ac.jp

Different independent susceptibility markers for first-ever cerebral infarction and myocardial infarction in young patients

Cerebral infarction (CI) and myocardial infarction (MI) share some common features, but there are other differences in risk factors.

The aim of our study is to determine whether there are some significantly independent susceptibility markers for them.

All consecutive patients between the ages of 18 and 45 years with first-ever CI and MI during 2001–2010 were recruited to participate in the study. Using multivariate logistic regression modeling, we explore many different data, such as age at onset, sex ratio, numbers of patients with history of hypertension, smoking, drinking, and serum lipid, uric acid, prealbumin (PA), and white blood cell (WBC) count levels.

Logistic regression analysis adjusted for confounders confirmed the following independent susceptibility markers for young CI patients: hypertension, admission serum PA levels, daily alcohol [odds ratio (OR), 0.251; 95% confidence interval (CI), 0.097–0.648, p = 0.004; OR, 0.994; 95% CI, 0.988–0.999, p = 0.031; OR, 0.150; 95% CI, 0.047–0.473, p = 0.001], and for MI patients: age at onset, current smoking, serum WBC, and glucose levels (OR, 1.293; 95% CI, 1.146–1.457, p = 0.000; OR, 8.914; 95% CI, 3.575–22.231, p = 0.000; OR, 1.344; 95% CI, 1.169–1.544, p = 0.000; OR, 1.149; 95% CI, 1.022–1.291, p = 0.020).

We conclude that there are some significantly different independent susceptibility markers for young CI and MI patients.



Read Full Abstract

Request Reprint E-Mail: gzyxysjk@yahoo.com.cn

Exacerbation of alcohol-induced oxidative stress in rats by polyunsaturated fatty acids and iron load

The hypothesis that excessive intake of vegetable oil containing polyunsaturated fatty acids and iron load precipitate alcohol-induced liver damage was investigated in a rat model.

In order to elucidate the mechanism underlying this synergism, the serum levels of iron, total protein, serum glutamate pyruvate transaminase, liver thiobarbituric acid reactive substances, and activities of antioxidant enzymes superoxide dismutase, catalase in liver of rats treated with alcohol, polyunsaturated fatty acids and iron per se and in combination were examined. Alcohol was fed to the rats at a level of 10-30% (blood alcohol was maintained between 150-350 mg/dl by using head space gas chromatography), polyunsaturated fatty acids at a level of 15% of diet and carbonyl iron 1.5-2% of diet per se and in combination to different groups for 30 days.

Hepatotoxicity was assessed by measuring serum glutamate pyruvate transaminase, which was elevated and serum total protein, which was decreased significantly in rats fed with a combination of alcohol, polyunsaturated fatty acids and iron. It was also associated with increased lipid peroxidation and disruption of antioxidant defense in combination fed rats as compared to rats fed with alcohol or polyunsaturated fatty acids or iron.

The present study revealed significant exacerbation of the alcohol-induced oxidative stress in presence of polyunsaturated fatty acids and iron.


Read Full Article

Increasing prices of alcohol decreases consumption: study

Minimum alcohol prices in British Columbia have been adjusted intermittently over the past 20 years. The present study estimates impacts of these adjustments on alcohol consumption.

Time series and longitudinal models of aggregate alcohol consumption with price and
other economic data as independent variables.
Setting: British Columbia (BC), Canada.
Measurements: Data on alcohol prices and sales for different beverages were provided by the
BC Liquor Distribution Branch for 1989 to 2010. Data on household income were sourced from
Statistics Canada.

Longitudinal estimates suggest that a 10% increase in the minimum price of an
alcoholic beverage reduced its consumption relative to other beverages by 16.1% (P<0.001).
Time series estimates indicate that a 10% increase in minimum prices reduced consumption of spirits and liqueurs by 6.8% (P=0.004), wine by 8.9 % (P=0.033), alcoholic sodas and ciders by
13.9% (P=0.067), beer by 1.5% (P=0.043) and all alcoholic drinks by 3.4 % (P=0.007).

Increases in minimum prices of alcoholic beverages can substantially reduce
alcohol consumption.


Read Full Report (PDF)

Do designated drivers and workplace policies effect alcohol consumption?

Is there a link between designated driver usage and alcohol consumption? We hypothesize that the use of a designated driver lowers the cost of drinking which, in turn, increases alcohol consumption.

We examine the effect on drinking intensity (which incorporates low levels of alcohol use) and binge drinking (which measures greater alcohol use), using a proxy for designated driver usage.

If workplace rules forbid alcohol use for safety or other reasons, a large potential cost of drinking is the possible job loss (or other penalty) incurred if an employed person tests positive for alcohol.

We add variables to our model related to workplace policies on alcohol use by workers to ascertain if designated drivers still influence drinking.

We test these hypotheses utilizing a large dataset from the 2006 and 2007 National Survey on Drug Use and Health (NSDUH) which includes several measures of alcohol use, in addition to a host of other correlates.

Findings reveal that our proxy for designated driver use increases the incidence of drinking and the results hold even after controlling for workplace alcohol testing.







Read Full Abstract

Request Reprint E-Mail: wes.econ@hotmail.com

MPs urge Government to review its sensible drinking guidelines

MPs on the Science and Technology Committee conclude that greater efforts should also be focused on helping people understand the guidelines and how to use them.

• Report: Alcohol guidelines
• Inquiry: Alcohol guidelines
• Science and Technology Committee

Andrew Miller MP, Chair of the committee, said:

"Alcohol guidelines are a crucial tool for Government in its effort to combat excessive and problematic drinking. It is vital that they are up-to date and that people know how to use them.

Unfortunately, public understanding of how to use the guidelines and what an alcohol unit looks like is poor, although improving.

While we urge the UK Health Departments to re-evaluate the guidelines more thoroughly, the evidence we received suggests that the guidelines should not be increased and that people should be advised to take at least two drink-free days a week."

In 1987, the "sensible limits" for drinking were defined as 21 units of alcohol a week for men and 14 for women. By the early 1990s, scientific evidence had emerged suggesting that alcohol consumption might reduce the risk of coronary heart disease (CHD), prompting a review of the guidelines. The Government therefore recommended that drinking guidelines should be couched in daily terms: men should not regularly drink more than three to four units a day and women no more than two to three units a day.

The committee found a lack of expert consensus over the health benefits of alcohol and is therefore sceptical about using the purported health benefits of alcohol as a basis for daily guidelines for the adult population, particularly as it is clear that any protective effects would only apply to men over 40 years and post-menopausal women, yet the guidelines apply to all adults.

The committee also found that while public awareness of the existence of guidelines was high, a deeper understanding of what the guidelines were and of what a unit of alcohol looked like was lacking. > > > > Read More

Central Neuropeptide Y Modulates Binge-Like Ethanol Drinking in C57BL/6J Mice via Y1 and Y2 Receptors

Frequent binge drinking has been linked to heart disease, high blood pressure, type 2 diabetes, and the development of ethanol dependence. Thus, identifying pharmaceutical targets to treat binge drinking is of paramount importance.

Here we employed a mouse model of binge-like ethanol drinking to study the role of neuropeptide Y (NPY). To this end, the present set of studies utilized pharmacological manipulation of NPY signaling, immunoreactivity (IR) mapping of NPY and NPY receptors, and electrophysiological recordings from slice preparations of the amygdala.

The results indicated that central infusion of NPY, a NPY Y1 receptor (Y1R) agonist, and a Y2R antagonist significantly blunted binge-like ethanol drinking in C57BL/6J mice (that achieved blood ethanol levels >80 mg/dl in control conditions).

Binge-like ethanol drinking reduced NPY and Y1R IR in the central nucleus of the amygdala (CeA), and 24 h of ethanol abstinence after a history of binge-like drinking promoted increases of Y1R and Y2R IR.

Electrophysiological recordings of slice reparations from the CeA showed that binge-like ethanol drinking augmented the ability of NPY to inhibit GABAergic transmission.

Thus, binge-like ethanol drinking in C57BL/6J mice promoted alterations of NPY signaling in the CeA, and administration of exogenous NPY compounds protected against binge-like drinking.

The current data suggest that Y1R agonists and Y2R antagonists may be useful for curbing and/or preventing binge drinking, protecting vulnerable individuals from progressing to the point of ethanol dependence.


Read Full Abstract

Request Reprint E-Mail: asparrow@mclean.harvard.edu

FASD News

Telegraph.co.uk (UK) - One in 50 babies has a birth defect: research

More than one in 50 babies has a birth defect – almost double the previous estimate, according to the most comprehensive report of its kind.

Read more

Science Network Western Australia (Australia) - Fitzroy children centre of Foetal Alcohol Disorder study

ABORIGINAL organisations in Fitzroy Valley have called for research into social, health and wellbeing issues associated with alcohol abuse.

Read more

PsychCentral.com (USA) - Health Screens Limit Substance Abuse in Pregnancy

Pregnant women who smoke cigarettes, use alcohol or take drugs increase the risk of medical complications for the baby and mother. That’s well-established science. Now, a program developed by the Kaiser Permanente Health System for women at risk of substance abuse during pregnancy could save nearly $2 billion annually in health care costs if implemented nationwide.

Read more

AllAfrica.com (Tanzania) - No Wine If You Want to Conceive

If you are a habitual drinker and you are planning to get pregnant, put that glass down.It is advisable to forgo your favourite tipple for at least three months before the planned pregnancy, and remain alcohol-free for the ensuing nine months to delivery. Here is why.

Read more

TbNewsWatch.com (Canada) – NAN tells province to get serious about FASD

Nishnawbe Aski Nation Deputy Grand Chief Terry Waboose is calling on the province to develop an integrated provincial strategy for prevention and support services for Fetal Alcohol Spectrum Disorder.

Read more

RESEARCH

MedIndia - Gestational Alcohol Exposure may be Revealed by Analysis of Fetal Meconium

A new study has examined fatty acid ethyl esters (FAEEs) and ethylglucuronide (EtG) in meconium samples from public hospitals in seven Italian cities to test for prenatal exposure to alcohol.

Read more

Alcoholism - Callosal Thickness Reductions Relate to Facial Dysmorphology in Fetal Alcohol Spectrum Disorders

Consistent with previous reports, findings suggest an adverse effect of prenatal alcohol exposure on callosal growth and further indicate that fiber pathways connecting frontal and parieto-occipital regions in each hemisphere may be particularly affected. Significant associations between callosal and facial dysmorphology provide evidence for a concurrent insult to midline facial and brain structural development in FASD.

Read more

Plos One - Large-Scale Analysis of Acute Ethanol Exposure in Zebrafish Development: A Critical Time Window and Resilience

In humans, ethanol exposure during pregnancy causes a spectrum of developmental defects (fetal alcohol syndrome or FAS). Individuals vary in phenotypic expression. Zebrafish embryos develop FAS-like features after ethanol exposure.

Read more

Obstetrics and Gynecology - Early Start: A Cost–Beneficial Perinatal Substance Abuse Program

To conduct a cost–benefit analysis of Early Start, an integrated prenatal intervention program for stopping substance use in pregnancy.

Read more

IN OTHER LANGUAGES

taz.de (Germany) - Achtung, Baby trinkt mit

Manchmal passt ein kompliziertes Problem in einen Satz: "Meine muter Trinkte", steht in krakeliger Schrift auf einem Plakat im Büro von Professor Hans-Ludwig Spohr. Der Kinderarzt leitet des FASD-Zentrum der Charité.

Read more

Lietuvos rytas (Lithuania) - Nuo fizinio ir dvasinio negalavimo kenčia ne vien alkoholikių vaikai

Vokietijos gydytojas Hansas Ludwigas Spohras - specialistas neįgaliųjų vaikų, kurių motinos, būdamos nėščios, vartojo alkoholį. Duodamas interviu šalies žurnalui „Der Spiegel“ profesorius perspėjo, kad nėščiosioms pavojinga vartoti alkoholį.

Read more

Iltalehti (Finland) - "En vihaa biologista äitiäni"

Annakaisa Tiirinki syntyi alkoholin vaurioittamana. FAS-taustastaan huolimatta hän on selättänyt oppimisvaikeudet ja elää itsenäisen nuoren naisen elämää.

Read more

La Stampa (Italy) - Il meconio fetale può smascherare l’abuso di alcol

L’alcolismo è problema molto grave. Ed è anche peggio se riguarda una donna in stato di gravidanza. I rischi per il feto sono altissimi e anche dopo la nascita è necessario tenere sotto controllo sia mamma che bambino.

Read more


Read Full Newsletter

WHO Bulletin on Global Fund conflict of interest

The recent issue of Bulletin of the World Health Organization carries a round table section: "Global Fund collusion with liquor giant is a clear conflict of interest. The First article is by Richard Matzopoulos, Charles DH Parry, Joanne Corrigall, Jonny Myers, Sue Goldstein and Leslie London. They describe how the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) has recently included SABMiller as a recipient of funding for an education intervention aimed at minimizing alcohol-related harm, including HIV prevention, among men in drinking establishments.The authors think Global Fund support for this initiative is cause for concern.

The article discusses whether men in drinking establishments are the best target group for the intervention, whether a drinking establishment is the best location, and whether the educational intervention itself is effective. Their experience is that the liquor industry is inclined to support alcohol interventions that will not affect drinking rates at a population level. These interventions allow the industry to simultaneously fulfil social and legal obligations to address the harmful use of alcohol while ensuring that sales and profits are maintained. > > > > Read More

Dihydromyricetin As a Novel Anti-Alcohol Intoxication Medication

Alcohol use disorders (AUDs) constitute the most common form of substance abuse. The development of AUDs involves repeated alcohol use leading to tolerance, alcohol withdrawal syndrome, and physical and psychological dependence, with loss of ability to control excessive drinking.

Currently there is no effective therapeutic agent for AUDs without major side effects. Dihydromyricetin (DHM; 1 mg/kg, i.p. injection), a flavonoid component of herbal medicines, counteracted acute alcohol (EtOH) intoxication, and also withdrawal signs in rats including tolerance, increased anxiety, and seizure susceptibility; DHM greatly reduced EtOH consumption in an intermittent voluntary EtOH intake paradigm in rats.

GABA_A receptors (GABA_ARs) are major targets of acute and chronic EtOH actions on the brain. At the cellular levels, DHM (1 μm) antagonized both acute EtOH-induced potentiation of GABA_ARs and EtOH exposure/withdrawal-induced GABA_AR plasticity, including alterations in responsiveness of extrasynaptic and postsynaptic GABA_ARs to acute EtOH and, most importantly, increases in GABA_AR α4 subunit expression in hippocampus and cultured neurons.

DHM anti-alcohol effects on both behavior and CNS neurons were antagonized by flumazenil (10 mg/kg in vivo; 10 μm in vitro), the benzodiazepine (BZ) antagonist. DHM competitively inhibited BZ-site [³H]flunitrazepam binding (IC₅₀, 4.36 μm), suggesting DHM interaction with EtOH involves the BZ sites on GABA_ARs.

In summary, we determined DHM anti-alcoholic effects on animal models and determined a major molecular target and cellular mechanism of DHM for counteracting alcohol intoxication and dependence.

We demonstrated pharmacological properties of DHM consistent with those expected to underlie successful medical treatment of AUDs; therefore DHM is a therapeutic candidate.


Read Full Abstract

Request Reprint E-Mail: jliang@ucla.edu

News Release - Moderate Red Wine Drinking May Help Cut Women’s Breast Cancer Risk

Drinking red wine in moderation may reduce one of the risk factors for breast cancer, providing a natural weapon to combat a major cause of death among U.S. women, new research from Cedars-Sinai Medical Center shows.

The study, published online in the Journal of Women’s Health, challenges the widely-held belief that all types of alcohol consumption heighten the risk of developing breast cancer. Doctors long have determined that alcohol increases the body’s estrogen levels, fostering the growth of cancer cells.

But the Cedars-Sinai study found that chemicals in the skins and seeds of red grapes slightly lowered estrogen levels while elevating testosterone among premenopausal women who drank eight ounces of red wine nightly for about a month. > > > > Read More

Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA

Little is known about the effects of a healthy lifestyle on mortality after stroke. This study assessed whether five healthy lifestyle factors had independent and dose dependent associations with all-cause and cardiovascular mortality after stroke.

In a nationally representative sample of the US population (n=15 299) with previous stroke (n=649) followed from survey participation (1988–1994) through to mortality assessment (2000), the relationship between five factors (eating ≥5 servings of fruits/vegetables per day, exercising >12 times/month, having a body mass index of 18.5–29.9 mg/kg², moderate alcohol use [1 drink/day for women and 2 drinks/day for men] and not smoking) and all-cause and cardiovascular mortality was assessed.

Mean age was 67.0 years (SE 1.1 years) and 53% were women. After adjusting for covariates, abstaining from smoking (HR 0.57, CI 0.34 to 0.98) and exercising regularly (HR 0.66, CI 0.44 to 0.99) were associated with lower all-cause mortality but no individual factors had independent associations with cardiovascular mortality. All-cause mortality decreased with higher numbers of healthy behaviours (1–3 factors vs none: HR 0.12, CI 0.03 to 0.47; 4–5 factors vs none: HR 0.04, CI 0.01 to 0.20; 4–5 factors vs 1–3 factors: HR 0.38, CI 0.22 to 0.66; trend p=0.04). Similar effects were observed for cardiovascular mortality (4–5 factors vs none: HR 0.08, CI 0.01 to 0.66; 1–3 factors vs none: HR 0.15, CI 0.02 to 1.15; 4–5 factors vs 1–3 factors: HR 0.53, CI 0.28 to 0.98; trend p=0.18).

Regular exercise and abstinence from smoking were independently associated with lower all-cause mortality after stroke. Combinations of healthy lifestyle factors were associated with lower all-cause and cardiovascular mortality in a dose dependent fashion.

Read Full Abstract

Request Reprint E-Mail: towfighi@usc.edu