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

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


Saturday, February 27, 2010

Introducing Spirituality into Psychiatric Care

Spirituality is important to many psychiatric patients, and these patients may be moved toward recovery more effectively if their spiritual needs are addressed in treatment. This, however, is rarely given expression in the psychiatric services of teaching hospitals.

In order to develop this potential area of improved care, we (1) evaluated the differential attitudes of patients and psychiatric trainees toward the value of spirituality in the recovery process, (2) established a program of group meetings conducted by psychiatric residents and staff where patients can discuss how to draw on their spirituality in coping with their problems, and (3) established related training experiences for psychiatric residents.

The results and implications of these three initiatives are presented.

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The Virgin of Guadalupe as an Ancillary Modality for Treating Hispanic Substance Abusers: Juramentos in the United States

During a 6-month research study of substance abuse outreach and retention methods in Mexico, the authors learned about the common practice of a self-control mechanism to abstain from substance abuse: Juramentos.

are pledges usually made to the Virgin of Guadalupe in the presence of a Catholic priest. The Jurado promises not to drink during a specified period of time.

The authors discuss the dynamics of
Juramentos and present data from an exploratory study indicating that Juramentos are being used among Mexican migrants in Florida and may provide a culturally sensitive adjunct for treatment of Mexican and other Hispanic clients in
the United States.

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The Influence of Religious Factors on Drinking Behavior Among Young Indigenous Sami and Non-Sami Peers in Northern Norway.

It has been hypothesized that Laestadianism has contributed to the less drinking observed among indigenous Sami.

This paper further investigates the bivariate protective influence of Sami ethnicity on youth drinking behavior using logistic regressions. We simultaneously controlled for the influence of religious revival movements (Laestadianism or evangelic) and religious importance (being personally Christian), in addition to socio-demographics and parental factors.

Cross-sectional data from the 1994/95 North Norwegian Youth Study including 2,950 (675 Sami) 15–19 year-old high school students (RR: 85%) was used.

Sami ethnicity was statistically significant for two out of six alcohol outcome measures, after adjustment for religiosity and other covariates, indicating less current drinking and party drinking. Religiousness was associated with higher youth and parental abstinence across ethnicities.

Generally, stronger protective influences on drinking behavior were found for religious importance (being personally Christian) than religious affiliation (Laestadianism).

The non-significance between Sami and non-Sami drinking may partly be explained by ethnic differences in religiosity, but also socio-demographics (e.g., residing in the Sami Highland) and parental factors (e.g., abstinence) contributed to such a result.

Laestadianism`s profound impact on Sami culture, and its strong anti-alcohol norms may have contributed to a religious-socio-cultural context of abstinence.

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Modelling continuous exposures with a spike at zero: A new procedure based on fractional polynomials

A common task in epidemiology is to estimate the dose-response function for a continuous exposure.

Often a proportion of subjects is unexposed. Typical examples are cigarette consumption, alcohol intake, or occupational exposures. The question arises as to how to model such variables statistically.

The fractional polynomial method of modelling continuous exposure variables is extended to allow for a proportion unexposed. A binary variable for the unexposed fraction is added to the model.

In a two-stage procedure, we assess whether the binary variable and/or the continuous function for the exposed individuals is required for a good fit to the data. Extension to the multivariable situation is described.

Three data sets with different characteristics are used as illustrations. The analyses of the three studies using the proposed procedure give differing results. In one example, only the binary variable seems to be required. In the other two examples, the binary variable and fractional polynomial functions of the exposure variable are needed. One function is monotonic and the other has a minimum. In the third example, adjusting for confounders has almost no effect on the function selected.

In conclusion, the new procedure offers a worthwhile extension of dose-response modelling with an unexposed fraction. It is simple to carry out with standard software.

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Alcohol consumption and work-related injuries among farmers in Heilongjiang Province, People's Republic of China

Alcohol consumption has been found to be associated with work-related injuries among workers around the world, but this association has not well been studied among agricultural workers in China.

Among 2,050 farmers who completed the survey, the 12-month prevalence of work-related injury was 12.2%. The leading external cause of injury was exposure to mechanical force.

The odds of injury among farmers with past month drinking, who drank distilled spirits, and reported intoxication were respectively 1.77 (95% CI = 1.27-2.47), 1.89 (95% CI = 1.35-2.66), 2.12 (95% CI = 1.42-3.11). The odds of injury also significantly increased with greater average amounts of pure alcohol per day, with increased frequency of drinking per week, and with greater reported years of drinking.

Each alcohol use variable was associated with injury in logistic regression models while controlling for sex, age, years of farm work, months of farm work in the past 12 months, driving a motor vehicle, and agricultural machinery use.

We found a significant association between alcohol consumption and work-related injuries among farmers.

Our findings stress the need for culturally appropriate interventions which affect alcohol use and prevent injuries among Chinese farmers.

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NMDA receptors in frontal cortex and hippocampus of alcohol consumers

Specific binding of [3H]MK801 to N-methyl-D-aspartate (NMDA) receptors in the frontal cortex and hippocampus (CA1 and gyrus dentatus) was measured by receptor autoradiography in 16 Caucasian chronic alcohol consumers free of clinical manifestations of alcoholism, and compared with 16 Caucasian control subjects.

Binding densities were not significantly different between heavy and moderate drinkers, neither between alcohol consumers that were abstinent or non-abstinent before death, nor between ethanol drinkers and controls.

Continued alcohol consumption, in the absence of hepatic, neurologic or psychiatric disorders related to alcoholism, does not alter the binding properties of NMDA receptors in the brain areas studied.

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Friday, February 26, 2010

Twelve-Month Follow-up Results from a Randomized Controlled Trial of a Brief Personalized Feedback Intervention for Problem Drinkers

To examine the impact of a web-based personalized feedback intervention, the Check Your Drinking (CYD; screener at 12-month follow-up.

By the 12-month follow-up, the impact of the intervention previously reported at 3 and 6 months of CYD on problem drinkers’ alcohol consumption was no longer apparent.

Recognizing that many people with alcohol concerns will never seek treatment, recent years have seen an increase in efforts to find ways to take treatment to problem drinkers. The CYD is one such intervention that has a demonstrated effect on reducing alcohol consumption in the short term (i.e. 6 months). Other more intensive Internet-based interventions or interventions via other modalities may enhance this positive outcome over the short and long term among problem drinkers who would be otherwise unlikely to access treatment for their alcohol concerns.

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Internet-based assessment and self-monitoring of problematic alcohol and drug use

A Swedish web-based service ( offers self-assessment and self-monitoring of alcohol and drug use via on-line screening with the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) as well as in-depth risk assessment using extended versions of both tests (Alcohol-E and DUDIT-E). Users receive individualized feedback concerning their alcohol and drug consumption and can follow their alcohol and drug use over time in personal diagrams and by writing in an electronic diary.

This study describes user characteristics, service utilization patterns, and psychometric test properties for 2361 individuals who created a valid account over 20 months starting in February 2007.

Problematic alcohol use according to AUDIT criteria was indicated for 67.4%, while 46.0% met DUDIT criteria for problematic drug use. Men and women accessed the service equally, with a mean age of 23 years. Internal consistency reliability figures were 0.90 for 1846 first-time AUDIT users and 0.97 for 1211 first-time DUDIT users; among 213 second-time AUDIT users reliability was 0.93, and 0.96 for 97 second-time DUDIT users.

Internet-based alcohol and drug monitoring could function as a self-help tool or as a complement to substance abuse treatment.

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Pre-teen alcohol use initiation and suicide attempts among middle and high school students: Findings from the 2006 Georgia Student Health Survey

Early alcohol use initiation has been linked to suicide attempts among youth. However, very little is known about the potential impact of alcohol-related norms and beliefs and how these may impact the association between alcohol use and suicide attempt.

This study examines the associations between early alcohol use and suicide attempts while controlling for demographic characteristics, and alcohol-related beliefs and norms (e.g., believing alcohol causes harm to health or that adults or friends disapprove of alcohol use) and potential confounders.

Analyses were based on the 2006 Georgia Student Health Survey (N = 175,311) of students in grades 6, 8, 10 and 12. The current analyses were limited to students in grades 8, 10 and 12, who either began drinking prior to age 13 or who were non drinkers (n = 87,349).

Pre-teen alcohol use initiation was associated with suicide attempts (Adj.OR = 1.51; 95%CI:1.38–1.66) relative to not drinking with similar associations for boys (Adj.OR = 1.72; 95%CI:1.52–1.94) and girls (Adj.OR = 1.26; 95%CI:1.08–1.45).

Students who believed that alcohol was harmful to their health, or that friends or adults disapproved of their alcohol use, or who had been taught about substance use in school were less likely to make a suicide attempt, although findings differed for boys and girls.

Pre-teen alcohol use initiation is an important risk factor for suicide attempts among boys and girls in Georgia.

Increased efforts to delay and reduce early alcohol use through clinical interventions, education, and policies that impact norms and knowledge related to alcohol use are needed and may in turn reduce suicide attempts.

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The association between earlier age of first drink, disinhibited personality, and externalizing psychopathology in young adults

Earlier age of first drink (AFD) of alcohol is associated with higher rates of alcohol abuse and dependence as well as a range of other externalizing problems.

This study tested the hypotheses that in young adults earlier AFD is associated with [1] the common variance among externalizing problems (lifetime alcohol, marijuana, other drug, childhood conduct, and adult antisocial behavior problems) rather than being uniquely associated with alcohol problems, and [2] the disinhibited personality traits of social deviance and impulsivity, and that the association between earlier AFD and externalizing problems is partly accounted for by disinhibited personality.

Analyses showed that [1] earlier AFD was associated with the covariance among the different domains of externalizing problems and was not unique to any one externalizing problem, [2] earlier AFD was associated with social deviance and impulsivity, and [3] social deviance and impulsivity accounted for part of the association between earlier AFD and externalizing problems.

The results suggest that earlier AFD is associated with a vulnerability to disinhibitory disorders and is not specifically associated with alcohol problems.

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Per capita alcohol consumption and alcohol-related harm in Belarus, 1970–2005

Although alcohol seems to be an important determinant of the mortality crisis in the former Soviet Republic of Belarus, little systematic research has been done on the relationship between alcohol consumption and harm at the aggregate level.

The aims of the present study were to estimate the effect of
per capita alcohol consumption on all-cause mortality, mortality from alcohol poisoning and hospital admissions for alcohol psychosis in Belarus.

The outcomes suggest that a 1 l increase in consumption was associated with an increase in male all-cause mortality of ~2.3%. The corresponding figures for alcohol poisoning mortality and alcohol psychosis admissions are 12 and 25%.

The present study strengthens the notion of alcohol consumption
as an important determinant of population health in this part of the world, and thus the notion that alcohol control must be a key priority for Belorussian public health policy.

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Are you a problem drinker?

Does this sound like anyone you know? Darryl is 35, has a steady job, a stable home and good marriage, enjoys a few beers in front of the TV most nights - doesn't have what most people would call a drink problem.

In the United States alone there are probably around 36 million Darryls, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which created the character, played by an actor on its website to help train doctors.

He doesn't exercise as much as maybe he should so he's a little overweight. At an average of four drinks a day, he is no alcoholic: but some experts now see him as a high-risk drinker and say he could succumb to "alcohol use disorder."

Millions more people across the developed world - who drink a few glasses of wine every night after work or look forward to three nights of repeated shots with chasers on the weekends - may today be adding up to a major health and social problem.

Could there be a pill to help them? . . . . .

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Substance Use among Black Adults

Among black adults aged 18 or older, rates of past month alcohol use and binge alcohol use were lower than the national average for adults (44.3 vs. 55.2 percent and 21.7 vs. 24.5 percent, respectively); the rate of past month illicit drug use, however, was higher than the national average (9.5 vs. 7.9 percent).

The rate of need for treatment for an alcohol use problem in the past year among black adults was similar to that of the national average among adults (7.7 and 8.1 percent); however, the rate of need for treatment for an illicit drug use problem was higher among blacks than the national average (4.4 vs. 2.9 percent).

One in seven (14.2 percent) black adults in need of alcohol treatment in the past year and 24.2 percent of those in need of illicit drug treatment received treatment at a specialty facility; both of these rates were higher than the national averages for adults.

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Thursday, February 25, 2010

Genetic polymorphisms in folate and alcohol metabolism and breast cancer risk: a case–control study in Thai women

Dietary folate as well as polymorphic variants in one-carbon metabolism genes may modulate risk of breast cancer through aberrant DNA methylation and altered nucleotide synthesis and repair. Alcohol is well recognized as a risk factor for breast cancer, and interactions with one-carbon metabolism has also been suggested.

The purpose of this study is to test the hypothesis that genetic polymorphisms in the folate and alcohol metabolic pathway are associated with breast cancer risk.

Twenty-seven single nucleotide polymorphisms (SNPs) in the
MTR, MTRR, MTHFR, TYMS, ADH1C, ALDH2, GSTP1, NAT1, NAT2, CYP2E1 DRD2, DRD3, and SLC6A4 were genotyped. Five hundred and seventy patients with histopathogically confirmed breast cancer and 497 controls were included in the present study.

Increased risk was observed for homozygotes at the
MTR SNPs (rs1770449 and rs1050993) with the OR = 2.21 (95% CI 1.18–4.16) and OR = 2.24 (95% CI 1.19–4.22), respectively. A stratified analysis by menopausal status indicated the association between the NAT2 SNP (rs1799930) and breast cancer was mainly evident in premenopausal women (OR 2.70, 95% CI 1.20–6.07), while the MTRR SNP (rs162049) was significant in postmenopausal women (OR 1.61, 95% CI 1.07–2.44).

Furthermore, SNPs of the genes that contribute to alcohol behavior,
DRD3 (rs167770), DRD2 (rs10891556), and SLC6A4 (rs140701), were also associated with an increased risk of breast cancer.

No gene–gene or gene–environment interactions were observed in this study.

Our results suggest that genetic polymorphisms in folate and alcohol metabolic pathway influence the risk of breast cancer in Thai population.

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Assessment of health risk behaviours and their interrelationships among young people from two counties of Romania

The first goal of this study was to assess the prevalence of different health risk behaviours among Romanian young people. Next, the interrelationship between different health risk behaviours as well as age and gender differences with respect to health risk behaviours were examined.

The results showed that 31% of junior high school students, 59.7% of senior high school students and 64.8% of university students reported more than one risk behaviour. Many of the risk behaviours were likely to correlate with each other and the strongest correlation was found between smoking, alcohol-related behaviour and precocious sexual intercourse. Factor analysis revealed that among junior high school students all health risk behaviours loaded on one factor. In senior high school students and university students the risk behaviours split into two factors, based probably on their frequency and severity. Factor 1 comprised smoking, alcohol-related behaviours as well as precocious sexual intercourse, while factor 2 included less common behaviours: violence, delinquency and illicit drug use. No gender differences were observed regarding the relationship between health risk behaviours.

The results stress the importance of developing prevention programmes among Romanian youth for the behaviours discussed. Further research is needed to identify how to best offer these programmes: as stand-alone programmes or as an integrated set of programmes and whether the same approach has to be taken for younger and older adolescents.

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Current alcohol use and risk for hypomania in male students: generally more or more binging?

Alcohol use disorders and bipolar disorder are highly comorbid. Some studies suggest that alcohol abuse or misuse might even precede the onset of bipolar disorder, but few studies have looked at the daily drinking pattern beyond diagnostic categories. We therefore examined if risk for hypomania is associated with a specific drinking pattern when using a calendar-based interview.

Conducting regression analyses, we found that an alcohol-related disorder was related to the amount and frequency of drinking, as expected. Risk for hypomania was specifically related to an unstable drinking pattern and binge drinking, but not generally higher consumption.

Risk for hypomania was associated with unstable alcohol consumption and binge drinking, even after controlling for alcohol-related disorders. This supports the idea that instability in different areas of behavior is characteristic of vulnerability to hypomania.

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News Release - Anti-drinking ads can increase alcohol use, IU Kelley School study shows

Public service advertising campaigns that use guilt or shame to warn against alcohol abuse can actually have the reverse effect, spurring increased drinking among target audiences, according to new research from the Indiana University Kelley School of Business.

Instead of the intended outcome, researchers in this first-of-its-kind study showed that the ads triggered an innate coping mechanism that enables viewers to distance themselves from the serious consequences of reckless drinking. . . . .

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Health Dept. eyes new alcohol tax; Would make New Yorkers drink less, get healthier: supporters

Getting drunk in New York could get more expensive.

The Health Department is mulling a new tax increase on alcohol - which supporters say would make New Yorkers drink less and get healthier.

"It's one of the things on the menu," said Executive Deputy Commissioner Adam Karpati, who oversees the Health Department's alcohol policy. . . . .

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Effect of Chronic Ethanol on Enkephalin in the Hypothalamus and Extra-Hypothalamic Areas

Ethanol may be consumed for reasons such as reward, anxiety reduction, or caloric content, and the opioid enkephalin (ENK) appears to be involved in many of these functions. Previous studies in Sprague–Dawley rats have demonstrated that ENK in the hypothalamic paraventricular nucleus (PVN) is stimulated by voluntary consumption of ethanol. This suggests that this opioid peptide may be involved in promoting the drinking of ethanol, consistent with our recent findings that PVN injections of ENK analogs stimulate ethanol intake.

To broaden our understanding of how this peptide functions throughout the brain to promote ethanol intake, we measured, in rats trained to drink 9% ethanol, the expression of the ENK gene in additional brain areas outside the hypothalamus, namely, the ventral tegmental area (VTA), nucleus accumbens shell (NAcSh) and core (NAcC), medial prefrontal cortex (mPFC), and central nucleus of the amygdala (CeA).

With qRT-PCR, the rats chronically drinking ethanol plus water compared to water alone showed significantly higher levels of ENK mRNA, not only in the PVN but also in the VTA, NAcSh, NAcC, and mPFC, although not in the CeA. Using radiolabeled ISH, levels of ENK mRNA in rats drinking ethanol were found to be elevated in all areas examined, including the CeA. The experiment using DIG confirmed this effect of ethanol, showing an increase in density of ENK-expressing cells in all areas studied. It additionally revealed a similar change in DYN mRNA in the PVN, mPFC, and CeA, although not in the NAcSh or NAcC.

While distinguishing the NAc as a site where ENK and DYN respond differentially, these findings lead us to propose that these opioids, in response to voluntary ethanol consumption, are generally elevated in extra-hypothalamic as well as hypothalamic areas, possibly to carry out specific area-related functions that, in turn, drive animals to further consume ethanol. These functions include calorie ingestion in the PVN, reward and motivation in the VTA and NAcSh, response-reinforcement learning in the NAcC, stress reduction in the CeA, and behavioral control in the mPFC.

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The Hispanic Americans Baseline Alcohol Survey (HABLAS): Predictors of Alcohol Attitudes and Expectancies in Hispanic National Groups

Multiple theoretical frameworks identify attitudes and expectancies as important predictors of alcohol behavior. Few studies have examined demographic predictors of these evaluative and belief-based cognitive mediators in the general population, and none have examined them in large-scale studies of Hispanics, a group at higher risk for drinking behavior and problems. This study probes the extent to which dimensions of attitudes and expectancies share common demographic predictors in a large sample of Puerto Ricans, Cuban-Americans, Mexican-Americans, and South/Central Americans.

Religious affiliation selectively predicted alcohol attitudes, with Catholics having more positive and fewer negative attitudes than other religious groups. Hispanic group selectively predicted alcohol expectancies, with Cuban-Americans having less positive and less negative expectancies than other groups. Being U.S.-born or male predicted more positive attitudes and expectancies, but birthplace and gender did not predict negative dimensions of attitudes or expectancies. Higher acculturation and more education were linked to a decreased tendency to agree with any item. Age was positively and negatively associated with negative expectancies and positive attitudes, respectively, and having never been married, higher income, and unemployment were each linked to fewer negative attitudes.

Although there is some overlap, attitudes and expectancies are influenced by different sociodemographic variables. Positive and negative dimensions of those constructs also show distinct patterns of relations. Prevention and treatment programs targeting cognitive mediators of behavior should be mindful of these differential determinants and future modeling endeavors should incorporate them.

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Effects of Ethanol on Extracellular Levels of Adenosine in the Basal Forebrain: An In Vivo Microdialysis Study in Freely Behaving Rats

Adenosine is implicated to play a pivotal role in mediating many neuronal responses to ethanol. While in vitro studies performed in cell culture have demonstrated that acute ethanol exposure increases extracellular adenosine levels, this effect has not been demonstrated, in vivo, in the brain. We performed an in vivo microdialysis study to examine the effects of local ethanol perfusion on extracellular levels of adenosine in the basal forebrain (BF).

Local ethanol perfusion in the BF produced a significant increase in extracellular adenosine with the highest dose of 300 mM ethanol producing a 4-fold increase. Cresyl violet (Nissl) staining did not indicate any toxic damage in the area surrounding the probe tip. Choline acetyltransferase immunohistochemistry revealed that all microdialysis probe sites were localized in the BF.

Our study is the first to demonstrate that ethanol acts directly in the brain to increase extracellular adenosine.

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Consequences of an Adolescent Onset and Persistent Course of Alcohol Dependence in Men: Adolescent Risk Factors and Adult Outcomes

While there is an extensive literature on the correlates of alcohol use disorders (AUD; alcohol abuse and dependence), there are relatively few prospective studies of representative birth cohorts that have examined the unique effects of an adolescent onset and persistent course of AUD on a wide range of psychosocial variables.

An adolescent onset of AUD (n = 57) was associated with severe deficits across multiple domains of psychosocial functioning in adolescence. Measures of behavioral disinhibition in adolescence were strong predictors of a persistent course of AUD (n = 93). Nearly 40% of men with an adolescent onset were able to desist by age 29, and were similar, but not identical to men who never experienced an AUD in terms of adult functioning. Men with an adolescent onset and persistent course of AUD exhibited the most severe deficits in functioning.

Results emphasize the importance of examining developmental course to understand the etiology of AUD. Our findings are optimistic in that individuals who desist from AUD are able to achieve high levels of psychosocial functioning. Our findings suggest that future research on the persistence of AUD into adulthood should focus on the contributions of behavioral disinhibition and social environment variables including peer and romantic relationships.

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Effect of a Comprehensive Lifestyle Modification Program on the Bone Density of Male Heavy Drinkers

Heavy alcohol drinking is implicated in osteoporosis. Although abstinence is rapidly followed by a restoration of osteoblastic activity, little is known about the contributions of alcohol-related factors or the effectiveness of a lifestyle modification program (LMP) on bone density.

The patients had a high prevalence of daytime drinking (93.5%), continuous drinking (84.1%), and current smoking (82.0%) with mean duration of alcohol abuse of 30.0 ± 12.8 years. The patients had lower bone density than a reference control group (Z-scores: −0.45 ± 1.02). Multiple stepwise regression analysis identified age, poor activities of daily living (ADL), continuous drinking, absence of liver cirrhosis, depression, and dementia as determinants of low bone density. The bone density of the 20 participants in the LMP improved 2.3% (p = 0.0003) with a more ameliorating effect on bone density than a conventional abstinence therapy (p = 0.014 for interventional effect). The upper normal range of PTH levels at baseline were significantly decreased, and 1.25-(OH)2 vitamin D levels also had a trend toward decrease during the abstinence.

Alcoholic patients may have many complications such as poor ADL and dementia, which are independently associated with decreased bone density. The results of this study support the idea that comprehensive approach to lifestyle factors to minimize risk of osteoporosis is the best way to improve bone density.

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Wednesday, February 24, 2010

Effects of Adolescent Ethanol Exposure on Event-Related Oscillations (EROs) in the Hippocampus of Adult Rats.

Electrophysiological studies have shown that adolescent ethanol (EtOH) exposure can produce long-term changes in hippocampal EEG and ERP activity. Recently, evidence has emerged suggesting that event-related oscillations (EROs) may be good indices of alcoholism risk in humans, however, have not been evaluated for their ability to index the effects of EtOH exposure.

The objective of the present study was to characterize EROs generated in hippocampus in adult rats exposed to EtOH during adolescence. Adolescent male Sprague–Dawley rats were exposed to EtOH vapor for 12 h/d for 10 days. A time–frequency representation method was used to determine delta, theta, alpha and beta ERO energy and the degree of phase variation in the hippocampus of adult rats exposed to EtOH and age-matched controls.

The present results suggest that the decrease in P3 amplitudes, previously observed in adult rats exposed to EtOH during adolescence, is associated with increases in evoked theta ERO energy. These studies suggest that EROs are suitable for characterizing the long-term effects of adolescent EtOH exposure.

Further studies are needed to determine the relationship between the mechanisms that regulate these neurophysiological endophenotypes and the consequences of adolescent EtOH exposure.

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Alcohol involvement among young female drivers in US fatal crashes: unfavourable trends

Young men have greater representation in fatal alcohol-related crashes. Recent studies of young women and risky behaviours have raised concerns about the implications this may have for alcohol-related fatal crashes.

The objective of this study was to investigate the representation of young female drivers in US alcohol-involved fatal crashes (1995–2007) and to identify trends heralding future negative changes in crash profiles for young female drivers.

179 891 fatal crashes in all age groups occurred over the study period. The rate of involvement in fatal crashes for young drivers with positive blood alcohol concentrations (BAC) decreased for men and women aged 16 years but increased for women age 19–24 years. Young female drivers had a greater increase than young men in the proportion of alcohol-involved fatal crashes (3.1%, 95% CI 1.9 to 4.3% vs 1.2%, 95% CI 0.2 to 2.1%, p=0.02). Most of the increase occurred in drivers with BAC ≥0.15 g/dl. Drivers with higher BAC had markedly lower safety restraint use. Over time restraint use increased in all BAC groups studied.

Alcohol-involved fatal crash rates in young female drivers aged 19–24 years have increased. However, male drivers continue to surpass women in the number of alcohol-involved fatal crashes. Restraint use decreases markedly with increasing BAC.

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News Release - Under 40s risking serious health harm

Scotland's culture of heavy and binge drinking is having an increasing impact on the health of younger people, according to statistics published today.

And the nation is also bucking the international trend for chronic liver disease. While most European countries have seen levels fall, rates in Scotland have almost trebled over the last 15 years.

The Alcohol Hospital Statistics and Liver Disease Statistics, which are published today by ISD Scotland, show:

  • Scotland sees, on average, 115 hospital discharges per day due to alcohol misuse
  • Alcohol-related discharges have increased by nine per cent over the past five years
  • Alcohol-related discharges have increased by 22 per cent for 30-34 year olds and by 19 per cent for 35-39 year olds
  • Scotland's rate of chronic liver disease almost trebled over the last 15 years - and continues to rise
  • While death rates have been falling across most of Europe, they remain high in Scotland
  • Chronic liver disease death rates amongst 30-39 year olds have risen almost five-fold since the mid 1980s
  • Rates of hospital discharge for chronic liver disease among young Scottish women (25-29) has increased seven fold over the last 20 years.
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News Release - Beer and pub industry calls for Government action to support economic recovery

• Industry leaders urge Chancellor to adopt a tax policy to boost beer as low alcohol British drink

• Support for “Back the Pub” campaign grows as public urges Chancellor not to increase beer tax further

Beer should be taxed at a lower rate of duty to reflect its status as a low-strength, UK produced product according to the British Beer & Pub Association. Such a move would help support British pubs and brewing, with 400,000 UK jobs depending directly on the production and sale of beer.

The proposal is contained within the BBPA’s submission to the Treasury in advance of the March Budget. As a first step, the Government should freeze tax on beer in the forthcoming budget.
. . . . .

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The Effect of Religiosity and Campus Alcohol Culture on Collegiate Alcohol Consumption

Religiosity and campus culture were examined in relationship to alcohol consumption among college students using reference group theory.

Alcohol consumption was significantly higher among students at the university (M = 26.9 drinks) versus students at the religious college (M = 11.9 drinks). University students also had lower religiosity scores (M = 23.8) than students at the religious college (M = 26.5). Students who attend a secular university are 4 times more likely to be moderate or heavy drinkers compared to students attending a religiously affiliated college.

Students with the least religiosity were 27 times more likely to be a heavy alcohol user and 9 times more likely to be a moderate alcohol user compared to students with greater religiosity.

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Efficacy of a Web-Based, Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS).

Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men.

Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.

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Brief Screening and Intervention for Alcohol and Drug Use in a College Student Health Clinic: Feasibility, Implementation, and Outcomes

Evaluation of the Brief Alcohol Screen and Intervention in College Students (BASICS) in a university primary care setting.

Drinking and drug use decreased between baseline and 6 months. Participants reported an increase in protective factors and in readiness to change alcohol-related behaviors, and a decrease in alcohol-related consequences and in distress symptoms. Heavy episodic drinking at baseline significantly moderated the changes in number of drinks in a typical week and in a typical weekend, and number of drinks on the occasion drank most on a weekend.

BASICS can be implemented in a primary health care setting and university students may reduce their alcohol and/or drug use.

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Tuesday, February 23, 2010

Trends in Alcohol Consumption Among Undergraduate Students at a Northeastern Public University, 2002–2008

This study examined alcohol consumption patterns and trends at a public university in the Northeast from 2002 to 2008.

Four groups showed significant increases in both frequency and volume of alcohol consumption—students who were female, over 21 years of age or over, living off-campus, or performing well academically. There were no decreasing trends for any demographic group. These results differ from national college health surveys, which have shown alcohol use remaining steady during this period.

Campus-specific trend data can provide unique perspectives and guide programming efforts. These trends suggest a need for new intervention strategies on this campus.

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Alcohol Measures and Terms: A Perfect Storm for Chronic Confusion

Members in the prevention and treatment fields continue to examine how to most effectively assess and label high volume alcohol consumption.

Terms such as “binge” drinking have resulted in considerable controversy and debate. Conventionally the criteria for assessing high-risk drinking includes: five or drinks for men and four or more drinks for women during a sitting/event/occasion within the previous two weeks. Several standardized instruments simply use the cut off for high-risk drinking as five or more drinks and do not include the gender variable when defining this behavior.

Both of these measures have undergone criticism for not including a more specific time element. Yet asking respondents to recall specific time frames from a night of heavy drinking may also compromise validity. Further the 5+/4+ or 5+ drinking criterion does not adequately assess intoxication levels or more extreme levels of alcohol consumption. A variety of special measures and terms have been created to capture heavy drinking behaviors and ritualistic behavior.

Researchers and practitioners may benefit by using different measures and terms based on context and their specific prevention goals.

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HRC FREE Webcast: Guiding People Toward Change: The Spirit of Motivational Interviewing

Motivational Interviewing (MI) is a person-centered, empathic, guiding approach that can lead people to make significant changes in their lives. The practice of MI involves a creative combining of spirit and technique - or what has been described as "practicing kindness with skill." This web cast will explore what is meant by the spirit of MI, why it is essential, and how we can embrace and embody this spirit more fully in providing care for people experiencing homelessness.

Who should attend?

Direct service providers, outreach workers, case managers, peer support specialists, project directors, team leaders and policy makers can all benefit from this webcast.

About the presenter

Ken Kraybill, MSW Ken has been working in the health, behavioral health, and homelessness arena for the past 27 years. Drawing upon 18 years of direct service and advocacy experience in homeless settings, Ken has developed various curricula, resource guides and workshops to inform and equip others in the field. He provides training nationally on topics including outreach and engagement, motivational interviewing, supervision, and personal and organizational wellness. Ken works for the Homelessness Resource Center as a Training and Technical Assistance Specialist.

Steven Samra Steven recently joined the Homelessness Resource Center team as a Recovery Specialist. He is also a Veteran’s Services Coordinator with Operation Stand Down Nashville. He spent 30+ years in and out of homelessness while battling addictions, then "got it together" in 2000 and received his BA and MPA at Cal State University Chico. Since then, he has dedicated his life to serving those who are still on the street. For the past three years, Steven has worked as a street outreach worker and you can currently find him assisting homeless veterans in and around Nashville, Tennessee. He serves on the Board of the Nashville Coalition for the Homeless, co-founded and writes for The Contributor, a street newspaper produced and sold by the homeless, is a staff writer for’s homelessness section and blogs at Stone Soup Station. In his spare time, he breathes.


To register for this webcast please follow the link provided at the top of the page or register here

For information on the registration process please download the Registration manual


Monday, February 22, 2010

Health, United States, 2009

Health, United States is an annual report on trends in health statistics.

Health, United States, 2009 is the 33rd annual report on the health status of the Nation, prepared by the Secretary of the Department of Health and Human Services for the President and the Congress.

In a Chartbook and 150 detailed tables, the report provides an annual picture of the health of the entire United States. Trends are presented for health status and health care utilization, resources, and expenditures.

This year’s report includes a special feature on medical
technology. As advances in medical technology continue to transform the provision of health care and lengthen and improve quality of life, questions are increasingly raised about the appropriate and equitable use of this technology and how best to control its contribution to rising health care expenditures.

. . . . In 2007, 21% of adults 18 years of age and over reported having five or more drinks in a day at least once in the past year, and 9% reported having five or more drinks in a day at least 12 times in the past year (Table 66).

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Neuroprotective effect of vitamin C against the ethanol and nicotine modulation of GABAB receptor and PKA- expression in prenatal rat brain

Prenatal ethanol exposure has various deleterious effects on neuronal development and can induce various defects in developing brain, resulting in fetal alcohol syndrome (FAS). -Aminobutyric acid (GABAB) receptor (R) is known to play an important role during the development of the central nervous system (CNS).

Our study was designed to investigate the effect of ethanol (100 mM), nicotine (50
M) (for 30 min and 1 h), vitamin C (vitC, 0.5 mM), ethanol plus vitC, and nicotine plus vitC on expression level of GABAB1, GABAB2R, and protein kinase A- (PKA) in prenatal rat cortical and hippocampal neurons at gestational days (GD) 17.5.

The results showed that, upon ethanol and nicotine exposure, GABA
B1 and GABAB2R protein expression increased significantly in the cortex and hippocampus for a short (30 min) and long term (1 h), whereas only GABAB2R subunit was decreased upon nicotine exposure for a long term in the cortex. Furthermore, PKA expression in cortex and hippocampus increased with ethanol exposure during short term, whereas long-term exposure results increased in cortex and decreased in hippocampus.

Moreover, the cotreatment of vitC with ethanol and nicotine showed significantly decreased expression of GABA
B1, GABAB2R, and PKA in cortex and hippocampus for a long-term exposure. Mitochondrial membrane potential, Fluoro-jade-B, and propidium iodide staining were used to elucidate possible neurodegeneration.

Our results suggest the involvement of GABA
BR and PKA in nicotine and ethanol-mediated neurodevelopmental defects and the potential use of vitC as a effective protective agent for FAS-related deficits.

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News Release - More alcohol sales sites mean more neighborhood violence, new Indiana University research finds

More alcohol sales sites in a neighborhood equate to more violence, and the highest assault rates are associated with carry-out sites selling alcohol for off-premise consumption, according to new research released Sunday (Feb. 21) by two Indiana University professors. . . . . .

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'Children, Young People and Alcohol' DCSF report published

The report 'Children, Young People and Alcohol' aims to better understand parents’ and young people’s attitudes and behaviour towards alcohol and alcohol consumption. The research was also designed to investigate how children’s behaviour may be influenced by their parent’s attitudes and behaviour towards alcohol. . . . . .

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Sunday, February 21, 2010

Improving the quality of reporting alcohol outcome studies: Effects of the CONSORT Statement

It is critical that the reporting of randomized controlled trials (RCTs) be transparent and comprehensive.

The aim of this study was to examine if adopting standards of reporting, the Consolidated Standards of Reporting Trials (CONSORT), improved the quality of reporting of alcohol treatment outcome studies.

RCTs were identified from eight journals publishing a substantial number of alcohol treatment outcome studies (n = 127 RCTs) and coded for the quality of reporting according to the CONSORT guidelines.

Both CONSORT adopter and non-adopter journals showed significant improvements in the quality of reporting of alcohol treatment outcome studies over time.

While overall results suggested a nonsignificant trend for more improvement over time in the quality of reporting for adopter compared to non-adopter journals, comparison of effects sizes suggested that specific areas of reporting did significantly improve for the adopter journals.

Results suggest that efforts to improve reporting such as the CONSORT guidelines can be useful and influential.

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Are subthreshold alcohol dependence symptoms a risk factor for developing DSM-IV alcohol use disorders? A three-year prospective study of ‘diagnostic

Research suggests that diagnostic orphans (i.e., individuals experiencing only 1–2 criteria for DSM-IV alcohol dependence) may be at increased risk for developing more severe alcohol problems.

This study aimed to: (i) investigate the course of diagnostic orphans in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), and (ii) explore whether a specific symptom endorsement pattern(s) could identify diagnostic orphans at Wave 1 who remitted or progressed to alcohol dependence at Wave 2.

Compared to the no-AUD group, one-criterion orphans at Wave 1 were twice as likely to be in the abuse group and four times more likely to be dependent at Wave 2. Two-criterion orphans were three times more likely to be in the abuse group and eight times more likely to have progressed to dependence. Criterion endorsement patterns of diagnostic orphans at baseline did not significantly differentiate between those who remitted and those who progressed to dependence at follow-up.

Like previous research, diagnostic orphans are at increased for developing to more severe alcohol problems. Relying solely on the DSM-IV AUD diagnostic criteria, however, may not be sufficient to identify those diagnostic orphans who are at risk for progressing to dependence.

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Recognition and management of alcohol misuse in OEF/OIF and other veterans in the VA: A cross-sectional study

Mental health problems have been identified among soldiers serving in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but little is known about the prevalence and management of alcohol misuse in OEF/OIF veterans seen in the Veterans Administration health care system (VA).

OEF/OIF men were more likely to screen positive for alcohol misuse than non-OEF/OIF men. Overall, approximately half of those with alcohol misuse had documented BI and/or referral to alcohol treatment suggesting a need for improvement in addressing alcohol misuse in OEF/OIF and other veterans.

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