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Alcohol use disorder commonly occurs in patients with schizophrenia and dramatically worsens their course. The atypical antipsychotic clozapine has been associated with reduced drinking in these patients, but its toxicity reduces its use. We have attempted to create a clozapine-like drug by combining agents that capture components of clozapine's pharmacologic action, including its weak dopamine D2 blockade and noradrenergic modulation. The current study assessed whether paliperidone, a dopamine D2 receptor and adrenergic alpha-2 receptor antagonist like clozapine, would attenuate alcohol drinking in the alcohol-preferring P rat and the Syrian golden hamster, and whether desipramine, a norepinephrine reuptake inhibitor, would potentiate the ability of paliperidone to attenuate alcohol drinking in the P rat and the Syrian golden hamster. Daily subcutaneous injections of paliperidone (5 mg/kg for the rat; 1 mg/kg for the hamster) over 20 days slightly and transiently attenuated initiation of alcohol consumption in both animals. Desipramine (3 mg/kg) or lower doses of paliperidone alone did not affect alcohol drinking. However, the combination of desipramine (3 mg/kg) and paliperidone essentially prevented initiation of alcohol drinking and acquisition of alcohol preference in the P rat (2.5 or 5 mg/kg), and almost as dramatically suppressed chronic alcohol intake and alcohol preference in the hamster (2.5 mg/kg). Taken together, the current data suggest that (1) the desipramine and paliperidone combination attenuates alcohol drinking in a synergistic manner, and (2) desipramine and paliperidone may serve as an effective new treatment for alcohol use disorder in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Over the past two decades, advances in genetic technologies have posed unexpected challenges to the ethical and legal framework guiding the application of the most recent advances in healthcare technologies. By and large, these challenges have been successfully met by the introduction by statutes such as the Genetic Information Nondiscrimination Act (GINA). However, over the past several years, these advances in the ability to measure genetic (or heritable) contributions to medical illness have been joined by advances in epigenetic (or acquired) contributions to common medical illnesses. Unfortunately, the moral and legal framework for the use of these epigenetic technologies, which can objectively determine the presence of medical illnesses such as diabetes or the consumption of substances of abuse, is not as well developed. This communication provides an introduction to the fundamentals of epigenetics and then reviews how some of the latest advances in this technology can now be used to assess the consumption of alcohol and tobacco. Next, the possible mechanisms through which these tools could be employed clinically are discussed. Finally, the authors outline the potential for misuse of this technology and suggest that well-informed policy could play a critical role in shaping the optimal implementation of epigenetic technologies. [ABSTRACT FROM AUTHOR]

Background: Deficits in information processing may be a core deficit after fetal alcohol exposure. This study was designed to investigate the possible effects of weekly low to moderate maternal alcohol consumption and binge drinking episodes in early pregnancy on choice reaction time (CRT) and information processing time (IPT) in young children. Method: Participants were sampled based on maternal alcohol consumption during pregnancy. At the age of 60–64 months, 1,333 children were administered a modified version of the Sternberg paradigm to assess CRT and IPT. In addition, a test of general intelligence (WPPSI-R) was administered. Results: Adjusted for a wide range of potential confounders, this study showed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT. There was, however, an indication of slower CRT associated with binge drinking episodes in gestational weeks 1–4. Conclusion: This study observed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT as assessed by the Sternberg paradigm. However, there were some indications of CRT being associated with binge drinking during very early pregnancy. Further large-scale studies are needed to investigate effects of different patterns of maternal alcohol consumption on basic cognitive processes in offspring. [ABSTRACT FROM AUTHOR]

Alcohol consumption is known to lead to gene expression changes in the brain. After performing weighted gene co-expression network analyses (WGCNA) on genome-wide mRNA and microRNA (miRNA) expression in Nucleus Accumbens (NAc) of subjects with alcohol dependence (AD; N = 18) and of matched controls (N = 18), six mRNA and three miRNA modules significantly correlated with AD were identified (Bonferoni-adj. p≤ 0.05). Cell-type-specific transcriptome analyses revealed two of the mRNA modules to be enriched for neuronal specific marker genes and downregulated in AD, whereas the remaining four mRNA modules were enriched for astrocyte and microglial specific marker genes and upregulated in AD. Gene set enrichment analysis demonstrated that neuronal specific modules were enriched for genes involved in oxidative phosphorylation, mitochondrial dysfunction and MAPK signaling. Glial-specific modules were predominantly enriched for genes involved in processes related to immune functions, i.e. cytokine signaling (all adj. p≤ 0.05). In mRNA and miRNA modules, 461 and 25 candidate hub genes were identified, respectively. In contrast to the expected biological functions of miRNAs, correlation analyses between mRNA and miRNA hub genes revealed a higher number of positive than negative correlations (χ2 test p≤ 0.0001). Integration of hub gene expression with genome-wide genotypic data resulted in 591 mRNA cis-eQTLs and 62 miRNA cis-eQTLs. mRNA cis-eQTLs were significantly enriched for AD diagnosis and AD symptom counts (adj. p = 0.014 and p = 0.024, respectively) in AD GWAS signals in a large, independent genetic sample from the Collaborative Study on Genetics of Alcohol (COGA). In conclusion, our study identified putative gene network hubs coordinating mRNA and miRNA co-expression changes in the NAc of AD subjects, and our genetic (cis-eQTL) analysis provides novel insights into the etiological mechanisms of AD. [ABSTRACT FROM AUTHOR]

Background: A recent systematic review reported that mild drinking showed beneficial effects on mortality. However, this relationship between alcohol consumption and mortality differs by race, and there are few studies on Koreans. In this study, we reviewed previous studies conducted on Koreans to investigate the association between mild drinking and mortality.Methods: Four databases (Medline, Web of Science, KoreaMed, and DBpia) were searched. Studies investigating the risk of alcohol consumption on three types of mortality (all-cause mortality, cancer-related mortality, and cardiovascular mortality) for Koreans were included.Results: A total of 16 studies assessed alcohol consumption as a risk factor for mortality. Nine studies reported on the risk of alcohol consumption in relation to all-cause mortality, eight to cancer-related mortality, and three to cardiovascular mortality. Among these, only studies assessing alcohol amount not drink status or drink frequency were included in meta-analysis. The results of the meta-analysis did not show a significant effect of mild alcohol consumption on all-cause mortality (5 studies, OR: 0.85, 95 % CI: 0.72, 1.01). While meta-analysis of studies using all-cancer mortality showed significant effect of alcohol consumption (4 studies, OR: 0.89, 95 % CI: 0.85, 0.94), results of studies including all-cancer and specific type of cancer was not significant (7 studies, OR: 1.02, 95 % CI: 0.9, 1.15). Although a meta-analysis of cardiovascular mortality could not be conducted owing to a lack of studies, all studies reported a non-significant effect of occasional or mild alcohol consumption.Discussion: In this study, mild alcohol consumption in Korean did not show beneficial effect on mortality and it might be caused by three factors: criterion of mild drinking, the subjects, and sample size. The criterion of mild alcohol consumption was diverse in included studies. The effect of alcohol consumption could differ based on subjects' sex, age as well as race. In addition, the effect of alcohol consumption might be different from previous one due to the small number of studies.Conclusions: Mild alcohol consumption did not show any beneficial effects in relation to all-cause, cancer-related, and cardiovascular mortality. Additional studies are necessary to verify any association between mild drinking and mortality in Koreans. [ABSTRACT FROM AUTHOR]

A quantitative genetic approach, which involves correlation of transcriptional networks with the phenotype in a recombinant inbred ( RI) population and in selectively bred lines of rats, and determination of coinciding quantitative trait loci for gene expression and the trait of interest, has been applied in the present study. In this analysis, a novel approach was used that combined DNA-Seq data, data from brain exon array analysis of HXB/ BXH RI rat strains and six pairs of rat lines selectively bred for high and low alcohol preference, and RNA-Seq data (including rat brain transcriptome reconstruction) to quantify transcript expression levels, generate co-expression modules and identify biological functions that contribute to the predisposition of consuming varying amounts of alcohol. A gene co-expression module was identified in the RI rat strains that contained both annotated and unannotated transcripts expressed in the brain, and was associated with alcohol consumption in the RI panel. This module was found to be enriched with differentially expressed genes from the selected lines of rats. The candidate genes within the module and differentially expressed genes between high and low drinking selected lines were associated with glia (microglia and astrocytes) and could be categorized as being related to immune function, energy metabolism and calcium homeostasis, as well as glial-neuronal communication. The results of the present study show that there are multiple combinations of genetic factors that can produce the same phenotypic outcome. Although no single gene accounts for predisposition to a particular level of alcohol consumption in every animal model, coordinated differential expression of subsets of genes in the identified pathways produce similar phenotypic outcomes. Database The datasets supporting the results of the present study are available at [ABSTRACT FROM AUTHOR]

Background and Aim: Harmful alcohol consumption has long been recognized as being the major determinant of male premature mortality in the European countries of the former USSR. Our focus here is on Belarus and Russia, two Slavic countries which continue to suffer enormously from the burden of the harmful consumption of alcohol. However, after a long period of deterioration, mortality trends in these countries have been improving over the past decade. We aim to investigate to what extent the recent declines in adult mortality in Belarus and Russia are attributable to the anti-alcohol measures introduced in these two countries in the 2000s. Data and Methods: We rely on the detailed cause-specific mortality series for the period 1980–2013. Our analysis focuses on the male population, and considers only a limited number of causes of death which we label as being alcohol-related: accidental poisoning by alcohol, liver cirrhosis, ischemic heart diseases, stroke, transportation accidents, and other external causes. For each of these causes we computed age-standardized death rates. The life table decomposition method was used to determine the age groups and the causes of death responsible for changes in life expectancy over time. Conclusion: Our results do not lead us to conclude that the schedule of anti-alcohol measures corresponds to the schedule of mortality changes. The continuous reduction in adult male mortality seen in Belarus and Russia cannot be fully explained by the anti-alcohol policies implemented in these countries, although these policies likely contributed to the large mortality reductions observed in Belarus and Russia in 2005–2006 and in Belarus in 2012. Thus, the effects of these policies appear to have been modest. We argue that the anti-alcohol measures implemented in Belarus and Russia simply coincided with fluctuations in alcohol-related mortality which originated in the past. If these trends had not been underway already, these huge mortality effects would not have occurred. [ABSTRACT FROM AUTHOR]

Importance: The high prevalence of traumatic brain injuries (TBI) among adolescents has brought much focus to this area in recent years. Sports injuries have been identified as a main mechanism. Although energy drinks, including those mixed with alcohol, are often used by young athletes and other adolescents they have not been examined in relation to TBI. Objective: We report on the prevalence of adolescent TBI and its associations with energy drinks, alcohol and energy drink mixed in with alcohol consumption. Design, Settings and Participants: Data were derived from the Centre for Addiction and Mental Health’s 2013 Ontario Student Drug Use and Health Survey (OSDUHS). This population-based cross-sectional school survey included 10,272 7th to 12th graders (ages 11–20) who completed anonymous self-administered questionnaires in classrooms. Main Outcome Measures: Mild to severe TBI were defined as those resulting in a loss of consciousness for at least five minutes, or being hospitalized for at least one night. Mechanism of TBI, prevalence estimates of TBI, and odds of energy drink consumption, alcohol use, and consumption of energy drinks mixed with alcohol are assessed. Results: Among all students, 22.4% (95% CI: 20.7, 24.1) reported a history of TBI. Sports injuries remain the main mechanism of a recent (past year) TBI (45.5%, 95% CI: 41.0, 50.1). Multinomial logistic regression showed that relative to adolescents who never sustained a TBI, the odds of sustaining a recent TBI were greater for those consuming alcohol, energy drinks, and energy drinks mixed in with alcohol than abstainers. Odds ratios were higher for these behaviors among students who sustained a recent TBI than those who sustained a former TBI (lifetime but not past 12 months). Relative to recent TBI due to other causes of injury, adolescents who sustained a recent TBI while playing sports had higher odds of recent energy drinks consumption than abstainers. Conclusions and Relevance: TBI remains a disabling and common condition among adolescents and the consumption of alcohol, energy drinks, and alcohol mixed with energy drinks further increase the odds of TBI among adolescents. These associations warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: There is currently a lack of reliable, minimally invasive biomarkers that could predict the extent of alcoholism-induced CNS damage. Developing such biomarkers may prove useful in reducing the prevalence of alcohol use disorders (AUDs). Extracellular microRNAs (miRNAs) can be informative molecular indicators of changes in neuronal gene expression. In this study, we performed a global analysis of extracellular miRNAs to identify robust biomarkers of early CNS damage in humans diagnosed with DSM-IV AUDs. We recruited a relatively young set of 20 AUD subjects and 10 age-matched controls. They were subjected to comprehensive medical, neuropsychological and neuroimaging tests, followed by comparison of miRNA levels found in peripheral blood serum. Employing a conservative strategy to identify candidate biomarkers, miRNAs were quantified using two independent high-throughput methods: microarray and next-generation RNA-sequencing. This improved our capacity to discover and validate relevant miRNAs.Results: Our results identified several miRNAs with significant and reproducible expression changes in AUD subjects versus controls. Moreover, several significant associations between candidate miRNA biomarkers and various medical, neuropsychological and neuroimaging parameters were identified using Pearson correlation and unbiased hierarchical clustering analyses. Some of the top candidate biomarkers identified, such as mir-92b and mir-96 have established roles in neural development. Cross-species validation of miRNA expression was performed using two different in vivo rat drinking models and two different in vitro mouse neural stem cell exposure models. A systems level analysis revealed a remarkable degree of convergence in the top changes seen in all of these data sets, specifically identifying cell death, cell proliferation and cell cycle processes as most consistently affected. Though not necessarily the same molecules, the affected miRNAs within these pathways clearly influence common genes, such as p53 and TNF, which stand out as potential keystone molecules. Lastly, we also examined the potential tissue origins of these biomarkers by quantifying their levels in 15 different tissue types and show that several are highly-enriched in the brain.Conclusions: Collectively, our results suggest that serum miRNA expression changes can directly relate to alterations in CNS structure and function, and may do so through effects on highly specific cellular pathways. [ABSTRACT FROM AUTHOR]

Stress is a major driving force in alcohol use disorders (AUDs). It influences how much one consumes, craving intensity and whether an abstinent individual will return to harmful alcohol consumption. We are most vulnerable to the effects of stress during early development, and exposure to multiple traumatic early life events dramatically increases the risk for AUDs. However, not everyone exposed to early life stress will develop an AUD. The mechanisms determining whether an individual's brain adapts and becomes resilient to the effects of stress or succumbs and is unable to cope with stress remain elusive. Emerging evidence suggests that neuroplastic changes in the nucleus accumbens (NAc) following early life stress underlie the development of AUDs. This review discusses the impact of early life stress on NAc structure and function, how these changes affect cholinergic signaling within the mesolimbic reward pathway and the role nicotinic acetylcholine receptors (nAChRs) play in this process. Understanding the neural pathways and mechanism determining stress resilience or susceptibility will improve our ability to identify individuals susceptible to developing AUDs, formulate cognitive interventions to prevent AUDs in susceptible individuals and to elucidate and enhance potential therapeutic targets, such as the nAChRs, for those struggling to overcome an AUD. [ABSTRACT FROM AUTHOR]

Background: The quantitative, measurable detection of drinking is important for the successful treatment of alcohol misuse in transplantation of patients with alcohol disorders, people living with human immunodeficiency virus that need to adhere to medication, and special occupational hazard offenders, many of whom continually deny drinking. Their initial misconduct usually leads to medical problems associated with drinking, impulsive social behavior, and drunk driving. The accurate identification of alcohol consumption via biochemical tests contributes significantly to the monitoring of drinking behavior. Methods: A systematic review of the current methods used to measure biomarkers of alcohol consumption was conducted using PubMed and Google Scholar databases (2010-2015). The names of the tests have been identified. The methods and publications that correlate between the social instruments and the biochemical tests were further investigated. There is a clear need for assays standardization to ensure the use of these biochemical tests as routine biomarkers. Findings: Alcohol ingestion can be measured using a breath test. Because alcohol is rapidly eliminated from the circulation, the time for detection by this analysis is in the range of hours. Alcohol consumption can alternatively be detected by direct measurement of ethanol concentration in blood or urine. Several markers have been proposed to extend the interval and sensitivities of detection, including ethyl glucuronide and ethyl sulfate in urine, phosphatidylethanol in blood, and ethyl glucuronide and fatty acid ethyl esters in hair, among others. Moreover, there is a need to correlate the indirect biomarker carbohydrate deficient transferrin, which reflects longer lasting consumption of higher amounts of alcohol, with serum α-glutamyl transpeptidase, another long term indirect biomarker that is routinely used and standardized in laboratory medicine. [ABSTRACT FROM AUTHOR]

Introduction: Soft pancreas is one of the most important risk factor for postoperative pancreatic fistula after pancreatoduodenectomy. The aim of this study is to investigate whether pancreatic attenuation index utilized to assess the pancreatic texture with computed tomography can be used to predict the risk of developing a clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy. Methods: We reviewed 76 consecutive patients undergoing pancreatoduodenectomy between 2012 and 2014. The pancreatic attenuation index is found by dividing the pancreas density by the spleen density achieved with non-enhanced computed tomography. The independent predictors of clinically relevant postoperative pancreatic fistula were investigated. Results: Clinically relevant postoperative pancreatic fistula occurred in 13 patients (17.1 %). The group of patients with postoperative pancreatic fistula is compared with the group of patients without postoperative pancreatic fistula in terms of age, gender, body mass index, the American Society of Anesthesiologists (ASA) score, smoking, alcohol consumption, medical comorbidities, preoperative biliary drainage, type of anastomosis, and pancreatic duct size and pancreatic attenuation index. Univariate analyses have shown a significant difference in relation to chronic obstructive pulmonary disease and pancreatic attenuation index. The multivariate analyses showed that only pancreatic attenuation index was associated with a high postoperative pancreatic fistula rate ( P = 0.012). Conclusion: A preoperative non-contrast computed tomography scan evaluating pancreatic attenuation index could help to predict the occurrence of clinically significant postoperative pancreatic fistula after pancreatoduodenectomy. [ABSTRACT FROM AUTHOR]

Alcohol consumption increases the incidence of multiple types of cancer. However, how chronic alcohol consumption affects tumor progression and host survival remains largely unexplored. Using a mouse B16BL6 melanoma model, we studied the effects of chronic alcohol consumption on s.c. tumor growth, iNKT cell antitumor immune response, and host survival. The results indicate that although chronic alcohol consumption inhibits melanoma growth, this does not translate into increased host survival. Immunizing mice with a melanoma cell lysate does not significantly increase the median survival of water-drinking, melanoma-bearing mice, but significantly increases the median survival of alcohol-consuming, melanoma-bearing mice. Even though survival is extended in the alcohol-consuming mice after immunization, the median survival is not different from the immunized mice in the water-drinking group. Immunization with tumor cell lysate combined with α-galatosylceramide activation of iNKT cells significantly increases host survival of both groups of melanoma-bearing mice compared to their respective non-immunized counterparts; however, the median survival of the alcohol-consuming group is significantly lower than that of the water-drinking group. Alcohol consumption increases NKT cells in the thymus and blood and skews NKT cell cytokine profile from Th1 dominant to Th2 dominant in the tumor-bearing mice. In summary, these results indicate that chronic alcohol consumption activates the immune system, which leads to the inhibition of s.c. melanoma growth and enhances the immune response to immunization with melanoma lysate. With tumor progression, alcohol consumption accelerates iNKT cell dysfunction and compromises antitumor immunity, which leads to decreased survival of melanoma-bearing mice. [ABSTRACT FROM AUTHOR]

Alcohol exposure in a clinical population impairs working memory. In order to establish the effects of alcohol on working memory in typical young adults, this study looked at their alcohol consumption behaviours and how they predict working memory. A battery of cognitive tasks and a recreational drug use questionnaire assessed working memory and alcohol consumption of 100 participants. The results revealed that alcohol abstinence predicted set-shifting, verbal executive, phonological loop, spatial and visual working memory performance, which is consistent with current literature. I surmise that the recent use of alcohol plays a role in working memory impairments and offer novel findings that the length of abstinence plays a role in the cognitive recovery of young adults. [ABSTRACT FROM AUTHOR]

Research has shown differences in alcohol use and problems across race/ethnicity. This study examines whether there are differential effects of alcohol use disorder (AUD) symptoms on drinking outcomes across race/ethnicity. Data from 1483 patients admitted to a hospital for treatment of an injury were utilized (19% Black, 45% non-Latino White, and 36% Latino). AUD symptoms and race/ethnicity reported at baseline and their interaction were the predictor variables. Drinking patterns and associated problems measured at the 6- and 12-month follow-up were the outcome variables of interest. Linear regression was the analytic method employed. Endorsement of “spending a great deal of time to obtain, use, or recover from effects of drinking,” “craving,” “failure to fulfill major role obligations,” and “alcohol use in physically hazardous situations” at baseline was associated with greater levels of subsequent alcohol use and alcohol-related problems at both 6- and 12-month follow-ups, regardless of race/ethnicity. Endorsement of “important social, occupational, or recreational activities given up because of drinking” was differentially associated with greater alcohol-related problems at both 6- and 12-month follow-ups dependent on race/ethnicity. Follow-up analyses indicated that this symptom was a significant predictor of alcohol problems among Latino and Black participants, but not non-Latino White participants. Brief interventions targeting these AUD symptoms could increase the effectiveness of brief motivational interventions among different racial/ethnic groups. [ABSTRACT FROM AUTHOR]

This study aims to psychometrically validate the Chilean version of the treatment outcomes profile (TOP), an instrument that can be used by treatment centers to monitor the results of drug and alcohol treatments. Specifically, this study is interested in evaluating the inter-rater reliability, concurrent validity, change sensitivity and discriminant and construct validity of this instrument. The TOP was modified to reflect the Chilean context and then applied in three successive stages: an initial application at the beginning of treatment, a retest after 1 week, and a follow up after a month. The sample was composed of 411 users of different types of drugs who were in treatment centers in the three largest regions of the country. The TOP reliability was greater than .75 for most items. Regarding concurrent validity, all the coefficients were in the expected direction and statistically significant. Change over time, as measured by Cohen's d statistic and the Reliable Change Index, was significant for most items. Users in treatment for less than 3 months showed higher alcohol consumption (odds ratio [OR] = 1.07; 95% confidence interval [95% CI]: 1.01–1.13), poorer psychological health (OR = 0.94; 95% CI: 0.87–1.00), fewer days worked (0.56; 0.95–0.99) and poorer housing conditions (OR = 2.76; 95% CI: 1.22–6.23) than did their counterparts who had more than 3 months of treatment. Researchers extracted six components with eigenvalues greater than one, accounting for 69.0% of the total variance. In general, the Chilean TOP is a reliable and valid mechanism to monitor outcomes of people treated for problems with drug and alcohol abuse in Chile, but further validation work is required in some dimensions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the naturalistic outcomes of parolees and probationers with alcohol and/or opioid problems who were treated with extended-release naltrexone (XR-NTX) to those treated with other medication-assisted therapies or psychosocial treatment only. Methods consisted of using intake and discharge data collected as part of SAMHSA’s Treatment Episode Data Set (TEDS) assessments, controlling for group differences using propensity scores that were based on a range of intake variables. Results showed that patients receiving XR-NTX had longer durations of care (compared to oral naltrexone and psychosocial treatment only) and were more likely to become abstinent (compared to oral naltrexone, buprenorphine/naloxone, and psychosocial treatment only). Findings were similar for the total sample and those with opioid problems. These XR-NTX results were found in the absence of significant differences in rates of self-help participation. No differences were found in employment or arrests in this relatively short time frame. This study documents the real-world effectiveness study of current FDA-approved addiction medications in parolees/probationers and encourages the use of XR-NTX in such a criminal justice population. [ABSTRACT FROM AUTHOR]

Prenatal alcohol exposure (PAE) programs the fetal hypothalamic-pituitaryadrenal (HPA) axis, resulting in HPA dysregulation and hyperresponsiveness to stressors in adulthood. Molecular mechanisms mediating these alterations are not fully understood. Disturbances in one-carbon metabolism, a source of methyl donors for epigenetic processes, contributes to alcoholic liver disease. We assessed whether PAE affects one-carbon metabolism (including Mtr, Mat2a, Mthfr, and Cbs mRNA) and programming of HPA function genes (Nr3c1, Nr3c2, and Slc6a4) in offspring from ethanol-fed (E), pair-fed (PF), and ad libitum-fed control (C) dams. At gestation day 21, plasma total homocysteine and methionine concentrations were higher in E compared with C dams, and E fetuses had higher plasma methionine concentrations and lower whole brain Mtr and Mat2a mRNA compared with C fetuses. In adulthood (55 days), hippocampal Mtr and Cbs mRNA was lower in E compared with C males, whereas Mtr, Mat2a, Mthfr, and Cbs mRNA were higher in E compared with C females. We found lower Nr3c1 mRNA and lower nerve growth factor inducible protein A (NGFI-A) protein in the hippocampus of E compared with PF females, whereas hippocampal Slc6a4 mRNA was higher in E than C males. By contrast, hypothalamic Slc6a4 mRNA was lower in E males and females compared with C offspring. This was accompanied by higher hypothalamic Slc6a4 mean promoter methylation in E compared with PF females. These findings demonstrate that PAE is associated with alterations in one-carbon metabolism and has long-term and region-specific effects on gene expression in the brain. These findings advance our understanding of mechanisms of HPA dysregulation associated with PAE. [ABSTRACT FROM AUTHOR]

Background: Awareness to neurocognitive issues after mild traumatic brain injury (mTBI) is increasing, but currently no imaging markers are available for mTBI. Advanced structural imaging recently showed microstructural tissue changes and axonal injury, mild but likely sufficient to lead to functional deficits. Magnetoencephalography (MEG) has high temporal and spatial resolution, combining structural and electrophysiological information, and can be used to examine brain activation patterns of regions involved with specific tasks. Methods: 16 adults with mTBI and 16 matched controls were submitted to neuropsychological testing (Wechsler Abbreviated Scale of Intelligence (WASI); Conners; Alcohol Use Disorders Identification Test (AUDIT); Generalised Anxiety Disorder Seven-item Scale (GAD-7); Patient Health Questionnaire (PHQ-9); Symptom Checklist and Symptom Severity Score (SCAT2)) and MEG while tested for mental flexibility (Intra-Extra Dimensional set-shifting tasks). Three-dimensional maps were generated using synthetic aperture magnetometry beamforming analyses to identify differences in regional activation and activation times. Reaction times and accuracy between groups were compared using 2×2 mixed analysis of variance. Findings: While accuracy was similar, patients with mTBI reaction time was delayed and sequence of activation of brain regions disorganised, with involvement of extra regions such as the occipital lobes, not used by controls. Examination of activation time showed significant delays in the right insula and left posterior parietal cortex in patients with mTBI. Conclusions: Patients with mTBI showed significant delays in the activation of important areas involved in executive function. Also, more regions of the brain are involved in an apparent compensatory effort. Our study suggests that MEG can detect subtle neural changes associated with cognitive dysfunction and thus, may eventually be useful for capturing and tracking the onset and course of cognitive symptoms associated with mTBI. [ABSTRACT FROM AUTHOR]

Objectives Rigorous tests are not usually applied to determine whether mass media campaigns that promote responsible drinking are useful, that is whether they lead to responsible drinking or not. In two experiments, we investigated the effectiveness of a mass media campaign that runs in Germany since 2009. This campaign used posters, which emphasized negative alcohol-related outcome expectancies and challenged the positive expectancies. Based on models of alcohol use, we investigated the influence of the campaign on alcohol-related outcome expectancies, implicit and explicit attitudes, and drinking intentions. Design In Experiment 1, we investigated alcohol-related outcome expectancies via ratings and response latencies among 81 young adult light drinkers. Employing an affective priming task, Experiment 2 was designed to assess implicit attitudes before and after mass media campaign exposure among 83 young adult light drinkers. In both experiments, the effects of the posters were investigated before and after poster exposure as well as compared to a control group. Results Experiment 1 revealed that the campaign affected only the implicit associations of young adult drinkers, whereas explicit outcome expectancies remained unaffected. Experiment 2 showed that implicit attitudes towards alcohol were turned into more negative ones, but explicit attitudes as well as drinking intentions were not influenced. Conclusions The mass media campaign was deemed effective even though its influence occurred on an implicit level. This research highlights the need for experimental investigations of mass media campaigns. Reasons that the findings were obtained on an implicit but not on an explicit level are discussed. [ABSTRACT FROM AUTHOR]

Objectives Excessive alcohol consumption is a persistent problem in Northern European cultures. Across a 2-week period, we tested the effect of varying message frames, message types, and response measures, in reducing alcohol consumption. Design Three hundred and twenty-three respondents were allocated to a 2 (message frame: gain vs. loss) × 2 (message type: health vs. social) × 2 (response type: engaging vs. refraining) mixed design. Method Binge drinking and units consumed were measured at Time 1 and Time 2 (2 weeks later). Participants read (following Time 1) a gain- or loss-framed message on binging emphasizing either social or health consequences and answered engaging in or refraining from drinking attitude measures. Results No main effects were identified. The key finding was that gain-framed messages, when used in conjunction with engage response measures (an incongruous pairing), were highly effective in reducing alcohol consumption 2 weeks later compared with the other message frame/response measure combinations. Conclusions We suggest that for prevention behaviours, gain-framed messages, when paired with engage response measures, initiate an inconsistency resolution process. Together, our findings emphasize the importance of message frame and response type when seeking to reduce alcohol consumption using persuasive health messages. [ABSTRACT FROM AUTHOR]

The article offers the author's insights on the policy on takeaway dosing of opiate substitute methadone in Victoria. Topics discussed include the incident of overdose deaths in the country that involves takeaway doses of methadone, the effectiveness of opioid substitution treatment, and the involvement of drug toxicity, and use of alcohol and antidepressant in opioid overdose deaths.

Fetal Alcohol Spectrum Disorder (FASD) is a non-diagnostic umbrella term that describes a range of effects that can occur as a result of a mother consuming alcohol during pregnancy (SAMSHA, 2014). Awareness of the need for professionals to become educated on FASD has emerged as a critical topic in the field of social work and child welfare practice specifically. The social work practice response to children and families, in order to be effective, must develop and emerge from an FASD Informed Practice lens - which implies particular knowledge and competencies in practice. This article will highlight the need to recognize FASD as a disabling condition and identify why training and knowledge is essential in order to work effectively with children and families. Further, an educational pathway to FASD informed practice in relation to a broad array of interventions and enabling/supportive approaches relevant to social work theory will be identified. The focus of this paper is to identifying why knowledge and education on FASD is important to social work practice. [ABSTRACT FROM AUTHOR]

Background: Research on alcohol and sexual behaviour has focused on young adults or high-risk groups, showing alcohol use contributing to riskier sexual choices. Adults now in their late thirties have been exposed to heavier drinking norms than previously, raising questions about effects on sexual wellbeing. We examined self-reported use and consequences of alcohol in sexual contexts, and its association with usual drinking pattern at age 38, and also associations of heavy drinking occasion (HDO) frequency with number of sexual partners, sexually transmitted infections (STIs), and terminations of pregnancy (TOPs), from 26–32 and 32–38 years of age. Methods: Members of the Dunedin Study birth cohort answered computer-presented questions about sexual behaviour and outcomes, and interviewer-administered alcohol consumption questions, at age 26, 32 and 38 years. Results: Response level was >90% at each assessment. At 38, drinking before or during sex in the previous year was common (8.2% of men; 14.6% of women reported “usually/always”), and unwanted consequences were reported by 13.5% of men and 11.9% of women, including regretted sex or failure to use contraception or condoms. Frequent heavy drinkers were more likely to “use alcohol to make it easier to have sex” and regret partner choice, particularly women. Heavy drinking frequency was strongly associated with partner numbers for men and women at 32, but only for women at 38. Significantly higher odds of STIs amongst the heaviest drinking men, and TOPs amongst the heaviest drinking women were seen at 32–38. Conclusions: Alcohol involvement in sex continues beyond young adulthood where it has been well documented, and is common at 38. Women appear to be more affected than men, and heavy drinking is associated with poorer outcomes for both. Improving sexual health and wellbeing throughout the life course needs to take account of the role of alcohol in sexual behaviour. [ABSTRACT FROM AUTHOR]

The heavy consumption of ethanol can lead to alcohol use disorders (AUDs) which impact patients, their families, and societies. Yet the genetic and physiological factors that predispose humans to AUDs remain unclear. One hypothesis is that alterations in mitochondrial function modulate neuronal sensitivity to ethanol exposure. Using Drosophila genetics we report that inactivation of the mitochondrial outer membrane translocator protein 18kDa (TSPO), also known as the peripheral benzodiazepine receptor, affects ethanol sedation and tolerance in male flies. Knockdown of dTSPO in adult male neurons results in increased sensitivity to ethanol sedation, and this effect requires the dTSPO depletion-mediated increase in reactive oxygen species (ROS) production and inhibition of caspase activity in fly heads. Systemic loss of dTSPO in male flies blocks the development of tolerance to repeated ethanol exposures, an effect that is not seen when dTSPO is only inactivated in neurons. Female flies are naturally more sensitive to ethanol than males, and female fly heads have strikingly lower levels of dTSPO mRNA than males. Hence, mitochondrial TSPO function plays an important role in ethanol sensitivity and tolerance. Since a large array of benzodiazepine analogues have been developed that interact with the peripheral benzodiazepine receptor, the mitochondrial TSPO might provide an important new target for treating AUDs. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorders are among the mental disorders with the lowest treatment rates. Increasing the treatment rates requires insight on the reasons why patients do not seek treatment. This study examined selfreported reasons for not seeking treatment and their association with alcohol use disorder severity among primary health care patients diagnosed with an alcohol use disorder. Methods: Alcohol use disorders, health service utilization, and reasons for not seeking treatment were assessed via interviews on regionally representative samples of primary care patients from 6 European countries (Italy, Germany, Hungary, Latvia, Poland and Spain, total N = 9,098). Additionally, general practitioners had to fill in a questionnaire assessing their patients' alcohol use and alcohol use disorders. A multinomial logistic regression was performed to investigate the association between reasons for not seeking treatment and alcohol use disorder severity. Results: Of 1,008 patients diagnosed with an alcohol use disorder (via general practitioner or patient interview) in the past 12 months, the majority (N = 810) did not receive treatment and 251 of those gave a reason for not seeking treatment. The most frequent reason was 'lack of problem awareness' (55.3 % of those who responded), the second most common response was 'stigma or shame' (28.6 %), followed by 'encounter barriers' (22.8 %) and 'cope alone' (20.9 %). The results indicated lower probabilities of reporting 'denial' and higher probabilities to report 'encounter barriers' as alcohol use disorders severity increases. However, both trends were discontinued for patients with severe alcohol use disorders. Conclusions: Particularly at lower levels of alcohol use disorder severity, a lack of problem awareness prevents patients from seeking treatment. Routinely alcohol consumption monitoring in primary care practices could help primary and secondary prevention of alcohol use disorders and increase treatment coverage. [ABSTRACT FROM AUTHOR]

The article discusses research on depression and risky alcohol consumption among American Indian and Alaska Native women and their response to screening, brief intervention, and referral to treatment (SBIRT) intervention. Topics include the risks of alcohol-exposed pregnancy (AEP) which can lead to fetal alcohol spectrum disorders, the influence of depression on self-awareness and understanding of personal risk, and a reduction in alcohol use resulting from SBIRT.

Objective To characterize the relationship between body mass index (BMI) and all-cause mortality among adults with hypertension. Methods We conducted a retrospective cohort study of adults with hypertension from The Health Improvement Network primary care research database in the United Kingdom. Mortality rates within each BMI category were compared after adjustment for age, sex, pre existing medical conditions, smoking, alcohol use, and socioeconomic status. Results During a median follow-up period of 8.0 years, 34,354 deaths occurred (8.8%) among the 388,724 study patients. In multivariable analysis that included interaction terms between smoking, heavy alcohol use, preexisting cardiovascular disease and chronic obstructive pulmonary disease (COPD), and BMI category to account for these conditions' association with increased mortality at lower BMI levels, a U-shaped relationship was observed between BMI and mortality, with no difference in mortality in overweight (25.0-29.9 kg/m2) versus normal (18.5-24.9 kg/m2) BMI (risk ratio 1.00, 95% confidence interval 0.95 to 1.04, P = 0.80). In multivariable analysis that used narrower BMI categories, lowest mortality was observed between BMI of 23.0 and 26.9 kg/m2. Conclusions Patients with hypertension who have no history of smoking, heavy alcohol use, cardiovascular disease, or COPD have lowest mortality between BMI of 23.0 and 26.9 kg/m2. [ABSTRACT FROM AUTHOR]

Chronically homeless individuals with alcohol dependence experience severe alcohol-related consequences. It is therefore important to identify factors that might be associated with reduced alcohol-related harm, such as the use of safer-drinking strategies. Whereas effectiveness of safer-drinking strategies has been well-documented among young adults, no studies have explored this topic among more severely affected populations, such as chronically homeless individuals with alcohol dependence. The aims of this study were thus to qualitatively and quantitatively document safer-drinking strategies used in this population. Participants ( N = 31) were currently or formerly chronically homeless individuals with alcohol dependence participating in a pilot study of extended-release naltrexone and harm-reduction counseling. At weeks 0 and 8, research staff provided a list of safer-drinking strategies for participants to endorse. Implementation of endorsed safer-drinking strategies was recorded at the next appointment. At both time points, strategies to buffer the effects of alcohol on the body (e.g., eating prior to and during drinking) were most highly endorsed, followed by changing the manner in which one drinks (e.g., spacing drinks), and reducing alcohol consumption. Quantitative analyses indicated that all participants endorsed safer-drinking strategies, and nearly all strategies were implemented (80–90% at weeks 0 and 8, respectively). These preliminary findings indicate that chronically homeless people with alcohol dependence use strategies to reduce harm associated with their drinking. Larger randomized controlled trials are needed to test whether interventions that teach safer-drinking strategies may reduce overall alcohol-related harm in this population. [ABSTRACT FROM AUTHOR]

Research is limited on the effects of regular substance use on mental health-related outcomes. We used a large nationally representative survey to examine current and future quality of life and risk of psychiatric disorders among past-year regular (weekly) users of alcohol, nicotine, and cannabis. Data on psychiatric disorders and quality of life from two waves (Wave 1 N = 43,093, Wave 2 N = 34,653) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were used to test study aims. In cross-sectional analyses, regular nicotine and cannabis use were associated with higher rates of psychiatric disorder, though regular alcohol use was associated with lower rates of disorders. Prospective analyses found that regular nicotine use predicted onset of anxiety, depressive, and bipolar disorders. Regular alcohol use predicted lower risk of these disorders. Regular cannabis use uniquely predicted the development of bipolar disorder, panic disorder with agoraphobia, and social phobia. Lastly, regular alcohol use predicted improvements in physical and mental health-related quality of life, whereas nicotine predicted deterioration in these outcomes. Regular cannabis use predicted declines in mental, but not physical health. These data add to the literature on the relations between substance use and mental and physical health and suggest increased risk of mental health problems among regular nicotine and cannabis users and better mental and physical health among regular alcohol users. Examination of mechanisms underlying these relationships is needed. [ABSTRACT FROM AUTHOR]

Summary Chronic alcohol consumption negatively affects health, and has additional consequences if consumption occurs during pregnancy as prenatal alcohol exposure adversely affects offspring development. While much is known on the effects of prenatal alcohol exposure in offspring less is known about effects of alcohol in dams. Here, we examine whether chronic alcohol consumption during gestation alters maternal behavior, hippocampal neurogenesis and HPA axis activity in late postpartum female rats compared with nulliparous rats. Rats were assigned to alcohol, pair-fed or ad libitum control treatment groups for 21 days (for pregnant rats, this occurred gestation days 1–21). Maternal behavior was assessed throughout the postpartum period. Twenty-one days after alcohol exposure, we assessed doublecortin (DCX) (an endogenous protein expressed in immature neurons) expression in the dorsal and ventral hippocampus and HPA axis activity. Alcohol consumption during pregnancy reduced nursing and increased self-directed and negative behaviors, but spared licking and grooming behavior. Alcohol consumption increased corticosterone and adrenal mass only in nulliparous females. Surprisingly, alcohol consumption did not alter DCX-expressing cell density. However, postpartum females had fewer DCX-expressing cells (and of these cells more immature proliferating cells but fewer postmitotic cells) than nulliparous females. Collectively, these data suggest that alcohol consumption during pregnancy disrupts maternal care without affecting HPA function or neurogenesis in dams. Conversely, alcohol altered HPA function in nulliparous females only, suggesting that reproductive experience buffers the long-term effects of alcohol on the HPA axis. [ABSTRACT FROM AUTHOR]

Complex regulatory mechanisms control the expression of folate transporters within cells. Liver is the primary reserve of the folate stores within the body. As excessive alcohol consumption or inefficient dietary folate intake are known to create folate deficiency, so therefore the current study was designed to explore various regulatory mechanisms controlling the expression of folate transport in liver cells in conditions of ethanol exposure and folate deficiency. In order to see whether the effects mediated by the treatments are reversible or not, ethanol removal, and folate repletion was done after ethanol exposure and folate deficiency treatment respectively. Folate deficiency resulted an increase, whereas ethanol treatment decreased the folic acid uptake within the cells. The alterations in folic acid uptake were in agreement with the observed changes in the expression of folate transporters. Ethanol exposure resulted an increase in promoter methylation of reduced folate carrier; however, folate deficiency had no effect. The effects produced by ethanol exposure and folate deficiency were found to be reversible in nature as depicted in case of ethanol removal and folate repletion group. Rate of synthesis of folate transporters was found to be increased whereas half lives of mRNA of folate transporters was found to be decreased on folate deficiency treatment and reverse was the case on ethanol treatment. Overall, alteration in the expression of folate transporters under ethanol exposure and folate deficient conditions can be attributed to those regulatory mechanisms which work at the mRNA level. © 2015 BioFactors, 41(4):232-241, 2015 [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is an immense global problem with serious economic and social consequences. Modifiable risk factors for CVD have been identified internationally in adolescents where early intervention programs have the potential to reduce CVD risk on individual and population levels. In developing countries such as Nigeria, little is known about the prevalence of modifiable CVD risk factors among adolescents especially in the rural areas. Methods: This paper reports on a cross-sectional survey of modifiable CVD risk factors among rural adolescents in South-West Nigeria. All 15-18 years old adolescents in all the schools at Ibarapa central local government were approached and all those who assented and consented to participate in the study were involved. A total of 1500 adolescents participated in the study. Measurements of CVD risks factors taken were; smoking, physical activity, alcohol, dietary pattern using a questionnaire developed by authors. Other CVD risk factors such as waist hip ratio and BMI were taken using standardized instruments. Data were analyzed using STATA version 12. Results: Data from 1079 adolescents (56.5 % males and 53.5 % females) were analyzed. Mean age of males was 16.4 ± 1.14 years and mean age for females was 16.29 ± 1.13 years. Adolescents showed clustering of CVD risk factors with about 72 % having between two and four risk factors. A total of 102 clustering patterns were reported. The most common clustering pattern (19.6 %) included high animal lipid and salt diet. Conclusion: There is high level and clustering of CVD risk factors among rural adolescents in Southwest Nigeria. The most common clustering pattern was biased towards dietary factors. The high prevalence of CVD risk factors among rural adolescents in Southwest Nigeria suggests that urgent primary prevention programs are required to prevent the next generation of Nigerians from suffering of CVD. [ABSTRACT FROM AUTHOR]

Background: Increases in alcohol related mortality and morbidity have been reported among older people in England over the last decade. There is, however, evidence that drinking is protective for some health conditions. The validity of this evidence has been questioned due to residual confounding and selection bias. The aim of this study is to clarify which drinking profiles and other demographic characteristics are associated with poor self-rated health among a community-based sample of older adults in England. The study also examines whether drinking designated as being "increasing-risk" or "higher-risk" is associated with poorer self-rated health. Method: This study used data from Wave 0, Wave 1 and Wave 5 of the English Longitudinal Study of Ageing [ELSA]. Logistic regression analysis, was used to examine the association between drinking profiles (based on quantity and frequency of drinking) and self-rated health, adjusting for gender, age, wealth, social class, education, household composition, smoking and body mass index [BMI]. Results: Twenty percent of the sample reported drinking above the recommended level at wave 0. Rates of poor self-rated health were highest among those who had stopped drinking, followed by those who never drank. The rates of poor self-rated health among non-drinkers were significantly higher than the rates of poor self-rated health for any of the groups who reported alcohol consumption. In the adjusted logistic regression models there were no drinking profiles associated with significantly higher rates of poor self-rated health relative to occasional drinkers. Conclusions: Among those who drank alcohol, there was no evidence that any pattern of current alcohol consumption was associated with poor self-rated health, even after adjustment for a wide range of variables. The results associated with the stopped drinking profile indicate improvement in self-rated health can be associated with changes in drinking behaviour. Although several limitations of the study are noted, policy makers may wish to consider how these findings should be translated into drinking guidelines for older adults. [ABSTRACT FROM AUTHOR]

Background: Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are also reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. This study evaluates intra-household associations between alcohol abuse in men, and depression and suicidal attempts in women, in community-based settings of Chennai, India. Methods: This community-based cross-sectional study of chronic disease risk factors and outcomes was conducted in n = 259 households and n = 1053 adults (aged 15 years and above) in rural and urban Chennai. The Alcohol Use Disorder Identification Test (AUDIT) score was used to classify alcohol consumption into 'low-risk', 'harmful', 'hazardous' and 'alcohol dependence' drinking and the Patient Health Questionnaire (PHQ-9) score to classify depression as 'mild', 'moderate', 'moderate-severe' and 'severe'. Multivariate logistic regression models estimated the association of depression in women with men's drinking patterns in the same household. Results: A significant 2.5-fold increase in any depression (PHQ-9 ≥ 5) was observed in men who were 'alcohol-dependent' compared to non-drinkers (OR = 2.53; 95 % CI: 1.26, 5.09). However, there was no association between men's drinking behavior and depression in women of the same household, although suicidal attempts approached a significant dose-response relationship with increasing hazard-level of men's drinking (p=0.08). Conclusion: No significant intra-household association was observed between men's alcohol consumption and women's depression, though an increasing (non-significant) trend was associated with suicidal attempts. Complex relationships between suicidal attempts and depression in women and male abusive drinking require further exploration, with an emphasis on intra-household mechanisms and pathways. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption is a major risk factor for the burden of disease globally. This burden is estimated using Relative Risk (RR) functions for alcohol from meta-analyses that use data from all countries; however, for Russia and surrounding countries, country-specific risk data may need to be used. The objective of this paper is to compare the estimated burden of alcohol consumption calculated using Russia-specific alcohol RRs with the estimated burden of alcohol consumption calculated using alcohol RRs from meta-analyses. Methods: Data for 2012 on drinking indicators were calculated based on the Global Information System on Alcohol and Health. Data for 2012 on mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years (DALYs) lost by cause were obtained by country from the World Health Organization. Alcohol Population-Attributable Fractions (PAFs) were calculated based on a risk modelling methodology from Russia. These PAFs were compared to PAFs calculated using methods applied for all other countries. The 95 % Uncertainty Intervals (UIs) for the alcohol PAFs were calculated using a Monte Carlo-like method. Results: Using Russia-specific alcohol RR functions, in Russia in 2012 alcohol caused an estimated 231,900 deaths (95 % UI: 185,600 to 278,200) (70,800 deaths among women and 161,100 deaths among men) and 13,295,000 DALYs lost (95 % UI: 11,242,000 to 15,348,000) (3,670,000 DALYs lost among women and 9,625,000 DALYs lost among men) among people 0 to 64 years of age. This compares to an estimated 165,600 deaths (95 % UI: 97,200 to 228,100) (29,700 deaths among women and 135,900 deaths among men) and 10,623,000 DALYs lost (95 % UI: 7,265,000 to 13,754,000) (1,783,000 DALYs lost among women and 8,840,000 DALYs lost among men) among people 0 to 64 years of age caused by alcohol when non-Russia-specific alcohol RRs were used. Conclusions: Results indicate that if the Russia-specific RRs are used when estimating the health burden attributable to alcohol consumption in Russia, then the total estimated burden will be more than if RRs from meta-analyses are used. Furthermore, additional research is needed to understand which aspects of the Russian style of drinking cause the most harm. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to examine the social-cognitive and motivational factors associated with pre-drinking based on a model integrating motivational constructs from self-determination theory and belief-based constructs from the theory of planned behaviour. Methods A prospective correlational design was used. Participants ( N = 286; 66.4% female) completed self-report measures of past alcohol consumption, autonomous and controlled forms of motivation from self-determination theory, and attitudes, subjective norms, perceived behavioural control, and behavioural intentions from the theory of planned behaviour at baseline. Participants reported pre-drinking frequency four weeks later. Results Variance-based structural equation modelling showed that the hypothesised model predicted 54 per cent of the variance in pre-drinking intentions at baseline, and 20 per cent of the variance in pre-drinking behaviour at follow-up. Mediation analyses indicated strong, statistically significant effects of autonomous motivation on intentions to pre-drink, partially mediated by attitudes and subjective norms. Intention and perceived behavioural control significantly predicted pre-drinking frequency. Conclusions Results provide support for the hypothesised model relationships. Autonomous motivation, attitude, subjective norm, and perceived behavioural control were influential in forming students' intentions to pre-drink. However, consistent with previous findings, the intention-behaviour relationship was relatively weak. Future research should look to non-intentional and volitional processes that may influence pre-drinking in undergraduates. [ABSTRACT FROM AUTHOR]

Introduction High anxiety sensitivity (AS) has been associated with greater alcohol consumption and alcohol-related problems as well as greater sensitivity to the anxiety-reducing effects of alcohol and greater risky negative reinforcement motives for drinking. The present study reported on the alcohol-related outcomes of a telephone-delivered cognitive behavioral treatment (CBT) designed to reduce high AS. Methods Eighty individuals with high AS ( M age = 36 years; 79% women; 76% Caucasian) seeking treatment for their AS-related concerns participated in the study and were randomly assigned to an eight week telephone CBT program or a waiting list control. Participants completed measures of drinking motives and problem drinking at pre- and post-treatment. Results Multilevel modeling showed that the treatment was successful in reducing AS. The treatment also resulted in specific reductions in drinking to cope with anxiety motives as well as physical alcohol-related problems. Mediated moderation analyses showed treatment-related changes in AS mediated changes in drinking to cope with anxiety motives. Changes in drinking to cope with anxiety motives mediated changes in physical alcohol-related problems. Conclusions Results of the present study suggest that an AS-targeted intervention may have implications for reducing risky alcohol use cognitions and behaviors. Further research is needed in a sample of problem drinkers. [ABSTRACT FROM AUTHOR]

Introduction College student drinkers have the propensity to engage in heavy alcohol consumption. These consumption patterns can be problematic given the well-established relationship between heavy drinking and negative consequences of alcohol consumption. Though the research on college student drinking is abundant, much of the work conducted has been with Caucasian samples and less so with African American samples or at Historically Black Colleges and Universities (HBCUs). Methods The current paper assessed the internal reliability and concurrent validity of two popular measures of alcohol related negative consequences (CAPS-r and YAACQ) and a measure of drinking motives (DMQ-R) within a HBCU sample. Results Total scores for the CAPS-r and YAACQ and all five subscales of the DMQ-R were internally reliable as determined by Cronbach's alpha. Correlations and regressions established concurrent validity for both measures of negative consequences as well as the subscales for the DMQ-R. Conclusions Findings support the use of these measures in the assessment of negative consequences and motivations for alcohol consumption within a HBCU population. [ABSTRACT FROM AUTHOR]

Although the personality trait of urgency has been linked to problem gambling, less is known about psychological mechanisms that mediate the relationship between urgency and problem gambling. One individual variable of potential relevance to impulsivity and addictive disorders is age. The aims of this study were to examine: (i) a theoretical model associating urgency and gambling problems, (ii) the mediating effects of decision-making processes (operationalized as preference for small/immediate rewards and lower levels of deliberative decision-making); and (iii) age differences in these relationships. Participants comprised 986 students (64% male; mean age = 19.51 years; SD = 2.30) divided into three groups: 16–17 years, 18–21 years, and 22–25 years. All participants completed measures of urgency, problem gambling, and a delay-discounting questionnaire involving choices between a smaller amount of money received immediately and a larger amount of money received later. Participants were also asked to reflect on their decision-making process. Compared to those aged 16–17 years and 22–25 years, participants aged 18–21 years had a higher level of gambling problems and decreased scores on lower levels of deliberative decision-making. Higher levels of urgency were associated with higher levels of gambling problems. The association was mediated by a lower level of deliberative decision-making and preference for an immediate/small reward. A distinct pathway was observed for lower levels of deliberative decision-making. Young people who tend to act rashly in response to extreme moods, had lower levels of deliberative decision-making, that in turn were positively related to gambling problems. This study highlights unique decision-making pathways through which urgency trait may operate, suggesting that those developing prevention and/or treatment strategies may want to consider the model's variables, including urgency, delay discounting, and deliberative decision-making. [ABSTRACT FROM AUTHOR]

Introduction Heavy drinking during adolescence is associated with increased reactivity to alcohol related stimuli and to differential neural development. Alcohol cue reactivity has been widely studied among adults with alcohol use disorders, but little is known about the neural substrates of cue reactivity in adolescent drinkers. The current study aimed to identify changes in blood-oxygen level dependent (BOLD) signal during a cue reactivity task pre- and post-monitored abstinence from alcohol. Method Demographically matched adolescents (16.0–18.9 years, 54% female) with histories of heavy episodic drinking (HD; n = 22) and light or non-drinking control teens (CON; n = 16) were recruited to participate in a month-long study. All participants completed a functional Magnetic Resonance Imaging (fMRI) scan with an alcohol cue reactivity task and substance use assessments at baseline and after 28 days of monitored abstinence from alcohol and drugs (i.e., urine toxicology testing every 48–72 h). Repeated-measure analysis of variance (ANOVA) examined main effects of group, time, and group × time interactions on BOLD signal response in regions of interest defined by functional differences at baseline. Results The HD group exhibited greater ( p < .01) BOLD activation than CON to alcohol cues relative to neutral cues in all regions of interest (ROIs; bilateral striatum/globus pallidus, left anterior cingulate, bilateral cerebellum, and parahippocampal gyrus extending to the thalamus/substantia nigra) across time points. Group × time effects showed that HD exhibited greater BOLD activation to alcohol cues than CON at baseline in left anterior cingulate cortex and in the right cerebellar region, but these decreased to non-significance after one month of monitored abstinence. Conclusions In all ROIs examined, HD exhibited greater BOLD response than CON to alcohol relative to neutral beverage picture cues at baseline, indicating heightened cue reactivity to alcohol cues in heavy drinking adolescents prior to the onset of any alcohol use diagnosis. Across the majority of these brain regions, differences in BOLD response were no longer apparent following a month of abstinence, suggesting a decrease in alcohol cue reactivity among adolescent non-dependent heavy drinkers as a consequence of abstaining from alcohol. These results highlight the malleability of adolescent brain function despite no formal intervention targeting cue reactivity. Increased understanding of the neural underpinnings of cue reactivity could have implications for prevention and intervention strategies in adolescent heavy alcohol users. [ABSTRACT FROM AUTHOR]

Parental communications about alcohol can have a significant impact on college students' alcohol use; however, it is unclear what types of communication may be most beneficial for reducing alcohol risk, particularly among students who have already initiated alcohol use. The present research examines differences in alcohol use and employment of drinking protective behavioral strategies between pre-college matriculation high school seniors receiving predominantly abstinence parent messaging and students primarily receiving harm-reduction parent messaging. Students who identified as light drinkers were recruited during their last month in high school and completed an online assessment of alcohol use and parent alcohol communication. Analyses revealed that, in comparison to light drinkers who primarily received harm-reduction messaging from parents, light drinkers who received more abstinence messaging reported less frequent alcohol use, lower peak alcohol consumption, and greater use of protective drinking strategies aimed at changing the way they drank and avoiding serious hazards associated with drinking. Findings from this study underscore the utility of messages related to abstinence even for parents who are aware that their children have had previous experiences with alcohol and highlight the need for longitudinal research assessing additional mechanisms associated with message efficacy among light, moderate and heavy drinking students transitioning to college. [ABSTRACT FROM AUTHOR]

Background: The risk of renal damage in patients with high alcohol consumption is controversial. The objective of this meta-analysis was to evaluate the associations between high alcohol consumption and progression of kidney damage including chronic kidney disease (CKD), end-stage renal disease (ESRD) and proteinuria. Methods: A literature search was performed using MEDLINE, EMBASE and Cochrane Databases from inception through August 2014 to identify studies investigating the association between high alcohol consumption and CKD, ESRD or proteinuria. Studies that reported odds ratios, relative risks or hazard ratios comparing the risk of CKD, ESRD or proteinuria in patients consuming high amount of alcohol versus those who did not consume alcohol were included. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results: Twenty studies with 292 431 patients were included in our analysis to assess the associations between high alcohol consumption and progression of kidney damage. The pooled RRs of CKD, proteinuria and ESRD in patients with high alcohol consumption were 0.83 (95% CI: 0.71-0.98), 0.85 (95% CI: 0.62- 1.17) and 1.00 (95% CI: 0.55-1.82), respectively. Post hoc analysis assessing the sex-specific association between high alcohol consumption and CKD demonstrated pooled RRs of 0.72 (95% CI: 0.57-0.90) in males and 0.78 (95% CI: 0.58-1.03) in females. Conclusions: Our study demonstrates an inverse association between high alcohol consumption and risk for developing CKD in males. There is no significant association between high alcohol consumption and the risk for developing proteinuria or ESRD. [ABSTRACT FROM AUTHOR]

Background: Evidence that alcohol consumption is inversely associated with long-term coronary artery disease (CAD) mortality independent of genetic and early life environmental factors is lacking. Objective: We evaluated whether alcohol consumption was prospectively associated with CAD mortality risk independent of familial factors. Design: In total, 843 male twins (396 pairs and 51 unpaired twins) aged 42-55 y (mean: 48 y) without baseline CAD reported beer, wine, and spirits consumption at baseline (1969-1973) and were followed up to 2010 in the prospective National Heart, Lung, and Blood Institute Twin Study. Data on usual alcohol consumption over the past year were collected. Outcome was time to event, where the primary event was death from CAD and secondary events were death from cardiovascular disease and all causes. HRs were estimated by using frailty survival models, both overall and within-pair. Results: There were 129 CAD deaths and 219 cardiovascular deaths during 41 y of follow-up. In the whole cohort, after adjustment for caloric intake and cardiovascular disease risk factors, overall HRs per 10-g increment in alcohol intake were 0.94 (95% CI: 0.89, 0.98) for CAD and 0.97 (95% CI: 0.93, 1.00) for cardiovascular mortality. The within-pair adjusted HRs for a twin with 10-g higher daily alcohol consumption than his co-twin were 0.90 (95% CI: 0.84, 0.97) for CAD and 0.95 (95% CI: 0.90, 1.00) for cardiovascular disease mortality in the cohort pooled by zygosity, which remained similar among monozygotic twins. All 3 beverage types tended to be associated with lower CAD mortality risk within-pair to a similar degree. Alcohol consumption was not associated with total mortality risk overall or within-pair. Conclusion: Higher usual alcohol consumption is associated with lower CAD mortality risk, independent of germline and early life environment and adulthood experience shared among twins, supporting a possible causal role of alcohol consumption in lowering CAD death risk. This trial was registered at clinicaltrials.gov as NCT00005124. [ABSTRACT FROM AUTHOR]

It is well established that alcohol-related harm is disproportionately prevalent among low socioeconomic status (SES) drinkers despite their lower consumption of alcohol, but epidemiological investigations have been unable to explain those links causally. I argue that this inability arises from the consumption-as-harm proposition, which proceeds from the assumption that alcohol acts in stable and predictable ways. In this model, “social factors” have been associated with increasing or decreasing harms by modulating consumption, but their other transformations of alcohol effects have not been registered. Stepping away from this model, I deploy the notion of the causal assemblage, which was developed in science and technology studies and has recently been applied in studies of alcohol and other drug (AOD) use. I analyze data from interviews with a convenience sample of low SES young adult drinkers and develop case studies of drinking events. I demonstrate that, in the case studies, alcohol-related harms are co-produced by troubled family and ethnic patterns of relations to alcohol and associated memories, enforcement of gender norms in public spaces, and a lack of access to private drinking settings. These insights are significant because they make visible the social forces co-producing alcohol-related harms and demonstrate the limitations of a model of causality commonly deployed in AOD studies. [ABSTRACT FROM PUBLISHER]

This article discusses the role of public health in alcohol licensing in the UK, with a particular focus on the implementation of national legislation and guidance in local regulatory environments. It identifies a number of practical and theoretical challenges through an analysis of historical trends in licensing practice, recent policy developments, and key licensing decisions and appeals. There are strong historical precedents for a focus on strategic harm reduction in UK licensing; however, because licensing primarily addresses the proximate effects of retail, the incorporation of health considerations presents novel difficulties. These center on the identification and deployment of data, the attribution of population-level harms to individual outlets, alcohol industry resistance, local authority risk aversion, and epistemological tensions between public health and licensing. The conclusion proposes that for public health perspectives to gain traction in the licensing environment, clear and realistic goals need to be established, research needs to emphasize local data, and there needs to be a better understanding of the approaches to evidence, knowledge, and decision making that characterize licensing and other local regulatory services. [ABSTRACT FROM PUBLISHER]

This article examines how the issue of alcohol use has been problematized using past and current World Health Organization reports and associated publications as illustrations. The 2010 Global Strategy to Reduce the Harmful Use of Alcohol serves as a salient example. Applying an approach to policy analysis called “What’s the Problem Represented to be?” this article highlights grounding presuppositions in selected alcohol policies and policy proposals. Particular attention is directed to the genesis and continually evolving and changing key concept “alcohol problems” (or “alcohol-related problems” and other variations). The objective is to raise questions about the implications of public health frameworks of meaning around alcohol policy for how governing takes place and for governed subjects. On the basis of this analysis, this article signals the importance of interrogating the meaning and role of taken-for-granted categories of analysis. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the impact of alcohol on the reproductive hormones, oxidative stress and semen parameters. Design: This is an experimental animal study. Materials and methods: Adult male Sprague-Dawley rats weighing between 170 and 200 g received 30% v/v ethanol at a concentration of 2 g/kg body weight for a period of 4 weeks, 8 weeks and 16 weeks. Parameters tested include: testosterone, estrogen, luteinizing hormone (LH), follicle stimulating hormone (FSH), gonadotropin hormone releasing hormone (GnRH), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), sperm count and sperm motility. Results: After the 4 week study, there was a significant decrease (p < 0.05) in estrogen levels, sperm count and sperm motility. Testosterone levels also decreased while MDA levels increased significantly. After the 8 week study, testosterone levels decreased significantly, LH and FSH also decreased but GnRH levels increased significantly. MDA and SOD levels increased significantly but sperm count and sperm motility decreased significantly compared to controls. After the 16 week study, testosterone and GnRH levels decreased significantly compared to controls. MDA levels increased significantly while sperm count and motility decreased significantly. Conclusion: Acute and chronic administration of alcohol depletes testosterone levels, increases oxidative stress and decreases semen parameters. This impact of alcohol on testosterone levels is mediated by direct testicular toxicity and by altering the hormone feedback system in the pituitary gland and the hypothalamus. [ABSTRACT FROM AUTHOR]

This research extends the growing literature about online alcohol prevention programs for first-year college students. Two independent randomized control studies, conducted at separate universities, evaluated the short-term effectiveness of Alcohol-Wise, an online alcohol prevention program not previously studied. It was hypothesized the prevention program would increase alcohol knowledge and reduce alcohol consumption, including high-risk alcohol-related behaviors, among first-year college students. At both universities, the intervention significantly increased alcohol-related knowledge. At one university, the prevention program also significantly reduced alcohol consumption and high-risk drinking behaviors, such as playing drinking games, heavy drinking, and extreme ritualistic alcohol consumption. Implications for the use of online alcohol prevention programs and student affairs are discussed. [ABSTRACT FROM AUTHOR]