Distinguishing primary and secondary disorders in studies of alcohol dependence and depression

This paper is concerned with the relationship between alcohol dependence and depression, and more specifically with the issue of which criteria should be used in distinguishing primary and secondary disorders. The data presented indicate that borderline or subclinical depression frequently precedes the onset of alcohol dependence. This finding is discussed in terms of previous studies, which show that depression is generally secondary to alcohol dependence. Such studies have focused almost exclusively on severe forms of depressive disorder, and, it is argued, used inappropriate criteria to designate the onset of alcohol dependence (e.g. withdrawal phenomena and alcohol-related problems). In contrast to previous studies, the present paper indicates that subclinical episodes of depression should be assessed by clinicians as possible predisposing factors in the development of alcohol dependence. In addition, it is argued that research designed to establish whether alcohol dependence is a primary or secondary disorder when it occurs in the presence of an accompanying psychiatric disorder should measure onset in terms of changes in behaviour such as giving-up existing interests in order to spend time drinking and consuming more alcohol than former companions.

Measuring factors that influence the response of medical practitioners and social workers to problem drinkers: a pilot study

It is increasingly recognized that factors such as professionals' empathy, willingness to intervene, self-efficacy and role legitimacy influence the initial engagement of clients into treatment and the nature of any subsequent therapeutic relationship. These factors are difficult to measure using questionnaires, and for this reason qualitative research techniques are frequently used in this field of inquiry. The present methodological study is based on in-depth interviews conducted with 16 medical practitioners and 12 social workers, and attempts to overcome one of the main limitations associated with qualitative data-that is, the difficulty of reducing such complex material to a numerical value suitable for quantitative analysis. The interview technique and rating system described were most successful in achieving this in the case of self-efficacy and least successful in the case of empathy. Possible reasons for this are discussed. It is concluded that the technique described has the potential to elicit detailed data concerning the interactions of medical practitioners and social workers with problem drinkers, and that this material can be reliably rated in a manner that is not unduly time-consuming and burdensome to researchers.

Data collection in studies of life events and the harmful use of alcohol

Although stressful life events have been found to play a role in the development of a number of physical and psychiatric disorders, the research into their influence upon the harmful use of alcohol has been inconsistent. The published studies are reviewed in terms of the methods employed in data collection. It is concluded that a true test of the hypothesis that life events play an aetiological role in the development of the harmful use of alcohol has yet to be carried out, since valid and reliable techniques have not been used in assessing both life events and the onset of harmful use in any one study. Alternative procedures are suggested for use in future research.

Drug ‘hot-spots’, alcohol availability and violence

Ecological studies have shown a relationship between alcohol outlet densities and violence and between the location of crimes related to illicit drug use (so-called 'hot spots') and violence. To date, no study has compared the effects of alcohol outlets and drug hot spots on rates of violence. The present study examined this relationship in the City of Houston, Texas. An ecological study design was employed, using a sample of 439 census tracts from Houston, Texas. Neighborhood socio-structural, alcohol outlet density, drug crime density and violent crime density data were collected from archival sources and analyzed using multivariate and spatial statistics. Using ordinary least-squares analysis, the neighborhood socio-structural covariates explained about 40% of the variability in violent crime. Adding alcohol outlet density in the target census tracts explained an additional 6%, while the addition of drug crime density explained an additional 32%. In the final model, that controlled for the effects of autocorrelated error, both drug crime density in the target and adjacent census tracts remained significant predictors of violent crime, while only off-sale density in the target census tract remained significant in the model. The findings indicate that drug crime density explained a greater amount of variance in violent crime rates than the alcohol outlet density. The methodological and policy implications of these findings are discussed, along with the shortcomings of the analysis presented.

EVALUATION OF THE TEXAS 0.08 BAC LAW

AIMS

The purpose of the present study was to assess the effects on alcohol-involved traffic crashes and fatalities of the 0.08 blood alcohol concentration (BAC) per se law introduced in the state of Texas in 1999.

METHOD

Data pertaining to alcohol-involved traffic crashes and fatalities were extracted from two datasets: the Fatality Analysis Reporting System (FARS) compiled by the National Highway Traffic Safety Administration (for the period January 1995-September 2002), and the Texas Department of Public Safety (DPS) reports of Alcohol Related Motor Vehicle Traffic Accidents and Casualties (for the period January 1995-December 2000). The data were analysed using time-series methods (ARIMA routines). The effects of the law on all drivers were assessed, along with the effects among gender, racial, and age subgroups and crash location (urban vs rural).

RESULTS

Separate time-series analyses were conducted with all alcohol-involved and fatal alcohol-involved crashes from the DPS dataset and fatal alcohol-involved crashes from the FARS dataset as the outcome variables. None of the effects for either the total sample or any of the subgroups analysed was statistically significant (this was true of both the FARS and DPS datasets).

CONCLUSIONS

While there is a growing body of evidence that indicates that 0.08 BAC laws can be effective in reducing alcohol-involved traffic accidents and fatalities, the present study shows that this was not the case in Texas. Future research should move beyond the simple question of whether or not 0.08 BAC laws 'work' and instead explore in more detail the conditions, such as publicity and enforcement, under which the law does or does not contribute to a decline in alcohol-involved accidents and fatalities.

ALCOHOL OUTLET DENSITY AND VIOLENCE: A GEOSPATIAL ANALYSIS

AIMS

To examine the relationship between alcohol outlet density and violent crime controlling for neighbourhood sociostructural characteristics and the effects of spatially autocorrelated error.

DESIGN

The sample for this ecologic study comprised 188 census tracts from the City of Austin, Texas and 263 tracts from the City of San Antonio, Texas. Data pertaining to neighbourhood social structure, alcohol density and violent crime were collected from archival sources, and analysed using bivariate, multivariate and geospatial analyses.

RESULTS

Using ordinary least squares analysis, the neighbourhood sociostructural covariates explained close to 59% of the variability in violent crime rates in Austin and close to 39% in San Antonio. Adding alcohol outlet density in the target and adjacent census tracts improved the explanatory power of both models. Alcohol outlet density in the target census tract remained a significant predictor of violent crime rates in both cities when the effects of autocorrelated error were controlled for. In Austin, the effects of alcohol outlet density in the adjacent census tracts also remained significant. The final model explains 71% of the variance in violent crime in Austin and 56% in San Antonio.

CONCLUSIONS

The findings show a clear association between alcohol outlet density and violence, and suggest that the issues of alcohol availability and access are fundamental to the prevention of alcohol-related problems within communities.

Implications of systems dynamic models and control theory for environmental approaches to the prevention of alcohol- and other drug use-related problems

The approach described in this article is premised on the idea that drug and alcohol use-related problems are heterogeneously distributed with respect to population and geography, and therefore, are essentially local problems. More specifically, it is argued that viewing a local community as an interacting set of systems that support or buffer the occurrence of specific substance misuse outcomes, opens up to research two important prospects. The first of these involves creating adequate systems models that can capture the primary community structures and relationships that support public health problems such as alcohol and drug misuse and related outcomes. The second entails rationally testing control strategies that have the potential to moderate or reduce these problems. Understanding and controlling complex dynamic systems models nowadays pervades all scientific disciplines, and it is to research in areas such as biology, ecology, engineering, computer sciences, and mathematics that researchers in the field of addictions must turn to in order to better study the complexity that confronts them as they try to understand and prevent problems resulting from alcohol and drug use and misuse. Here we set out what such a systems-based understanding of alcohol- and drug use-related problems will require and discuss its implications for public policy and prevention programming.

Co-morbidity and treatment needs among nursing home residents receiving alcohol and drug treatment

This study profiles nursing home residents receiving alcohol and drug treatment, describing their sociodemographic, health, and treatment characteristics. We analyzed 3,662 admission assessments in the Minimum Data Set for people receiving alcohol/drug treatment from June, 1998 through September, 2000. These residents were likely to be male and under age 50. More than half were White and 29 percent were African American. Typically, these residents were not physically or cognitively impaired. However, more than 39 percent had unstable health patterns and almost 21 percent had HIV disease. Thirty-eight percent had a history of mental health conditions, with 24 percent having depression and almost 18 percent having schizophrenia. At least 75 percent received no psychological therapy in the previous 7 days and a majority did not receive antipsychotic, antianxiety, or antidepressant medications. These analyses indicate that most recently admitted residents receiving alcohol/drug treatment did not receive mental health therapy in nursing homes.

IL-25 induces IL-4, IL-5, and IL-13 and Th2-associated pathologies in vivo

We have characterized a cytokine produced by Th2 cells, designated as IL-25. Infusion of mice with IL-25 induced IL-4, IL-5, and IL-13 gene expression. The induction of these cytokines resulted in Th2-like responses marked by increased serum IgE, IgG(1), and IgA levels, blood eosinophilia, and pathological changes in the lungs and digestive tract that included eosinophilic infiltrates, increased mucus production, and epithelial cell hyperplasia/hypertrophy. In addition, our studies show that IL-25 induces Th2-type cytokine production by accessory cells that are MHC class II(high), CD11c(dull), and lineage(-). These results suggest that IL-25, derived from Th2 T cells, is capable of amplifying allergic type inflammatory responses by its actions on other cell types.

Spatial dynamics of alcohol availability, neighborhood structure and violent crime

OBJECTIVE

This study examined the relationship between neighborhood social structure, alcohol outlet densities and violent crime in Camden, New Jersey.

METHOD

Data pertaining to neighborhood social structure, violent crime and alcohol density were collected for 98 block groups, and analyzed using bivariate, multivariate and spatial analyses.

RESULTS

Each type of analysis showed that those areas with high alcohol outlet densities experienced more violent crime than low-density areas, after controlling for neighborhood social structure. In the multivariate regression analysis, alcohol outlet densities explained close to one fifth of the variability in violent crime rates across block groups--more than any one of the neighborhood structural variables included in the analysis. These findings were replicated in the spatial analysis, which also showed that alcohol outlet densities contributed significantly to violent crime within target block groups but not in adjacent block groups.

CONCLUSIONS

High alcohol outlet density is associated with high rates of violent crime in this urban community. Spatial analysis suggests that alcohol outlets elevate the rate of violent crime within the immediate neighborhood context, not in surrounding neighborhoods.

Human thymic stromal lymphopoietin preferentially stimulates myeloid cells

The sequence of a novel hemopoietic cytokine was discovered in a computational screen of genomic databases, and its homology to mouse thymic stromal lymphopoietin (TSLP) suggests that it is the human orthologue. Human TSLP is proposed to signal through a heterodimeric receptor complex that consists of a new member of the hemopoietin family termed human TSLP receptor and the IL-7R alpha-chain. Cells transfected with both receptor subunits proliferated in response to purified, recombinant human TSLP, with induced phosphorylation of Stat3 and Stat5. Human TSLPR and IL-7Ralpha are principally coexpressed on monocytes and dendritic cell populations and to a much lesser extent on various lymphoid cells. In accord, we find that human TSLP functions mainly on myeloid cells; it induces the release of T cell-attracting chemokines from monocytes and, in particular, enhances the maturation of CD11c(+) dendritic cells, as evidenced by the strong induction of the costimulatory molecules CD40 and CD80 and the enhanced capacity to elicit proliferation of naive T cells.

Ubiquitous transgenic expression of the IL-23 subunit p19 induces multiorgan inflammation, runting, infertility, and premature death

p19, a molecule structurally related to IL-6, G-CSF, and the p35 subunit of IL-12, is a subunit of the recently discovered cytokine IL-23. Here we show that expression of p19 in multiple tissues of transgenic mice induced a striking phenotype characterized by runting, systemic inflammation, infertility, and death before 3 mo of age. Founder animals had infiltrates of lymphocytes and macrophages in skin, lung, liver, pancreas, and the digestive tract and were anemic. The serum concentrations of the proinflammatory cytokines TNF-alpha and IL-1 were elevated, and the number of circulating neutrophils was increased. In addition, ubiquitous expression of p19 resulted in constitutive expression of acute phase proteins in the liver. Surprisingly, liver-specific expression of p19 failed to reproduce any of these abnormalities, suggesting specific requirements for production of biologically active p19. Bone marrow transfer experiments showed that expression of p19 by hemopoietic cells alone recapitulated the phenotype induced by its widespread expression, pointing to hemopoietic cells as the source of biologically active p19. These findings indicate that p19 shares biological properties with IL-6, IL-12, and G-CSF and that cell-specific expression is required for its biological activity.

Using social indicators to inform community drug and alcohol prevention policy

In recent years, the federal government has begun to require state agencies to allocate drug prevention resources according to the needs of local communities. The methods by which this is to be accomplished have not been described, and most published social indicator studies in the field of drug abuse research have used county-level data which are too insensitive to local needs to be of use in resource allocation decisions. The present study describes a needs assessment in drug abuse prevention in the state of New Jersey using municipal-level social indicator data. In addition, it examines the extent to which the resource allocation of one state prevention agency can be predicted by the municipal-level social indicators. Thirty-six social indicators pertaining to 508 municipalities were used in the study, and data were analyzed using principal component analysis and hierarchical regression analysis. Five factors were extracted from the principal component analysis, two of which clearly describe "high risk" municipalities and one of which clearly describes "low risk" municipalities. The regression analysis showed that these factors explained very little of the variance in the state agency's drug prevention spending. The study shows that social indicators can be used to distinguish between different levels of need for drug prevention services at a municipal level, and that these data can be used to inform decisions concerning resource allocation.

Violent crime and alcohol availability: relationships in an urban community

The relationship between violent crime, neighborhood sociodemographic characteristics, and alcohol outlet densities in Newark, New Jersey is reported, thus extending previous research of municipalities at more refined levels of analysis. Alcohol outlet densities were significant predictors in regression models, but rates of violent crime were better predicted in larger units (R2 = .673 for the census tract level vs. .543 at the census block group level). Alcohol outlet densities, however, were more predictive of violent crime at smaller units of analysis (change in R2 with the addition of alcohol outlet densities was .194 at the census tract level vs. .278 at the census block group level). Findings suggest that alcohol outlets represent a form of "undesirable land use" in urban neighborhoods that are a manifestation of increasingly concentrated economic disadvantage in the United States.

Alcohol availability and domestic violence

The purpose of this study was to examine the relationship among sociodemographic variables, alcohol outlet density, and rate of domestic violence in New Jersey. Data were obtained for the 223 largest municipalities in the state and were examined using factor analysis and bivariate and multivariate analyses. Three sociodemographic factors were extracted through factor analysis. These explained 58% of the variance among municipalities in rates of domestic violence. One factor--termed social disadvantage--explained the greatest amount of unique variance (42%). Alcohol outlet density added nothing to the sociodemographic model and did not interact with any of the three sociodemographic factors. The findings show that, in the state of New Jersey, higher levels of alcohol outlet density are not geographically associated with higher rates of domestic violence. These findings may be due to limitations in the data sets employed in the study, limitations of the macrolevel analysis employed, and/or the complex nature of the relationship between alcohol use and domestic violence.

The irrelevance of evidence in the development of school-based drug prevention policy, 1986-1996

This article examines development in school-based drug prevention policy and programming since the Anti-Drug Abuse Act of 1986. Using data from national surveys and evaluations of school-based programs, it argues, first, that there was really no need for a massive infusion of money into school-based drug prevention in the late 1980s, and, second, that there was little or no evidence to indicate that a "new generation" of effective programs, based on the so-called social influence model, was emerging at this time. Despite the infusion of resources into school-based prevention efforts, adolescent drug use has risen in recent years. Moreover, evaluations continue to show that the effectiveness of social influence programs is very much in the eye of the beholder. Fundamental questions need to be asked of school-based drug prevention--just as they should be asked of other key components of our current drug control policy.

Risk of assaultive violence and alcohol availability in New Jersey

OBJECTIVES

This study examined the relationship between rate of assaultive violence and density of alcohol outlets in New Jersey.

METHODS

Data pertaining to assaultive violence, alcohol outlet density, and sociodemographic factors were obtained from municipalities in New Jersey (n = 223) and assessed through bivariate and multivariate analyses.

RESULTS

Sociodemographic factors accounted for 70% (R(2)=.70) of the variance in the rate of assaultive violence. Outlet density did not add significantly to the explained variance of this model.

CONCLUSIONS

In New Jersey, alcohol outlet density is not geographically associated with higher rates of violence. Alternative methodological and analytic techniques are required to better specify the relationship between alcohol availability and violence.

The concentration of liquor outlets in an economically disadvantaged city in the northeastern United States

This study reports data from a mapping analysis designed to assess the extent to which liquor outlets concentrate in certain neighborhoods within one economically disadvantaged midsized city in New Jersey. Four neighborhoods, which occupy one-quarter of the residential land mass of the city and which are home to one-quarter of its population, were found to contain over half of its retail liquor outlets. Three of these neighborhoods are very poor and have large minority populations. The neighborhood with the highest concentration of outlets, however, has one of the lowest levels of poverty in the city and is ethnically quite diverse.

HNMP-1: a novel hematopoietic and neural membrane protein differentially regulated in neural development and injury

The hnmp-1 (hematopoietic neural membrane protein) gene encodes a protein with striking similarity to the tetra-transmembrane-spanning protein encoded by pmp22. hnmp-1 was cloned from an elutriated human monocyte library and is expressed in various human hematopoietic and lymphoid lineages as well as adult mouse spleen and thymus. In the mouse nervous system, HNMP-1 mRNA is temporally expressed by Schwann cells during sciatic nerve myelination. Dorsal root ganglia sensory and spinal cord alpha-motoneurons acquire HNMP-1 protein selectively throughout development. In the fiber tracts of the spinal cord and in sciatic nerve, HNMP-1 protein is axon-associated. Additionally a rapid and sustained level of HNMP-1 expression is observed in response to acute PNS injury. HNMP-1 is constituitively induced in sciatic nerve of Trembler J mice, which are mutant for pmp22 and have a demyelinating/hypomyelinating phenotype. The expression pattern of HNMP-1 suggests a possible role for this molecule during active myelination.

Identification of an oncogenic form of the thrombopoietin receptor MPL using retrovirus-mediated gene transfer

Thrombopoietin and its receptor (MPL) are important regulators of megakaryopoiesis. We have identified an activating mutation of MPL using a combination of a retrovirus-mediated gene transfer and polymerase chain reaction-driven random mutagenesis. This point mutation causes a single amino acid substitution from Ser498 to Asn498 in the transmembrane region and abrogates factor-dependency of all interleukin-3-dependent cell lines tested. Murine interleukin-3-dependent Ba/F3 cells expressing the mutated but not the normal form of MPL were tumorigenic when transduced into syngeneic mice. Analysis of intracellular signaling pathways indicated that the mutant MPL protein constitutively activated two distinct signaling pathways, SHC-Raf-MAPK and JAK2-STAT3/STAT5.

Identification through bioinformatics of cDNAs encoding human thymic shared Ag-1/stem cell Ag-2. A new member of the human Ly-6 family

The Ly-6 family of cell surface molecules includes many members that have been characterized in the mouse. Until recently, very few Ly-6 family members had been described in the human. A significant development with important implications for novel gene discovery has been the growth of the public Expressed Sequence Tag (EST) database. Here we report that, through the application of bioinformatics analysis to the dbEST database, we obtained the sequence of human TSA-1/SCA-2, a new member of the human Ly-6 family. In addition, we identified full-length clones encoding this molecule as well as expression data in various tissues. Sequencing of the clones identified this way confirmed the sequence predicted through bioinformatics. This study constitutes an example of the application of bioinformatics to the analysis of the recently expanded databases for the identification of genes of potential importance in the immune system.

Identification through bioinformatics of cDNAs encoding human thymic shared Ag-1/stem cell Ag-2. A new member of the human Ly-6 family

The Ly-6 family of cell surface molecules includes many members that have been characterized in the mouse. Until recently, very few Ly-6 family members had been described in the human. A significant development with important implications for novel gene discovery has been the growth of the public Expressed Sequence Tag (EST) database. Here we report that, through the application of bioinformatics analysis to the dbEST database, we obtained the sequence of human TSA-1/SCA-2, a new member of the human Ly-6 family. In addition, we identified full-length clones encoding this molecule as well as expression data in various tissues. Sequencing of the clones identified this way confirmed the sequence predicted through bioinformatics. This study constitutes an example of the application of bioinformatics to the analysis of the recently expanded databases for the identification of genes of potential importance in the immune system.

The Perth Amboy Community Partnership for Youth: Assessing its Effects at the Environmental and Individual Levels of Analysis

This article describes the Perth Amboy Community Partnership for Youth (PACPY), a comprehensive community-based intervention designed to reduce risk factors for alcohol, tobacco, and other drug use among Latino youth. The intervention is grounded in the principles of community empowerment and participatory education, and attempts to facilitate within the community a broad understanding of the societal factors that increase risk of drug use and related problems among young people. PACPY attempts to bring about change at both the individual level and the environmental level within the domains of the school, the family, and the community. The present article describes the types of interventions introduced through PACPY within each of these domains, and examines their impact on individual and environmental changes in the use and availability of tobacco products. We conclude with a discussion of some of the methodological issues that have arisen over the course of the evaluation, and outline the changes that have occurred in our underlying conceptual framework.

Applications of retrovirus-mediated expression cloning

We have recently established a novel expression cloning system using retroviral vectors. The system is based on a high-efficiency packaging cell line, BOSC23, and a simplified retroviral vector, pBabeX, carrying no selection marker. cDNA libraries, constructed in the pBabeX vector, are transiently transfected into BOSC23 cells. The supernatant contains more than 3X10(6)/mL, which would cover large complexities of cDNA libraries. The retrovirus stock gave 100% infection efficiency in NIH3T3 cells and 5-40% infection efficiency in various hematopoietic cell lines. In contrast to the conventional expression cloning system, in which it is necessary to transfect cDNA libraries transiently into particular cell types such as COS cells, retrovirus-mediated expression cloning allows us to transduce cDNAs into a wide variety of cell types. This method therefore makes it possible to select cells expressing a cDNA of interest by various functional assays. When combined with polymerase chain reaction (PCR)-driven random mutagenesis, this system is also useful in searching for mutations of various molecules that will result in alterations of their functions.

Community-based approaches for the prevention of alcohol, tobacco, and other drug use

This paper summarizes what is known about community-based approaches for the prevention of ATOD problems and how the current practices in the field reflect these approaches. The first section of the chapter provides a brief summary of events early in this century when community-based approaches were central to addressing alcohol and other public health problems. The second section contains an overview of current research and empirical findings that yield consensus as to what conceptually and in practice constitutes a comprehensive, community-based prevention program for the prevention of ATOD problems. The third section reviews the literature of existing programs to assess the extent to which they include the salient elements and employ interventions determined to be fundamental to comprehensive community-based prevention programs. The final section discusses some of the challenges that confront researchers and practitioners when developing prevention initiatives and programs in high-risk environments.

Impaired interleukin-3 (IL-3) response of the A/J mouse is caused by a branch point deletion in the IL-3 receptor alpha subunit gene

Interleukin-3 (IL-3) alone does not support hematopoietic colony formation of bone marrow cells from the A/J mouse. To elucidate the molecular lesion in A/J mice, we examined expression of the alpha and beta subunits of the IL-3 receptor (IL-3R). While IL-3R beta was normally expressed, IL-3R alpha was not detectable on the surface of A/J-derived cells by antibody staining. Genetic linkage analysis using recombinant inbred mouse strains between A/J and IL-3-responsive C57BL/6 indicated that the IL-3R alpha gene locus was responsible for the impaired IL-3 response in A/J mice. Molecular cloning and characterization of A/J-derived IL-3R alpha cDNA revealed that it lacked the sequence corresponding to exon 8, which encodes 10 amino acid residues in the extracellular domain. The aberrant splicing was due to a 5 base pair deletion at the branch point in intron 7 and was reproduced in heterologous cells by transfecting with an IL-3R alpha minigene carrying the deleterious intron. The A/J-specific abnormal form of IL-3R alpha was localized inside the cells, but not on the cell surface, providing the molecular basis for the impaired IL-3 response in the A/J mouse.

Subset of CD4+ T cell clones expressing IL-3 receptor alpha-chains uses IL-3 as a cofactor in autocrine growth

In this paper we demonstrate that IL-3 can act as a cofactor for the growth of some CD4+ T cells. This lymphokine synergized with IL-4 to induce both a unique set of protein tyrosine phosphorylations and the vigorous proliferation of the keyhole limpet hemocyanin-specific and I-Ab-restricted CD4+ Th0 cell clone, E6. In addition, neutralizing anti-IL-3 Abs specifically inhibited the growth of E6 T cells to Ag or anti-CD3 mAb stimulation. Finally, this T cell clone was shown to express both the IL-3R alpha-chain and an IL-3R beta-chain (AlC2A). An examination of other CD4+ T cell clones determined that one Th1 clone (A.E7), two Th0 clones (16B.2 and L9A.1), and one Th2 clone (D10.G4.1) were not influenced by the addition of rIL-3. However, proliferation of the Th2 clones CDC25 and CDC35 to CD3-stimulation was significantly enhanced by IL-3. The sensitivity of these latter two clones to IL-3 was also found to be associated with expression of IL-3R alpha-chains. Because E6 T cells are highly dependent on IL-4 for autocrine growth similar to Th2 cells, these results suggest that IL-3 may synergize with IL-4 to enhance the proliferation of a subset of IL-4-dependent CD4+ T cells, and the study indicates that IL-3R alpha-chain expression may be a specific marker of this CD4+ T cell subset.

Subset of CD4+ T cell clones expressing IL-3 receptor alpha-chains uses IL-3 as a cofactor in autocrine growth

In this paper we demonstrate that IL-3 can act as a cofactor for the growth of some CD4+ T cells. This lymphokine synergized with IL-4 to induce both a unique set of protein tyrosine phosphorylations and the vigorous proliferation of the keyhole limpet hemocyanin-specific and I-Ab-restricted CD4+ Th0 cell clone, E6. In addition, neutralizing anti-IL-3 Abs specifically inhibited the growth of E6 T cells to Ag or anti-CD3 mAb stimulation. Finally, this T cell clone was shown to express both the IL-3R alpha-chain and an IL-3R beta-chain (AlC2A). An examination of other CD4+ T cell clones determined that one Th1 clone (A.E7), two Th0 clones (16B.2 and L9A.1), and one Th2 clone (D10.G4.1) were not influenced by the addition of rIL-3. However, proliferation of the Th2 clones CDC25 and CDC35 to CD3-stimulation was significantly enhanced by IL-3. The sensitivity of these latter two clones to IL-3 was also found to be associated with expression of IL-3R alpha-chains. Because E6 T cells are highly dependent on IL-4 for autocrine growth similar to Th2 cells, these results suggest that IL-3 may synergize with IL-4 to enhance the proliferation of a subset of IL-4-dependent CD4+ T cells, and the study indicates that IL-3R alpha-chain expression may be a specific marker of this CD4+ T cell subset.

Alcohol misuse and the predisposing environment

In recent years, the aetiology of alcohol misuse has come to be conceptualised in terms of risk factor models. Risk can emanate from a number of sources ranging from the genetic to the sociostructural. This chapter reviews the major environmental risk factors under two broad headings--those that affect the availability of the agent and those that affect the vulnerability of the host. The former include a variety of economic, social and physical factors such as price, advertising and licensing laws. The latter include broad socioeconomic and sociocultural factors, as well as interpersonal influences such as family, peers, employment and stress. Practitioners (as distinct from policy-makers) concerned with prevention and treatment of alcohol misuse can most effectively intervene at the interpersonal level, and the paper concludes with a discussion of the implications for clinical practice of the research reviewed in this domain.

The sale of alcoholic beverages to minors

This study reports the findings of a field trial designed to assess the extent of alcohol sales to minors in one county in northwest New Jersey. Two 19-year-old males were successful in purchasing alcoholic beverages in 27 of 46 (58.7 percent) establishments visited. On the following day, 23 of the establishments that sold the alcohol were visited again and, on this occasion, 18 (78.3 percent) sold alcohol to the minor. This study supports the findings from surveys that show that underage drinkers can obtain alcohol with ease. Many community groups are now taking action to rectify this situation, and data of the type reported in this paper can be used to assess the effectiveness of their actions.

"War on drugs" continues in United States under new leadership

Criticism of the "war on drugs" pursued under Republican administrations has grown in the United States. With the election of Bill Clinton many experts expected a shift from law enforcement policies to an approach favouring treatment and prevention. The budget announced in April, however, revealed no such shift in allocation of resources. Although the war on drugs has apparently failed to reduce the supply of cheap heroin and cocaine to the United States, the prevention strategy favoured by its opponents--school based prevention programmes--has not yet been shown to be effective in dealing with the concentration of drug misuse among the socially disadvantaged. In looking for new strategies Clinton must satisfy both liberals and conservatives in Congress, and community policing might therefore prove to be a politically expedient option.

A theory-driven approach to the evaluation of professional training in alcohol abuse

This paper begins by observing that, to date, evaluations of brief training courses in alcohol abuse for non-specialist professionals indicate that they have little influence on attitudes and behaviour. The reasons why this is so have not been studied in detail, and such training courses continue to be widely used despite their minimal effects. It is argued that the failure of this field of inquiry to develop beyond this point is due to the fact that, with only a very few exceptions, it has not been informed by theoretical concerns. The research in this area is discussed in terms of the types of models tested and the research designs typically used in evaluations. This is followed by a detailed description of the 'theory driven approach' to evaluation. It is proposed that the use of such an approach by those concerned with the development and evaluation of training in alcohol abuse for non-specialists would increase the likelihood of identifying the real effects of such programmes and the processes that mediate their successful implementation. This would result in a more purposeful use of educators' and evaluators' energies and skills.

A review of studies comparing checklist and interview methods of data collection in life event research

This article is concerned with the relative merits of checklists and interviews as techniques for collecting data in the study of life events. It presents a detailed review of studies that have directly compared checklists and interviews. The author's conclusion is that the two techniques should not be seen as equivalent in the assessment of life events. Virtually all of the studies reviewed showed a marked tendency to overreport on checklists. The method appears inadequate in distinguishing truly stressful events from trivial occurrences. In contrast, the in-depth interview is sensitive to the subtleties of life events and should be the preferred method when data of any precision and accuracy are required in an empirical study.

Using theory and basic research to target primary prevention programs: recent developments and future prospects

This paper is concerned with recent attempts within the field of primary prevention to use theory and basic research to develop intervention programs. It starts by reviewing a number of recent large scale studies based upon the dominant theoretical perspective within this field--the social influences model. It argues that the results of such evaluations suggest that a 'universal' prevention strategy (i.e. one aimed in an undifferentiated manner at all individuals within a given population) is out of touch with our current knowledge concerning the etiological processes underlying substance use and misuse. As an alternative, it is suggested that prevention programs be developed according to a number of 'specific' strategies (i.e. ones targeted at vulnerable subgroups within larger populations). The rationale underlying this approach, as well as a number of theoretical models upon which such interventions might be developed, is then outlined.

Reports of physical symptoms and alcohol use: findings from a primary health care sample

The relationship between alcohol consumption and physical health was examined in a primary health care sample of 366 adults. Unlike many previous studies that relied on static measures of medical diagnoses, the data reported here are repeated assessments of self-reported symptoms and alcohol use over 12 months. The results suggest, first, that drinking patterns in non-alcoholic samples fluctuate over time, and, second, that abstainers who have more prior illnesses or worse current health consistently report the greatest number of physical symptoms. The data highlight the importance of accounting for the health status of abstainers before comparing them with users of alcohol, and suggest that the presence of physical symptoms in addition to objective indices of health (e.g. the need for medication) may play a role in the initiation or maintenance of abstinence.

Chromosomal localization and organization of the murine genes encoding the beta subunits (AIC2A and AIC2B) of the interleukin 3, granulocyte/macrophage colony-stimulating factor, and interleukin 5 receptors

Chromosomal genes for two mouse homologous beta subunits (AIC2A and AIC2B) of the interleukin-3, granulocyte/macrophage colony-stimulating factor, and interleukin-5 receptors were characterized. Both AIC2A and AIC2B genes were present on a 250-kilobase MluI restriction fragment and were mapped on murine chromosome 15 (these loci were provisionally designated as Il3rb-1 (AIC2A) and Il3rb-2 (AIC2B)), closely linked to the c-sis locus. Both genes consist of 14 exons and span about 28 kb each. The major transcription initiation sites of both genes were mapped at 194 bp from the initiation codon. These genes are 95% identical up to 700 bp from the transcription initiation sites. Potential recognition sequences for hemopoietic transcription factors including GATA-1 and PU.1 in addition to a TATA-like sequence are present in the 5'-flanking region. A stretch of 20 bp including the initiation site is homologous to the corresponding region of the erythropoietin receptor and the interleukin-7 receptor genes and to the initiator sequence of the adeno-associated virus P5 promoter, suggesting a possible role in transcription initiation. Comparison of the exon/intron boundaries of AIC2A and AIC2B genes with those of other members of the cytokine receptor superfamily reveals a conserved evolutionary structure. Isolation of various forms of AIC2 cDNAs reveals differential splicing of the transcripts.

Recent developments in life-event research and their relevance for the study of addictions

The idea that stressful life events can on occasions contribute to the development of addictive disorders is fairly well-accepted within both clinical and research communities. However, little support is available: research is sparse and investigators have generally neglected methodological refinements and innovations in the broader field of life-event research. Some of these developments are discussed, especially as they relate to the measurement of the meaning of life events. Findings from research based on such techniques are summarized, and their relevance for the study of addictions discussed under three headings: specification of life events, vulnerability, and diagnostic specificity.

Implications of using the composite and short versions of the Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ)

The Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ) has often been used in studies seeking to understand or change the attitudes of workers towards alcohol abusers. Data are normally presented in terms of either individual subscales or as a composite scale, and recently a short version of the composite scale has been proposed. Using data from a quasi-experimental community intervention the information provided by the summary scales is compared with that from the individual subscales. The analysis suggests that there are two systems within the data--a role security/basic role requirements system and a therapeutic commitment system. Both summary scales are misleading in that they reflect the role security/basic role requirements system scales and not those measuring therapeutic commitment. It is concluded that the summary scales should only be used when the underlying data structure is understood.