Cocaine- and amphetamine-regulated transcript (CART), as its name implies, was initially identified as an upregulated transcript in response to psychostimulant administration. Consequently, it has been posited to play a role in psychostimulant abuse and dependence. Spurred on by the finding that a polymorphism in the CART gene was associated with alcoholism, we initiated studies designed to elucidate the role of CART peptide in alcohol dependence. We first investigated the functional significance of CART peptide in alcohol dependence in vivo using a CART KO mouse. We found that CART KO mice had a significant decrease in ethanol consumption that could not be attributed to differences in total intake, taste perception, metabolism, or sensitivity to ethanol. In vitro we found that CART peptide facilitated NMDA receptor-mediated currents in central amygdala neurons. Given the emerging role of CART peptide in anxiety and stress, we decided to examine basal and stress-induced anxiety behaviors in CART KO mice. Under basal and acute stress conditions, CART KO mice did not differ in anxiety-like behaviors from WT mice; however, in response to a stressor, CART KO mice exhibited a potentiated corticosterone response. Using chronic intermittent ethanol exposure (CIE), we tested CART KO and WT mice for common signs of ethanol dependence including an escalation of volitional consumption and the presence of withdrawal-induced anxiety. We further investigated glutamatergic neuroadaptations within the central amygdala of CART KO and WT mice following CIE exposure and early withdrawal. CIE increased ethanol consumption and anxiety-like behaviors in mice of both genotypes but to a lower extent in CART KO mice. Electrophysiologically, CIE enhanced spontaneous excitatory postsynaptic currents in both genotypes and decreased the probability of presynaptic release in WT mice only. We believe that these electrophysiological neuroadaptations contribute to the development of ethanol dependence and may mediate withdrawal-induced anxiety behaviors. Overall, these studies indicate a role for CART peptide in alcohol dependence and specifically in modulating ethanol withdrawal-induced anxiety. / text

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<p>Since the anecdotal assumption is that GPs do not effectively diagnose and manage problem drinking amongst their patients, this study investigated the role of GPs in addressing problem drinking in Cape Town as well as the prevalence of problem drinking amongst their patients.</p>

A contemporary novel spanning thirteen years in the lives of an Indiana family. A boy enters abusive relationships with men in the belief he does not deserve love, a woman abandons her only son because of her alcoholism, a gay father learns to navigate the line between his personal life and that of being a parent. A story in which a family learns to grow, to mature, to forgive their past mistakes and exorcise the demons that haunt them.

Codependency is a highly contested construct featuring in the popular, clinical and research literature. Within the academic literature, the voices and lived experience of individuals who consider themselves codependents are mostly unavailable. This Interpretative Phenomenological Analysis (IPA) study explored the lived experiences of 8 individuals self-identified as codependents, who chose 12-Step recovery groups to frame their recovery process. This research addressed the following research question: What is the lived experience of codependency among people who have sought support from a 12-step recovery group for codependents? The idiographic, phenomenological and hermeneutic aspects of the study captured how participants made sense of their experiences of codependency and the meanings of the support group. The information was collected over 3-6 months by means of three in-depth semi-structured interviews and a visual method in which participants selected and analysed objects or photographs which, for them, expressed the meaning of codependency. Four main themes emerged from the analysis of the interviews: (1) Codependency experienced as real and tangible: ‘Codependency explains everything’. (2) Experiencing an undefined sense of self: ‘Codependency helps me to discover my sense of self.’ (3) Seesawing through extremes in life: ‘Like a seesaw, I feel out of control’. (4) Finding meaning in codependency through exploring family experiences: ‘Down to childhood’. The findings revealed that the experience of codependency frames these individuals’ sense of identity, their lifeworlds and the way they view and experience life difficulties. It also provided a highly nuanced and fine-grained analysis of the lived experience of codependency. The study brings a new perspective on the lived experiences of this client group. Although the findings are not straightforwardly generalizable, they may inform clinical practice. It is hoped that this study will raise awareness about this controversial topic, bring a better understanding of codependency and inspire further research.

M.A. / Patterns of substance abuse within the family is a widespread phenomenon that occurs through generations. Although various factors can be a symptom of a dysfunctional family, the dynamics that maintain the transgenerational patterns of substance abuse are of great interest. The family in which the abuse of alcohol is repetitive through generations, is seen as a dysfunctional family system. It appears that a circular pattern exists in the family that maintains the alcohol abuse. Although the family as a whole has an influence on individual members, these individual members enter their families with their own preconceived mind maps of past experiences that also have a great influence on the family dynamics. Family dynamics are seen as those factors that impact either positively or negatively on the family and its individual members. The alcoholic parent and adult child of the alcoholic parent are the subjects of concern in this study because it is assumed that parental inputs have been the most influential in the respondent’s lives. A qualitative method of research was implemented to describe this explorative study and was decided on because it describes the phenomenon of transgenerational patterns of alcohol abuse from the viewpoint of the respondent. The aim of this research study was to determine the dynamics that contribute to transgenerational patterns of alcohol abuse, with specific reference to the respondent’s family history of alcohol abuse, their co-dependency (alcohol abuse) and the maintenance of these dynamics throughout generations. These dynamics will be explained in terms of the Living Systems Theory and the Object Relations Theory. These theories form the theoretical foundation from which these dynamics were explained. From these theories a strategy of data-gathering was developed with specific focus on the genogram, family tree and general questions. A focused sampling method was implemented in this research study, and the research units consisted of five respondents with families that have a history of alcohol abuse. Data-gathering was done through phenomenological and semi-structured interviews. The interviews were audiotaped and fieldnotes were made, although limited and only to confirm some of the findings of the research study. The data was analysed according to a specific strategy. Preliminary coding was done by using the audiotapes (transcriptions) and fieldnotes. After the preliminary coding was completed, these categories were used to derive central themes from the findings and all the categories were then divided under one or several of these themes. These central themes were compared with existing literature in order to confirm the findings of this research study and to enhance the trustworthiness. From the study, certain recommendations with regard to methodology and content were made. / Dr. E. Oliphant

In this paper, I will analyze the production process of my thesis film, The Ninth Step. I will examine all of the various elements of the project, from development, through post-production to determine how effective it is in depicting human drama and conflict. I will employ the notes of unbiased audience members as a key criterion in the measure of this study.

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"The purpose of this study was to determine, if possible, whether there was any significant change in the 'social consequences' experienced by thirty-one alcoholic patients during the first six months they are in treatment as compared to the six months immediately prior to their entering treatment. The 'significant change' was determined on the basis of the 'social consequences' they suffered as a result of their relapse into compulsive drinking, and the difference 'before' and 'during' was tested by the chi square test for the significance of the difference"--Introduction. / Typescript. / "June, 1959." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Dorothy D. Hayes, Professor Directing Study. / Includes bibliographical references.

Este trabalho foi realizado com a finalidade de demonstrar a utilização de nitrogênio de dietas enterais quimicamente definidas ( DE) comparadas com dieta geral via oral em um grupo de pacientes alcoólatras crônicos. Além de verificar o efeito das DE na recuperação do estado nutricional destes pacientes. Para SG atingir este objetivo foram realizado:. basicamente balanços rnctabólicos nitrogenados ( BN) e aminoacidogramas venosos na internação e alta dos pacientes. Foram estudados 20 indivíduos do sexo masculino, com idade variando entre 25 e 64 anos ( média = 39,5), 15 brancos e 5 não brancos, divididos ao acaso em 3 grupos de 7, 7 e 6 pacientes respectivamente. Todos eram alcoólatras crônicos e ingeriam em media 1 litro de aguardente por dia. Em 7 pacientes foi feito clinicamente o diagnóstico de pelagra, em 5 de neuropatia periférica e em 1 de cirrose hepática, Um outro tinha ascite. Em 2 pacientes houve retenção de bromosulfaleina entre 20 e 30 % e em outros 2 entre 10 e 20 %, sondo nos demais pacientes inferior a 10%. Do ponto de vista nutricional estes indivíduos foram classificados como soado de baixo risco, segundo Sauberlich e cols., 1974. Aos 2 primeiros grupos de pacientes foram oferecidas dietas enterais quimicamente definidas e ao terceiro grupo uma dieta geral habitual, A oferta nitrogenada ± 16 g/dia) E calórica ( ± 3000 calorias/dia) foi mantida constante nos 3 grupos. No primeiro . grupo toda oferta calórica foi proveniente de hidratos de carbono e proteínas, portanto sem lápides. Nós 2 outros Grupos a oferta calórica foi balanceada entre 10% de proteínas, 65% de hidratos de carbono e, 25% de gorduras. As DE Foram constituídas basicamente de uma solução de L-aminoácidos, sacarose, vitaminas c minerais, com ou sem lápides. A dieta geral incluia arroz, feijão, carne e legumes ou verduras. Os pacientes foram internadas na Unidade Metabólica da Disciplina de Nutrologia, Departamento de Clínica Médica da Faculdade de Medicina de Ribeirão Preto, durante aproximadamente 15 dias, sendo 12 para o estudo. O período inicial de adaptação ao ambiente e à dieta foi de 6 dias. Nos 6 dias finais todo nitrogênio ingerido, fecal e urinário foi dosado e calculado o balanço metabólico nitrogenado aparente. De cada paciente na internação e alta foram dosados os níveis de aminoácidos venosos. Também foi calculado quantide de de nitrogênio absorvido em relação ao ingerido e a digestibilidade verdadeira das 3 dietas. Os principais ratos observados foram: 1. A ingestão de nutrientes foi mantida constante nos pacientes submetidos às 2 dietas enterais o que não foi possível nó terceiro grupo, que recebia dieta geral. 2. A absorção das dietas enterais foi significativamente superior à da dieta Geral. 3. O peso e\' quantidade de nitrogênio focal foram significativamente inferiores nos indivíduos submetidos a dietas enterais. 4. A digestibilidade verdadeira mostrou valores estatisticamente superiores para as dietas enterais. 5. A analise dos resultados das 2 dietas enterais não mostrou diferenças entre elas. 6. Ao final do estudo observou-se uma tendência de melhoria de todos os parâmetros antropométricos e laboratoriais utilizados na avaliação do estado nutricional. Não houve diferenças entre ás pacientes que receberem as 3 dietas. 7. Os níveis de aminoácidos plasmáticos na admissão e na alta não apresentaram diferenças nos 3 grupos de pacientes. 8. As dietas enterais utilizadas são facilmente administradas e controladas, não tendo sido encontrados problemas com efeitos colaterais indesejáveis. / The objective of this research was to determine the utilization of nitrogen from chemically defined enteral diets ( ED), compared with oral diets, by groups of chronic alcoholic patients. The effect of ED on the recovery of nutritional status by the patients was also determined. The methods used were metabolic nitrogen balance ( WE ) and amino acid analysis of venous blood. The study was done on 20 males, If range 25-64 years ( mean age = 39,5). The subjects ( 15 White and 5 non-White individuals) ware divided at into 3 croups of 7, 7 and 6 patients, respectively. All were chronic al coholics, whose mean daily intake was 1 liter of sugar cane liquor. Seven of the patients were diagnosed as having pellagra, 5 as having peripheral neuropathy, and 1 cirrhosis of the liver. Another patient had ascites. Two patients showed 20 to 30 %. bromosulfalein retention, and 2 more showed 10 to 20 %, while the -remainder had less than MID retention. Nutritionally , these individuals were classified as low risk accoreiiny to Sauberlich .et al., 1974. The first 2 groups were offered chemically defined cntcral diets, while the third group received a usual general diet. The amount of nitrogen ( ± 16 g/day) and of calories ( 3000 cal/day) was kept constant for all groups. The calories offered to the first group consisted solely of carbohydrate and protein, without lipids. The two remaining groups received a balanced diet, with calories distribute as approximately follows: 10% protein, 65% carbohydrate and 25% fat. The .EDs consisted basically of a solution of L-amino acids, sucrose, vitamins and rninerals, with without lipide.The general diet include rice, beans meat and legumes or vegetables. The patients were admitte to the Metabolic unit of the Discipline of Nutroloyy, Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto, where they remained far 15 days, 12 of which devoted to the study, The initial period of adaptation to the environment and diet lasted 6 days. During the final 6 days, all ingested nitrogen as well as fecal and urinary nitrogen were measured and the metabolic nitrogen balance was calculated. The levels of peripheral venous amino acids were measured for each patient upon admission and at discharge. The amount of absorbed nitrogen in relation to ingested nitrogen and the true gestibility of the three diets were also calculated. The following main observations were made: 1. Nutrient intake was kept constant for the patients submitted to the two enteral diets, whereas this was not possible for the third group which received the oral diet. 2. Absorption of the enteral diets WQS significantly higher than that of the oral diet. 3. The weight and amount of fecal nitrogen were significantly 6 lower for the individuals submitted to the enteral diets. 4. True digestibility was statistically higher for the enteral diets. 5. The two enteral diets gave equal results. 6. At the end of the study, a tendency towards improvement was observed for all anthropometric and laboratory parameters used to evaluate nutritional status. No differences were observed axons the patients who received the three diets. 7. No differences in plasma amino acids upon admission and at discharge were found among the three groups. 8. The enteral diets used are easy to administer and to control, and produced no problems or undesirable side effects..