Evaluating moderators of beneficial effects of severity-based assignment to substance use treatments in impaired drivers.

Remedial programs for impaired driving offenders have proved valuable in reducing subsequent alcohol and other drug use and preventing recidivism in this population. Many of these programs are based on a severity-based assignment scheme, where individuals assessed to have greater problems or be at higher risk are assigned to longer, more intensive interventions. Recent research, using regression discontinuity analyses, provided support for severity-based assignment schemes in demonstrating that those with higher problem or risk levels assigned to longer and more intensive programming showed a significant reduction in drinking days over a follow-up interval, attributable to program assignment. Regression discontinuity analyses can also be used to assess moderators of this assignment benefit. We report an assessment of the impact of eight potential moderators of assignment benefit, derived from a factor analysis of the Research on Addictions Self-Inventory screening instrument. Five of the eight factors were found to moderate the assignment benefit: Negative Affect, Sensation Seeking, High Risk Lifestyle, Alcohol Problems, and Family History. The significance of these results for developing more effective program assignment procedures is discussed.

Multiple "Lower BAC" offenders: Characteristics and response to remedial interventions.

BACKGROUND: In recent years, there has been increasing attention to "lower BAC" drinking drivers, typically those whose blood alcohol content (BAC) is under the legal limits defined in criminal law. In 2009, legislation was enacted in Ontario, Canada that enabled police to issue roadside license suspensions to individuals caught driving with BAC between 0.05% and 0.08%, known as the "warn range". Multiple warn range (MWR) offenders are required to attend the Back on Track (BOT) remedial measures program. This study aimed to provide: (1) a preliminary characterization of MWR drivers charged under warn range legislation; and (2) an initial assessment of outcomes associated with BOT participation among MWR offenders. METHODS: A subsample of 727 MWR offenders was drawn from program records, and compared to samples of 3597 first-time Criminal Code (CC) offenders (those caught driving with a BAC of 0.08% or higher) and 359 second-time CC offenders. To provide an initial assessment of outcomes associated with BOT participation, another subsample consisted of 394 MWR participants from whom pre- and post-workshop questionnaires were collected and successfully matched using probabilistic matching processes. RESULTS: Similarities in demographic profile and driving history between MWR and first-time CC participants were apparent. MWR offenders scored higher on risk of problem drinking and drink-driving recidivism than either of the CC offender groups. Second-time CC offenders scored higher on these measures than first-time CC offenders. Following BOT participation, MWR participants demonstrated positive change including improved knowledge of and intentions to avoid drink-driving. CONCLUSIONS: MWR offenders share a similar demographic profile to that of first-time CC offenders and they report significantly higher risk of problem drinking and recidivism. MWR offenders may include high-functioning problem drinkers who are likely to continue drink-driving and who may escalate to a CC drink-driving offense. Like CC offenders, MWR offenders benefited from BOT participation.

Metabolic effects of eradicating breath methane using antibiotics in prediabetic subjects with obesity.

OBJECTIVE: Methanogens colonizing the human gut produce methane and influence host metabolism. This study examined metabolic parameters in methane-producing subjects before and after antibiotic treatment. METHODS: Eleven prediabetic methane-positive subjects (9F, 2M) with obesity (BMI 35.17 ± 7.71 kg/m(2) ) aged 47 ± 9 years were recruited. Subjects underwent breath testing, symptom questionnaire, oral glucose tolerance test (OGTT), lipid profile, and stool Methanobrevibacter smithii levels, gastric transit, and energy utilization analyses. After a 10-day antibiotic therapy (neomycin 500 mg bid/rifaximin 550 mg tid), all testing was repeated. RESULTS: Baseline stool M. smithii levels correlated with breath methane (R = 0.7, P = 0.05). Eight subjects (73%) eradicated breath methane and showed reduced stool M. smithii (P = 0.16). After therapy, methane-eradicated subjects showed significant improvements in low-density lipoprotein (LDL) (P = 0.028), total cholesterol (P = 0.01), and insulin levels on OGTT (P = 0.05 at 120 minutes), lower blood glucose levels on OGTT (P = 0.054 at 90 minutes), significant reductions in bloating (P = 0.018) and straining (P = 0.059), and a trend toward lower stool dry weight. No changes were detected in gastric emptying time or energy harvest. CONCLUSIONS: Breath methane eradication and M. smithii reduction are associated with significant improvements in total cholesterol, LDL, and insulin levels and with lower glucose levels in prediabetic subjects with obesity. The underlying mechanisms require further elucidation.

Characteristics and predictors of recidivist drink-drivers.

OBJECTIVE: The current study compared characteristics of nonrecidivist versus recidivist drink-drivers and of recidivists in their first versus second appearance at Back on Track (BOT), the remedial measures program for impaired drivers in Ontario, Canada. METHODS: Information from 59,134 convicted drivers who participated in BOT between 2000 and 2010 was examined to identify drivers who completed the program a second time following reconviction. RESULTS: A total of 586 recidivists were identified. Compared to nonrecidivist drivers, recidivists at first attendance were more likely to be male and had higher scores on measures of alcohol dependence and adverse legal consequences of substance use. Compared to nonrecidivist drivers, recidivists at second attendance were significantly older, had a higher income, were more likely to be retired, and were less likely to be employed part-time. They had fewer legal problems. Recidivists reported fewer drinking days and fewer drinks per occasion but greater use of benzodiazepines than nonrecidivists and had higher scores on a measure of future risk of alcohol- and drug-related problems. Comparison of recidivists' characteristics at first versus second attendance confirmed many of these findings, with second-time recidivists reporting fewer drinks per drinking day and greater use of benzodiazepines and having higher scores on a measure of future substance use problems than first-time recidivists. CONCLUSIONS: Results suggest that identification of drivers at increased risk of recidivism may be possible at first program attendance by examining indicators of increased alcohol-related problems. In addition, recidivists appear to show a greater readiness to change at second attendance. Implications for remedial program development and recommendations for future research are discussed.

Pet Therapy in Correctional Institutions: A Perspective From Relational-Cultural Theory.

In this article the authors apply Relational-Cultural Theory to pet therapy in correctional institutions. An important premise is that when pet therapy is used in prisons a symbiotic relationship develops between pets and prison inmates which, at the same time, improve their relationships with people themselves. Relational-Cultural Theory posits that relationships with individuals are not just a means to an end. Rather, good relationships promote growth and healthy development; they also cultivate reciprocal empathy. Hence, a major reason of suffering for most people is their experience of isolation; healing can occur in growth-fostering relationships.

Evidence from regression-discontinuity analyses for beneficial effects of a criterion-based increase in alcohol treatment.

Brief interventions effectively reduce alcohol problems; however, it is controversial whether longer interventions result in greater improvement. This study aims to determine whether an increase in treatment for people with more severe problems resulted in better outcome. We employed regression-discontinuity analyses to determine if drinking driver clients (n = 22,277) in Ontario benefited when they were assigned to a longer treatment program (8-hour versus 16-hour) based on assessed addiction severity criteria. Assignment to the longer16-hour program was based on two addiction severity measures derived from the Research Institute on Addictions Self-inventory (RIASI) (meeting criteria for assignment based on either the total RIASI score or the score on the recidivism subscale). The main outcome measure was self-reported number of days of alcohol use during the 90 days preceding the six month follow-up interview. We found significant reductions of one or two self-reported drinking days at the point of assignment, depending on the severity criterion used. These data suggest that more intensive treatment for alcohol problems may improve results for individuals with more severe problems.

Genome-wide changes in expression profile of murine endogenous retroviruses (MuERVs) in distant organs after burn injury.

BACKGROUND: Previous studies have shown that burn-elicited stress signals alter expression of certain murine endogenous retroviruses (MuERVs) in distant organs of mice. These findings suggest that MuERVs may participate in a network of pathophysiologic events during post-burn systemic response. To gain a better understanding of the biological roles of MuERVs in post-burn systemic response, we examined the genome-wide changes in the MuERV expression profiles in distant organs and the biological properties of the putative-burn related MuERVs were characterized. RESULTS: Female C57BL/6J mice were subjected to an approximately 18 % total body surface area flame burn and tissues (liver, lung, and kidney) were harvested at 3 hours and 24 hours after injury. The changes in the MuERV expression profiles in these tissues were examined by RT-PCR using a primer set flanking the non-ecotropic MuERV U3 promoter region within the 3' long terminal repeat. There were differential changes in the expression profiles of MuERV U3 regions after injury in all three tissues examined. Subsequently, a total of 31 unique U3 promoter sequences were identified from the tissues of both burn and no burn mice. An analysis of viral tropisms revealed that putative MuERVs harboring these U3 promoter sequences were presumed to be either xenotropic or polytropic. Some putative transcription regulatory elements were present predominantly in U3 promoter sequences isolated from burn and no burn mice, respectively. In addition, in silico mapping using these U3 sequences as a probe against the mouse genome database identified 59 putative MuERVs. The biological properties (coding potentials for retroviral polypeptides, primer binding sites, tropisms, branching ages, recombination events, and neighboring host genes) of each putative MuERV were characterized. In particular, 16 putative MuERVs identified in this study retained intact coding potentials for all three retroviral polypeptides (gag, pol, and env). None of the putative MuERVs identified in this study were mapped to the coding sequences of host genes. CONCLUSION: In this study, we identified and characterized putative MuERVs whose expression might be altered in response to burn-elicited systemic stress signals. Further investigation is needed to understand the role of these MuERVs in post-burn systemic pathogenesis, in particular, via characterization of their interaction with host genes, MuERV gene products, and viral activities.

A novel assay to determine the sequence preference and affinity of DNA minor groove binding compounds.

Sequence-specific binding in the minor groove of DNA by small molecules is a growing area of research with possible therapeutic relevance. By selectively binding to DNA sequences required by critical transcription factors, these small molecules could potentially modulate the expression levels of disease-causing genes. Precise targeting of a critical transcription factor of a selected gene requires an understanding of the preferred sequence of the DNA binding compound. As new compounds are being synthesized, there is a need to evaluate their DNA recognition profile. We sought to establish a procedure to determine sequence preference of compounds with previously unknown binding properties. A novel procedure for determining the optimal DNA binding sequence of minor groove binding compounds is described here. The assay also allows for determination of the binding affinity to a particular sequence.

CD14-dependent regulation of Grp78 in the liver and lungs of mice after burn injury.

Recent reports have suggested that interactions between the lipopolysaccharide receptor CD14 and heat shock proteins (Hsps) play roles in proinflammatory responses. The involvement of glucose-regulated protein 78 (Grp78), a member of Hsp70 family, and CD14 in signaling events activated in the liver and lungs of mice after burn injury was investigated. Differential induction of Grp78 in the liver of CD14 knockout (KO) mice after 18% total body surface area burn was associated with a transient down-regulation of serum glucose level at day 1 after injury. Subsequent studies revealed that the liver of both CD14 KO and wild-type control mice had a significant induction of Grp78 mRNA at day 1 after injury, while the level of induction was greater in CD14 KO mice. In contrast, in the lungs, there was an up-regulation of Grp78 mRNA only in CD14 KO mice at day 1 after injury. Interestingly, both the liver and the lungs had no apparent changes in Grp78 protein expression after injury. These data demonstrate CD14-dependent and tissue-specific regulation of the Grp78 expression after burn injury. They also suggest potential activation of a CD14-independent signaling pathway involving Grp78 in distant organs after injury.