Margaret M. Murray

Prevention and Treatment of Alcohol-Related Problems: An International Medical Education Model.

Alcohol abuse and alcoholism are among the worlds most pressing public health concerns. Research has shown that while primary care physicians are in a good position to screen for alcohol-use disorders and to aid in treating these problems, they tend to identify only a small percentage of patients with such disorders and they rarely intervene with these persons. This situation is probably attributable to the fact that medical students worldwide are taught very little about alcohol-related problems. Clearly there is an urgent need to educate the worlds doctors about preventing, diagnosing, and treating alcohol abuse and addiction. In this paper, the authors describe a model international program for educating physicians about alcohol-related problems that was developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in cooperation with the Center for Addiction Research and Education (CARE) at the University of Wisconsin-Madison. They describe the components of the initiatives “trainer-development” approach and critical issues in implementing the program in other countries. Finally, they discuss how the program was successfully implemented in Poland and describe the NIAAAs plans for introducing the model in several other countries.

The conception of the ABCD study: From substance use to a broad NIH collaboration

Adolescence is a time of dramatic changes in brain structure and function, and the adolescent brain is highly susceptible to being altered by experiences like substance use. However, there is much we have yet to learn about how these experiences influence brain development, how they promote or interfere with later health outcomes, or even what healthy brain development looks like. A large longitudinal study beginning in early adolescence could help us understand the normal variability in adolescent brain and cognitive development and tease apart the many factors that influence it. Recent advances in neuroimaging, informatics, and genetics technologies have made it feasible to conduct a study of sufficient size and scope to answer many outstanding questions. At the same time, several Institutes across the NIH recognized the value of collaborating in such a project because of its ability to address the role of biological, environmental, and behavioral factors like gender, pubertal hormones, sports participation, and social/economic disparities on brain development as well as their association with the emergence and progression of substance use and mental illness including suicide risk. Thus, the Adolescent Brain Cognitive Development study was created to answer the most pressing public health questions of our day.

Alcoholic liver disease and pancreatitis: Global health problems being addressed by the US National Institute on Alcohol Abuse and Alcoholism

The review article summarizes the mission of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with focus on the NIAAAs current and future research version for alcoholic liver disease and alcoholic pancreatitis.

The NIAAA BSN Nursing Education Curriculum: A Rationale and Overview

Since the 1980s, nurse educators have directly acknowledged the need for alcohol and health content in undergraduate nursing curricula (e.g., Church, 1995; Hoffman & Heinemann, 1987; Murphy, 1989). The nation’s capacity to reduce the negative impact of alcohol on health would be greatly increased if all nurses had basic clinical skills related to the prevention and treatment of alcohol related health consequences across the life span. However, alcohol content in nursing curricula today continues to be spotty and inconsistent (Campbell-Heider et al., 2009; Pillon, Ramos, Villar-Luis, & Rassool, 2004; Rassol & Rawaf, 2007). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is directly addressing this gap in collaboration with nurse experts in the field of addictions nursing through the introduction of a web-based curriculum on alcohol and health for nurses. NIAAA is one of the 19 Institutes comprising the U.S. National Institutes of Health. NIAAA provides leadership in the national effort to reduce alcohol-related problems by conducting and supporting research in a wide range of scientific areas including genetics, neuroscience, epidemiology, the health risks and benefits of alcohol consumption, and the prevention and treatment of alcohol-related harm. An important piece of the Christine Savage

Expanding the Role of the Generalist Nurse in the Prevention and Treatment of Alcohol Use Disorders

Nursing has a central role in the prevention and treatment of alcohol use disorders in almost any practice setting. Alcohol consumption is the third leading actual cause of death in the United Stat...

Atención primaria y trastornos por consumo de alcohol: evaluación de un programa de formación del profesorado en Venezuela

Objetivos. La atencion primaria proporciona la oportunidad de identificar y tratar a personas cuyo consumo de alcohol se encuentra por encima de los niveles permisibles. Con el fin de preparar a los medicos de atencion primaria de todo el mundo para prevenir y tratar los problemas relacionados con el alcohol, el Instituto Nacional sobre el Abuso de Alcohol y el Alcoholismo (National Institute on Alcohol Abuse and Alcoholism: NIAAA) de los Estados Unidos de America (EE. UU.) ha creado y probado un Programa Internacional de Educacion Medica sobre el Alcohol, destinado a aumentar las aptitudes clinicas, educativas e investigadoras del profesorado de las facultades de medicina que trabaja con los estudiantes universitarios, los residentes y los medicos de atencion primaria. Venezuela fue uno de los paises seleccionados para la puesta en marcha de esta iniciativa. Metodos. Durante 5 dias del mes de septiembre de 1999 se realizo en la Universidad del Zulia, Maracaibo, Venezuela, un curso de formacion del profesorado que consistio en 19 talleres. Los metodos de ensenanza fueron clases, representaciones demostrativas, presentaciones de casos, talleres de desarrollo de aptitudes y la creacion de un plan educativo por cada uno de los participantes. Resultados. En el proyecto participaron 33 profesores de nueve de las 10 escuelas de medicina en Venezuela: 18 mujeres y 15 hombres con un promedio de 44 anos, 9 de ellos con formacion en medicina de familia, 7 en psiquiatria, 6 en pediatria, 4 en obstetricia, 3 en medicina interna, y 4 en especialidades no especificadas. El 76% de los participantes completaron una entrevista 6 meses mas tarde. Este grupo refirio que su competencia en 14 areas clinicas habia aumentado de forma significativa y que habia emprendido con buenos resultados nuevas actividades curriculares en sus respectivas facultades de medicina y programas de residencia. Conclusiones. Este modelo demostro ser eficaz para incrementar la formacion de los medicos en la prevencion y el tratamiento de los problemas relacionados con el alcohol en Venezuela. La evaluacion del programa proporciono resultados similares a los obtenidos en otros paises en los que tambien se ha puesto en marcha.

Biomedical ethics and clinical oversight in multisite observational neuroimaging studies with children and adolescents: The ABCD experience

Observational neuroimaging studies with children and adolescents may identify neurological anomalies and other clinically relevant findings. Planning for the management of this information involves ethical considerations that may influence informed consent, confidentiality, and communication with participants about assessment results. Biomedical ethics principles include respect for autonomy, beneficence, non-maleficence, and justice. Each project presents unique challenges. The Adolescent Brain and Cognitive Development study (ABCD) collaborators have systematically developed recommendations with written guidelines for identifying and responding to potential risks that adhere to biomedical ethics principles. To illustrate, we will review the ABCD approach to three areas: (1) hazardous substance use; (2) neurological anomalies; and (3) imminent potential for self-harm or harm to others. Each ABCD site is responsible for implementing procedures consistent with these guidelines in accordance with their Institutional Review Board approved protocols, state regulations, and local resources. To assure that each site has related plans and resources in place, site emergency procedures manuals have been developed, documented and reviewed for adherence to ABCD guidelines. This article will describe the principles and process used to develop these ABCD bioethics and medical oversight guidelines, the concerns and options considered, and the resulting approaches advised to sites.