Freedom of Information Act Office
IC Directors' Meeting Highlights
November 18, 2005
|From:||Director, Executive Secretariat|
|Subject:||IC Directors' Meeting Highlights —August 11, 2005|
I. Understanding Alcohol Drinking Behavior (Good and Bad) Through Studies in Animal Models
After noting that alcohol is our most primitive intoxicant (barley beer is traced to prior to 4200 BC in Egypt), Dr. Li summarized the U.S. population drinking patterns:
- 67 percent of the population are drinkers (at least one drink in the past 12 months),
- Males reported drinking 76 percent and females 24 percent of all alcohol consumed, and
- 60 percent of the alcohol is consumed by 10 percent of the population.
While most people abstain or drink moderately, which places them at low risk for alcohol use disorders, Dr. Li emphasized that a recurring pattern of high risk drinking results in adverse outcomes including personal problems, problems to others, and problems for society. He then discussed various correlations of amount of alcohol consumption and increased risks of alcohol abuse and alcohol dependence and the odds of co-occurrence of alcohol dependence and selected psychiatric conditions. After explaining how the metabolism of ethanol and acetaldehyde in hepacytes creates polymorphisms that result in elevated acetaldehyde levels in the liver and circulation, he described how the process protects against heavy drinking and alcoholism and described alcohol neuropharmacology.
The research underlying this discussion has resulted in a provisional description of a clinical syndrome. Dr. Li noted that rodents have been selectively bred to serve as models for alcohol research and that resulting research that he detailed is providing genetic and environmental findings that translate to the human population.
He personally thanked NIAAA staff including Drs. Noronha, Zakhari, and Sorenson and Ms. Brenda Hewitt for their efforts towards this presentation.
II. Symptom Management: Chronic Disease and End-of-Life
After reviewing NINRís mission, Dr. Grady summarized the burdens of chronic conditions as follows:
- 1.7 million deaths per year in the US,
- 10 percent of all Americans experience major limitations on daily living, and
- Account for 75 percent of the $1 trillion spent on health care annually
She then described cutting-edge research in several areas addressing challenges to patients facing chronic conditions. She began by highlighting research by Dr. Margaret Grey, et al., showing that coping skills training (CST) for teens with type 1 diabetes —
- Can improve metabolic and quality of life outcomes,
- Can be taught, and
- Can be maintained over time.
As a result of this research, current clinical guidelines on juvenile diabetes emphasize comprehensive behavioral care and over 100 practices have incorporated CST into their routine care.
The second area she detailed was an experimental hypertension management intervention program in African American males. She began by summarizing research conducted by Dr. Martha N. Hill, et al., finding that —
- Inner-city African American men can be recruited, retained, and followed for years;
- The hypertension management program can work in a community setting; and
- The hypertension management program can be effective in blood pressure management.
The Subcommittee on Professional and Public Education of the AHA Council on High Blood Pressure Research has cited Dr. Hillís research.
Next Dr. Grady addressed symptom management and rehospitalization in the elderly. Because elders with heart failure have the highest rehospitalization rate of all adult patient groups, a randomized clinical trial by Mary Naylor, et al., focused on whether elders can identify and monitor symptoms to avoid rehospitalization. The trial found that —
- Readmissions can be decreased,
- Elderly patients can successfully manage symptoms with frequent follow-up guidance, and
- This intervention was more cost-effective than routine care.
Finally she discussed applying disease management principles to end-of-life issues including functional decline, pain, and decision making and pointed the group to the 2004 State of the Science: Improving End-of-Life Care recommendations (see http://consensus.nih.gov/2004/2004EndOfLifeCareSOS024html.htm).
cc: OD Senior Staff