The opioid antagonist naltrexone and its pharmacological role in treating alcohol dependence: A literature review

Naltrexone, an opioid antagonist, was the second drug approved for treatment of alcohol dependence in the U.S. Its approval followed two landmark studies published in the U.S. in 1992. [1, 2] These studies showed that a combined treatment of naltrexone and behavioral therapy reduced alcohol consumption in alcoholics. Opioid antagonists decrease craving for alcohol and help to reduce drinking by blocking opioid peptide receptors in the body that are active in a dopamine chemical reward system. ^ Despite their usefulness, opioid antagonists have been underutilized. Health providers not educated in the use of opioid antagonists hold the view that opioid antagonist therapy is ineffective. However, it is apparent from the relevant literature that this therapy, when properly understood and targeted, has the potential to make a positive contribution in treating alcohol dependent patients. ^ This thesis will review the scientific literature and the present body of knowledge regarding opioid antagonists (naltrexone) and their pharmacological role in treating alcohol dependence.^

Alcohol and other drugs in the Australian construction industry : A national evaluation and the best way forward

Anecdotal evidence highlights issues of alcohol and other drugs (AODs) and its association with safety risk on construction sites. Information is limited however regarding the prevalence of AODs in the workplace and there is limited evidential guidance regarding how to effectively address it. This research aimed to scientifically evaluate the use of AODs within the Australian construction industry in order to reduce the potential resulting safety and performance impacts and engender a cultural change in the workforce. A national qualitative and quantitative evaluation of the use of AODs was conducted with approximately 500 employees. Results indicate that as in the general population, a proportion of those sampled in the construction sector may be at risk of hazardous alcohol consumption and support the need for evidence-based, tailored responses. This is the first known study to scientifically evaluate the use of AODs and potential workplace safety impacts in the construction sector.

Identifiable, queer and risky : the role of the body in policing experiences for LGBT young people

This paper explores how visibly non-heteronormative bodies mediate policing experiences of LGBT (lesbian, gay, bisexual, transgender) young people, an area that has been mostly ignored in research about policing young people. Informed by interviews with 35 LGBT young people in Brisbane, Queensland, this paper addresses this gap by exploring how the non-heteronormative body mediates policing experiences of LGBT young people. Drawing on Foucault (1984), Butler (1990a), and other queer theory, the paper argues young non-heteronormative bodies visibly perform ‘queerness’, are read by police, and shape police-LGBT youth interactions. While this is complicated by looking at-risk (in terms of risk factors like homelessness, substance abuse), and looking risky (in terms of risk-taking or criminalised activities), the paper concludes noting how youthful LGBT bodies are regulated by police as non-heteronormative and deviant.

The cost effectiveness of Naltrexone added to cognitive-behavioral therapy in the treatment of alcohol dependence

he purpose of this study was to evaluate the comparative cost of treating alcohol dependence with either cognitive behavioral therapy (CBT) alone or CBT combined with naltrexone (CBT+naltrexone). Two hundred ninety-eight outpatients dependent on alcohol who were consecutively treated for alcohol dependence participated in this study. One hundred seven (36%) patients received adjunctive pharmacotherapy (CBT+naltrexone). The Drug Abuse Treatment Cost Analysis Program was used to estimate treatment costs. Adjunctive pharmacotherapy (CBT+naltrexone) introduced an additional treatment cost and was 54% more expensive than CBT alone. When treatment abstinence rates (36.1% CBT; 62.6% CBT+naltrexone) were applied to cost effectiveness ratios, CBT+naltrexone demonstrated an advantage over CBT alone. There were no differences between groups on a preference-based health measure (SF-6D). In this treatment center, to achieve 100 abstainers over a 12-week program, 280 patients require CBT compared with 160 CBT+naltrexone. The dominant choice was CBT+naltrexone based on modest economic advantages and significant efficiencies in the numbers needed to treat.

Safety impacts of alcohol and other drugs in the construction industry : Preliminary findings

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The body literate: Discourse and inscription in early literacy

The collection will cover all the major fields of discourse studies: including, grammar, stylistics, conversation analysis, narrative analysis, argumentation, psychology of comprehension, ethnography of speaking, and media. It will include classic articles, work from the top scholars in the field, and reflect all the significant debates.

Engineering an Ecosystem : Taking Cues from Nature’s Paradigm to Build Tissue in the Lab and the Body

This manuscript took a 'top down' approach to understanding survival of inhabitant cells in the ecosystem bone, working from higher to lower length and time scales through the hierarchical ecosystem of bone. Our working hypothesis is that nature “engineered” the skeleton using a 'bottom up' approach,where mechanical properties of cells emerge from their adaptation to their local me-chanical milieu. Cell aggregation and formation of higher order anisotropic struc- ture results in emergent architectures through cell differentiation and extracellular matrix secretion. These emergent properties, including mechanical properties and architecture, result in mechanical adaptation at length scales and longer time scales which are most relevant for the survival of the vertebrate organism [Knothe Tate and von Recum 2009]. We are currently using insights from this approach to har-ness nature’s regeneration potential and to engineer novel mechanoactive materials [Knothe Tate et al. 2007, Knothe Tate et al. 2009]. In addition to potential applications of these exciting insights, these studies may provide important clues to evolution and development of vertebrate animals. For instance, one might ask why mesenchymal stem cells condense at all? There is a putative advantage to self-assembly and cooperation, but this advantage is somewhat outweighed by the need for infrastructural complexity (e.g., circulatory systems comprised of specific differentiated cell types which in turn form conduits and pumps to overcome limitations of mass transport via diffusion, for example; dif-fusion is untenable for multicellular organisms larger than 250 microns in diameter. A better question might be: Why do cells build skeletal tissue? Once cooperatingcells in tissues begin to deplete local sources of food in their aquatic environment, those that have evolved a means to locomote likely have an evolutionary advantage. Once the environment becomes less aquarian and more terrestrial, self-assembled organisms with the ability to move on land might have conferred evolutionary ad-vantages as well. So did the cytoskeleton evolve several length scales, enabling the emergence of skeletal architecture for vertebrate animals? Did the evolutionary advantage of motility over noncompliant terrestrial substrates (walking on land) favor adaptations including emergence of intracellular architecture (changes in the cytoskeleton and upregulation of structural protein manufacture), inter-cellular con- densation, mineralization of tissues, and emergence of higher order architectures?How far does evolutionary Darwinism extend and how can we exploit this knowl- edge to engineer smart materials and architectures on Earth and new, exploratory environments?[Knothe Tate et al. 2008]. We are limited only by our ability to imagine. Ultimately, we aim to understand nature, mimic nature, guide nature and/or exploit nature’s engineering paradigms without engineer-ing ourselves out of existence.

Empirical basis for adopting a theory-driven approach to preventing alcohol and other drug impairment (AOD) in the workplace

Background: A State-based industry in Australia is in the process of developing a programme to prevent AOD impairment in the workplace. The objective of this study was to determine whether the Theory of Planned Behaviour can help explain the mechanisms by which behaviour change occurs with regard to AOD impairment in the workplace. ---------- Method: A survey of 1165 employees of a State-based industry in Australia was conducted, and a response rate of 98% was achieved. The survey included questions relevant to the Theory of Planned Behaviour: behaviour; behavioural intentions; attitude; perceptions of social pressure; and perceived behavioural control with regard to workplace AOD impairment. ---------- Findings: Less than 3% of participants reported coming to work impaired by AODs. Fewer than 2% of participants reported that they intended to come to work impaired by AODs. The majority of participants (over 80%) reported unfavourable attitudes toward AOD impairment at work. Logistic regression analyses suggest that, consistent with the theory of planned behaviour: attitudes, perceptions of social pressure, and perceived behavioural control with regard to workplace AOD impairment, all predict behavioural intentions (P < .001); and behavioural intentions predict (self-reported) behaviour regarding workplace AOD impairment (P < .001). ---------- Conclusions: The Theory of Planned Behaviour appears to assist with understanding the mechanisms by which behaviour change occurs with regard to AOD impairment in the workplace. An occupational AOD programme which targets those mechanisms for change may improve its impact in preventing workplace AOD impairment.

The role of education and awareness in workplace alcohol and drug use in the Australian construction industry : proposed program of research and preliminary results

The main aim of this paper is to outline a proposed program of research which will attempt to quantify the extent of the problem of alcohol and other drugs in the Australian construction industry, and furthermore, develop an appropriate industry-wide policy and cultural change management program and implementation plan to address the problem. This paper will also present preliminary results from the study. The study will use qualitative and quantitative methods (in the form of interviews and surveys, respectively) to evaluate the extent of the problem of alcohol and other drug use in this industry, to ascertain the feasibility of an industry-wide policy and cultural change management program, and to develop an appropriate implementation plan. The study will be undertaken in several construction organisations, at selected sites in South Australia, Victoria and Northern Territory. It is anticipated that approximately 500 employees from the participating organisations across Australia will take part in the study. The World Health Organisation’s Alcohol Use Disorders Identification Test (AUDIT) will be used to measure the extent of alcohol use in the industry. Illicit drug use, ‘‘readiness to change’’, impediments to reducing impairment, feasibility of proposed interventions, and employee attitudes and knowledge regarding workplace AOD impairment, will also be measured through a combination of interviews and surveys. Among the preliminary findings, for 51% (n=127) of respondents, score on the AUDIT indicated alcohol use at hazardous levels. Of the respondents who were using alcohol at hazardous levels, 76% reported (n97) that they do not have a problem with drinking and 54% (n=68) reported that it would be easy to ‘‘cut down’’ or stop drinking. Nearly half (49%) of all respondents (n=122) had used marijuana/cannabis at some time prior to being surveyed. The use of other illicit substances was much less frequently reported. Preliminary interview findings indicated a lack of adequate employee knowledge regarding the physical effects of alcohol and other drugs in the workplace. As for conclusions, the proposed study will address a major gap in the literature with regard to the extent of the problem of alcohol and other drug use in the construction industry in Australia. The study will also develop and implement a national, evidence-based workplace policy, with the aim of mitigating the deleterious effects of alcohol and other drugs in this industry.

Stories of cross-dressing and the body : family memories in fiction

Ruth Finnegan (2006, 179) describes how family myths have the power to provoke images that recur throughout generations. This paper will document my own encounter with such persistent images in the stories of a mother and daughter. Both mother and daughter told stories about encountering cross-dressing men in the streets of Brisbane, and both showed similar anxiety over their own body size. As a creative writer working with oral histories, I found these stories of the disguised body compelling. By drawing on the storytelling strategies and preoccupations present in the interview, I used imagination and fictional techniques to investigate the possibility of symbolic resonance of memories across generations. In her novel Beloved, Toni Morrison (1987) uses the notion of ‘rememory’ to describe how characters actively make and suppress meanings in their recollections. Like Morrison, my writing speaks to notions around the way stories are remembered and told.

Fashion, the body and technology : tracing early 20th century techno-utopian ideas, aesthetics and impulses in 21st century wearable technology

‘Wearable technology’, or the use of specialist technology in garments, is promoted by the electronics industry as the next frontier of fashion. However the story of wearable technology’s relationship with fashion begins neither with the development of miniaturised computers in the 1970s nor with sophisticated ‘smart textiles’ of the twenty-first century, despite what much of the rhetoric suggests. This study examines wearable technology against a longer history of fashion, highlighted by the influential techno-sartorial experiments of a group of early twentieth century avant-gardes including Italian Futurists Giacomo Balla and F.T. Marinetti, Russian Constructivists Varvara Stepanova and Liubov Popova, and Paris-based Cubist, Sonia Delaunay. Through the interdisciplinary framework of fashion studies, the thesis provides a fuller picture of wearable technology framed by the idea of utopia. Using comparative analysis, and applying the theoretical formulations of Fredric Jameson, Louis Marin and Michael Carter, the thesis traces the appearance of three techno-utopian themes from their origins in the machine age experiments of Balla, Marinetti, Stepanova, Popova and Delaunay to their twenty-first century reappearance in a dozen wearable technology projects. By exploring the central thesis that contemporary wearable technology resurrects the techno-utopian ideas and expressions of the early twentieth century, the study concludes that the abiding utopian impetus to embed technology in the aesthetics (prints, silhouettes, and fabrication) and functionality of fashion is to unify subject, society and environment under a totalising technological order.