Another focus is defining techniques that allow for looking at the reactions occurring within the cell that are not just an end product or electrophysiological changes. One objective has been to adapt the existing technique of fluorescence resonance energy transfer (FRET) to these needs. FRET makes it possible to look optically at real time protein-protein interactions, which become visible as different wavelengths of light. The key for this research will be restricting observation to the cell membrane, where events of interest in synaptic transmission occur. Total internal reflectance fluorescence microscopy, using a principle called evanescent field illumination, is helping to build a laser subsystem to accomplish this goal.

With these techniques it will be possible to measure protein-protein interactions with a very high spatial and temporal resolution, enabling a kind of optical single-cell biochemistry. As new and very specific G-protein coupled receptor pathways are identified, the role of these pathways in the action of ethanol may be elucidated.

  Loan Repayment Program

Dr. Kenneth Warren introduced the next agenda item, the Extramural Loan Repayment Program.  He introduced Mr. Mark S. Horowitz, Director of the NIH Office of Loan Repayment and Scholarship, to describe the program and the efforts over the past 6 months. 

Designed to remove financial disincentives to research careers, the Congressionally mandated NIH loan repayment programs (LRP) provide repayment of student loans for qualified researchers in NIH extramural and intramural programs. The two largest extramural programs are the clinical research loan repayment program and the pediatric research loan repayment program; researchers supported by any NIH institute can receive loan repayment funding through these programs. In FY 2002, the NIH Office of Loan Repayment and Scholarship (OLRS) received about 500 qualified applications for the clinical research program and about 200 for the pediatric program.

Intramural NIH loan repayment programs have existed since 1989, when the AIDS LRP began. Since then, three other intramural LRP programs have been created, primarily to support physicians, but also including dentists and Ph.D.s conducting research on campus as Federal employees.

OLRS serves as the central receipt point for all NIH loan repayment applications, and the Office verifies eligibility before forwarding them for review. In addition, financial services are provided for participants' often complex loan repayment portfolios, organizing, sometimes consolidating, and keeping records for all their student loan accounts.

This year OLRS developed a web site that enables a paperless application process: everyone involved from applicants to those writing recommendations enters all material on-line. Applicants can go to the web site, check the status of their application at any time, and see whether all the necessary forms have been submitted. For personal assistance and answers to questions, applicants can call the toll-free LRP Help Line; about 6500 people called in the first six months the Help Line was open. For after-hours inquiries,  LRP Email Support is available (LRP@NIH.GOV); about 6500 people used this service in the first six months as well, receiving answers to their questions about 18 hours a day.

In FY 2002, 17 people from NIAAA received LRP clinical research contracts and one for pediatric research, which represented about a 90 percent success rate for applicants. Most awardees hold Ph.D.s and have an average debt of about $58,000. Of the eight males and ten females, 14 are Caucasian, two are African American, one is Hispanic, one is Asian, and two did not specify race.

Current eligibility criteria include being a U.S. citizen or permanent resident; holding a doctoral level degree; and having qualifying debt that equals or exceeds 20 percent of base salary. Recipients sign a contract to engage in qualified research for two years, and they can apply for renewal contracts. Proposed changes for FY 2003 would broaden eligibility by allowing those conducting research for non-profit organizations or U.S. Government organizations to apply, as well as part-time Federal employees engaged in qualifying research as part of their non-Federal activities for at least 20 hours per week. OLRS anticipates receiving substantially more applications for LRPs as a result of these changes. Another proposed change relates to people who had National Research Service Awards. Under current rules, they cannot apply for loan repayment until they complete their service obligations; the suggested change would allow them to defer their service and receive loan repayment assistance first.

Dr. Kenneth Warren introduced the next speaker, Council member Dr. Raul Caetano, who is professor and Assistant Dean at the School of Public Health at the University of Texas.  His presentation was entitled, "Intimate Partner Violence Among Whites, Blacks, and Hispanics in the U.S. Population: The Role of Alcohol".

The University of Texas began an NIAAA-funded longitudinal study in 1995, randomly selecting 1600 couples to interview in their homes about intimate partner violence (IPV) in their relationships. About 85 percent agreed to participate in the interviews, which trained interviewers conducted separately with each partner (one hour with one partner, 20 minutes with the other). In 2000, approximately 1200 of the couples were still intact, and 69 percent of them agreed to participate in a follow-up interview (one hour with each partner). In the 2000 sample, drinking and violence behaviors did not differ substantially among participants and those who decline to take part.

The study measured IPV using the conflict tactics scale, which groups specific violent behaviors into moderate and severe categories. For example, participants were asked whether either partner had thrown something at, pushed, grabbed, or shoved the other (moderate violence) and whether either had choked, burned, and used or threatened to use a knife or gun (severe violence). Reports of a violent behavior were counted even if one of the partners denied it had happened, which is known as an "upper bound estimate." Interviewers also collected demographic data and data on alcohol use, family history of violence, and personal characteristics, such as impulsivity. Enough whites, blacks, and Hispanics participated to allow data break-downs by race, and behaviors were also analyzed by gender.

Key results of the study include the following:

• IPV is higher among blacks and Hispanics for all events than it is for whites, and most of the differences are statistically significant.
  
  
• Female-to-male violence is mostly moderate violence and it is higher in the community (this study) than it is in studies in institutional settings, which feature very severe violence that is primarily male-perpetrated. Female-to-male violence is greater in the black community than in other groups.
  
  
• Regarding alcohol and violence, there was a relationship between consumption and violence for Whites and Hispanics. For Blacks, however, the relationship was between alcohol problems and violence. By gender, female-to-male violence was related to alcohol problems among blacks and for female alcohol problems among whites. Among blacks, males with alcohol problems are about three times more likely to be a victim of female-to-male violence.  Black women with alcohol problems are seven times more likely than a black woman without alcohol problems to commit female-to-male violence.
  
  
• Intimate partner violence is more common among those who are younger, have lower incomes, are unemployed, have a history of childhood physical abuse, and live in a poor neighborhood.
  
  
• Comparing 1995 and 2000 data, most couples who were non-violent in 1995 remained non-violent in 2000. A few progressed to moderate violence and even fewer to severe violence.  Among those reporting moderate violence in 1995, most reported no violence in 2000, while about one-third continued to report moderate violence, and a few progressed to severe violence. Overall, severe violence was more stable than moderate violence.
  
  
• Blacks and Hispanics are two to three times more likely than whites to have reported intimate partner violence in both 1995 and 2000. Specifically, 54 percent of the Hispanic couples who reported violence in 1995 reported it again in 2000, compared to 47 percent of blacks and 34 percent of whites. Across races, about 60 percent of cases were chronic, and 40 per cent of cases consisted of one incident within the past 12 months. The severity of chronic violence was higher among blacks than among Hispanics or whites.
  
  
• Longitudinal analysis of alcohol/IPV issues produced no clear patterns.

It is important to note that the study did not control for socioeconomic or other characteristics, so increased rates by ethnicity are likely related to a variety of additional factors.

Dr. Raynard S. Kington, Acting Director, NIAAA, joined the meeting, and was introduced by Dr. Kenneth S. Warren.  Dr. Kington began his portion of the presentation with the Director's Report (available on the NIAAA web-page at http://www.niaaa.nih.gov  Each member received a written copy of the complete document. Key items included the following:

• Council member Ralph Hingson, Ph.D. received the Widmark Award from the International Council on Alcohol, Drugs, and Traffic Safety. The reward recognized his research and advocacy on traffic safety issues, such as zero tolerance for drinking alcohol among drivers age 21 and younger and lowering legal blood alcohol levels for all drivers.
  
  
• NIH Director Dr. Elias Zerhouni has given NIAAA $500,000 from his discretionary budget (the Director's Discretionary Fund) to support research to develop a biosensor that enables continuous, unobtrusive measurement of alcohol levels in individuals in daily life. This technology would advance understanding of the pathologic and behavioral effects of alcohol as well as having potential application to other areas of medical research.
  
  
• Dr. Ting-Kai Li has been appointed Director of NIAAA, a position he is expected to assume on November 17, 2002.
• NIAAA and several other NIH institutes took part in the NIH Consensus Panel on the Management of Hepatitis C on June 10-12, 2002.
  
  
• In the Congressional budget process, the Senate has proposed giving NIAAA $418.8 million in FY 2003, $2 million more than the President's budget requested. The final figure will be determined in coming months.
  
  
• Dr. Zerhouni visited NIAAA on August 12, 2002, to meet staff, learn about the Institute's mission, and hear about NIAAA research efforts from basic neuroscience to community outreach. Staff presentations were excellent, and the visit was successful.
  
  
• NIAAA's College Drinking Initiative will sponsor a series of regional workshops beginning in October 2002. The Initiative's web site (http://www.collegedrinkingprevention.gov) has been visited by more than 2.5 million people and received numerous awards.
  
  
• The Institute sponsored a planning meeting in June 2002, to develop ideas for increasing the number of Hispanic/Latino researchers and increasing NIAAA's capacity to conduct research in Hispanic/Latino communities.
  
  
• Among many other products, the Leadership Initiative has developed and placed educational dioramas on alcohol issues in airports, such as Washington Dulles and Reagan National.
  
  
• The NIAAA Office of Collaborative Research sponsored a workshop for the children affected by fetal alcohol syndrome and their caregivers from August 15-17, 2002. Other activities included sponsoring meetings, research training program awards, and grant awards on HIV/AIDS and alcohol.
  
  
• The Scientific Communications Branch has released a variety of new publications, including a poster targeting 11 to 13-year olds developed in partnership with the Center for Substance Abuse Prevention.
  
  
• The Division of Basic Research sponsored a working group on the neurobiology of alcohol and aging on September 10-11, 2002.
  
  
• Two prevention programs based on NIAAA research, the Border Binge-Drinking Project and Brief Alcohol Screening and Intervention for College Students, received awards for effectiveness from the Center for Substance Abuse in June 2002.
  
  
• NIAAA is forming a national advisory committee to guide the ongoing NESARC (National Epidemiologic Study on Alcohol and Related Conditions) study. The Council will hear a presentation about the group's activities at a future meeting.
  
  
• A number of NIAAA staff received an NIH Director's Award for their participation in the development and implementation of NIAAA's College Drinking Prevention Initiative.
  
  
• Dr. Kington thanked retiring Council members Anna Mae Diehl, M.D., Professor of Medicine at Johns Hopkins University School of Medicine; Linda Kaplan, CAE, Executive Director, Danya Institute; Barbara J. Mason, Ph.D., Professor and Director of Substance Abuse at the University of Miami School of Medicine; and Paul Samuels, J.D., President of the Legal Action Center.

Dr. Kington introduced Mrs. Mary Easley, First Lady of North Carolina, Mrs. Mikey Hoeven, First Lady of North Dakota, Mrs. Patricia Kempthorne, First Lady of Idaho, and the former First Lady of Montana, Ms. Teresa Racicot.  These First Ladies represented the 32 other Governors' spouses who support the Leadership to Keep Children Alcohol Free national initiative founded by NIAAA and The Robert Wood Johnson Foundation. Mrs. Easley, First Lady of North Carolina, reported on the results from a nationwide poll of opinion leaders in education, law enforcement, prevention, public health and Government about their perspective on the "Hidden Costs of Childhood Drinking." The nationwide poll was funded by The Robert Wood Johnson Foundation and conducted in behalf of the Leadership initiative. The poll results were the topic of a press conference earlier that morning at the National Press Club.

Mrs. Easley noted that the past several months had seen an increased report and survey activity on the issue of underage drinking and its consequences. "We have increased our knowledge about the impact of alcohol upon youth, we know that when prompted to face the issue directly, the public admits it is concerned about underage drinking. What we haven't known until now is what do our leaders know about this issue and how do they characterize the underage drinking issue." Mrs. Easley shared with the Council several of the key findings from this latest nationwide poll:

-- 78 percent of respondents said drinking by children is a "very serious" problem in the United States;

-- 74 percent of those polled responded that more children are drinking alcohol at an earlier age compared to 10 years ago; and

-- 85 percent agreed that it was either "very easy" or somewhat easy" for children ages 9 to 15 to get access to alcohol.

Mrs. Easley further noted that in the poll of opinion leaders, there was widespread agreement about the negative impact drinking by the young have on our society. These include:

-- 87 percent said childhood drinking may create lifelong problems with alcohol;

-- 81 percent indicated that it can cause serious health and emotional problems for children;

-- 77 percent agreed drinking causes children to do poorly in school;

-- 74 percent held that drinking causes disruptive and anti-social behavior;

-- 73 percent state that drinking by children contributes to their becoming sexually active at a younger age; and

-- 64 percent responded that childhood drinking leads to long-term increases in health care costs.

The survey also identified the solutions opinion leaders believed would make a difference. Those receiving most support included increasing the financial commitment to prevention, treatment, public education, and research; limiting advertising that reaches children; and strengthening the penalties for adults who provide alcohol to children.

Mrs. Easley concluded her presentation by reiterating the commitment of the participating Governors' spouses in supporting the NIAAA's and the Council's efforts in combating childhood drinking. Research evidence provides powerful evidence of the negative impact of early alcohol use. Objective evidence from research needs to continue to inform public education efforts and public policies. She called for more research on this vulnerable 9-15 age group.

Discussion:  In response to questions and comments from Council members and the audience, Mrs. Easley clarified that:

After Dr. Warren asked whether changes were needed in the Minutes from the April 2002 meeting, a motion to approve them was seconded and unanimously accepted.  A motion was made and seconded to accept the minutes for the June 2002 meeting. Those minutes were unanimously accepted.  Meeting dates in 2003 will be February 5-6; June 4-5; and September 17-18.

  NIDA/NIAAA Collaboration

Dr. Raynard Kington gave a presentation regarding the collaborative efforts of NIDA and NIAAA.