The presentation of secreted axon guidance factors plays a major role in shaping central nervous system (CNS) connectivity. Recent work suggests that heparan sulfate (HS) regulates guidance factor activity; however, the in vivo axon guidance roles of its carrier proteins (heparan sulfate proteoglycans, or HSPGs) are largely unknown. Here we demonstrate through genetic analysis in vivo that the HSPG Syndecan (Sdc) is critical for the fidelity of Slit repellent signaling at the midline of the Drosophila CNS, consistent with the localization of Sdc to CNS axons. sdc mutants exhibit consistent defects in midline axon guidance, plus potent and specific genetic interactions supporting a model in which HSPGs improve the efficiency of Slit localization and/or signaling. To test this hypothesis, we show that Slit distribution is altered in sdc mutants and that Slit and its receptor bind to Sdc. However, when we compare the function of the transmembrane Sdc to a different class of HSPG that localizes to CNS axons (Dallylike), we find functional redundancy, suggesting that these proteoglycans act as spatially specific carriers of common HS structures that enable growth cones to interact with and perceive Slit as it diffuses away from its source at the CNS midline.

Although alcohol use disorders (AUDs) adversely affect women, research on efficacious treatments for women is limited. In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and percentage of days of heavy drinking (PDH) over 6 months of treatment and 12 months of posttreatment follow-up. Baseline relationship functioning and comorbid disorders were tested as moderators of outcome. Piecewise linear growth models were used to model outcomes. During treatment, women increased their PDA and decreased their PDH, with significantly greater improvements in ABCT than in ABIT (d = 0.59 for PDA; d = 0.79 for PDH). Differences favoring ABCT were maintained during follow-up. Women with poorer baseline relationship functioning improved more on PDA during treatment with ABCT than with ABIT. For PDH, results during treatment and follow-up favored ABCT for women with better baseline relationship functioning. ABCT resulted in better outcomes than ABIT for women with Axis I disorders at the end of follow-up (PDA), and for women with Axis II disorders at the end of treatment (PDA) and at the end of follow-up (PDH).

No abstract

No abstract

Results favored the two behavioral conditions and did not suggest additional benefit from combining AA with behavioral couples therapy, but those who did attend AA showed a positive impact.

No abstract

The increase in prevalence rates of alcohol use disorders in younger versus older cohorts of female drinkers is many times higher than the corresponding increase in prevalence rates for male drinkers. Thus, the number and impact of older female drinkers is expected to increase over the next 20 years as the disparity between men's and women's drinking rates decrease. Due to differences in metabolism of alcohol, women of all ages compared to men are at higher risk for negative physical, medical, social, and psychological consequences associated with at-risk and higher levels of alcohol consumption. Aging women face new sets of antecedents related to challenges in the middle and older adult phases of life, such as menopause, retirement, "empty nest," limited mobility, and illness. As women age, they are subject to an even greater physiological susceptibility to alcohol's effect, as well as to a risk of synergistic effects of alcohol in combination with prescription drugs. On the other hand, there is mixed research indicating that older women may benefit from the buffering effect of low levels of alcohol on hormonal declines associated with menopause, perhaps serving as a protective factor against Coronary Heart Disease and osteoporosis. However, with heavier drinking, these benefits are either reversed or eclipsed. In addition, any alcohol consumption increases the risk for breast cancer in older women. The possible beneficial effects of alcohol must be weighed with the fact that the research does not typically establish causality, that low-risk drinking equates to one standard drink per day, that there is a risk of progression towards alcohol dependence, and that there are alternate methods to gain the same benefits without the associated risks. Older women also experience unique barriers to detection of and treatment for alcohol problems. Current treatment options specifically for older women are limited, though researchers are beginning to address differential treatment response of older women, as well as development of elder women-specific treatment approaches. Treatment options include self-help/mutual peer support, which provides ancillary advantages, brief interventions in primary care settings, which have been demonstrated to be effective in reducing drinking levels, and cognitive behavioral techniques, which have been demonstrated to be useful; but more studies and larger samples are needed. Elder-specific treatments need to be appropriate in terms of content, to address the challenges associated with life stage, such as the loss of the parental role and widowhood, and in terms of process, such as delivery in a respectful therapeutic style and at a slower pace. Future directions in research should address the lack of assessment instruments, the risks of simultaneous use of alcohol and prescription medications, and the under-representation of older women in randomized trials of alcohol treatments.

Women with alcohol use disorder (AUD) experience more barriers to AUD treatment and are less likely to access treatment than men with AUD. A literature review identified several barriers to women seeking help: low perception of a need for treatment; guilt and shame; co-occurring disorders; employment, economic, and health insurance disparities; childcare responsibilities; and fear of child protective services. Women entering treatment present with more severe AUD and more complex psychological, social, and service needs than men. Treatment program elements that may reduce barriers to AUD treatment include provision of childcare, prenatal care, treatment for co-occurring psychological problems, and supplemental social services. Research has suggested that outcomes for women are best when treatment is provided in women-only programs that include female-specific content. To date, research on treatments tailored to the individual needs of women is limited, but research on mechanisms of change has suggested the importance of targeting anxiety and depression, affiliative statements in treatment, abstinence self-efficacy, coping skills, autonomy, and social support for abstinence. Future research should focus on early interventions, linkages between primary care or mental health clinics and AUD treatment settings, and integrated treatments for co-occurring AUD and other disorders. Further research should also explore novel treatment delivery approaches such as digital platforms and peer support groups.