There are many reasons why collaboration between academic institutions and private industry should be encouraged. At the same time, such collaborations raise the potential for profound conflicts of interest. Furthermore, there may be different kinds of issues in different kinds of industry, as is reflected in the metaphors we employ to think about them. The pharmaceutical industry is at times viewed as a "good" industry that can go wrong, while the tobacco industry is analogously viewed as a "bad" industry that can do little right. The alcohol and gambling industries may be particularly useful to think through insofar as they arguably require a continuum of benefits and harms to be acknowledged. I consider a number of initiatives by the alcohol and gambling industry in South Africa, and argue that there are real opportunities for delineating and developing more robust models of academic-industry collaboration, which ensure that public health is maximized in that country and elsewhere.
Chronic methamphetamine use is associated with executive functioning deficits that suggest dysfunctional cognitive control networks (CCNs) in the brain. Likewise, abnormal connectivity between intrinsic CCNs and default mode networks (DMNs) has also been associated with poor cognitive function in clinical populations. Accordingly, we tested the extent to which methamphetamine use predicts abnormal connectivity between these networks, and whether, as predicted, these abnormalities are compounded in patients with a history of methamphetamine-associated psychosis (MAP). Resting-state fMRI data were acquired from 46 methamphetamine-dependent patients [19 with MAP, 27 without (MD)], as well as 26 healthy controls (CTRL). Multivariate network modelling and whole-brain voxel-wise connectivity analyses were conducted to identify group differences in intrinsic connectivity across four cognitive control and three DMN networks identified using an independent components analysis approach (meta-ICA). The relationship of network connectivity and psychotic symptom severity, as well as antipsychotic treatment and methamphetamine use variables, was also investigated. Robust evidence of hyper-connectivity was observed between the right frontoparietal and anterior DMN networks in MAP patients, and 'normalized' with increased duration of treatment with antipsychotics. Attenuation of anticorrelated anterior DMN-dorsal attention network activity was also restricted to this group. Elevated coupling detected in MD participants between anterior and posterior DMN networks became less apparent with increasing duration of abstinence from methamphetamine. In summary, we observed both alterations of RSN connectivity between DMN networks with chronic methamphetamine exposure, as well as DMN-CCN coupling abnormalities consistent with possible MAP-specific frontoparietal deficits in the biasing of task-appropriate network activity.
Attention-deficit/hyperactivity disorder (ADHD) and developmental stress are considered risk factors for the development of drug abuse. Though the physiological mechanisms underlying this risk are not yet clear, ADHD, developmental stress and drug abuse are known to share underlying disturbances in dopaminergic neurotransmission. Thus, we hypothesized that clearance of cocaine-induced elevations in striatal dopamine would be prolonged in a rat model of ADHD and that this would be further increased by exposure to developmental stress. In the current study, male spontaneously hypertensive rats (SHRs), a well-validated model of ADHD, and control Wistar-Kyoto (WKY) rats were exposed to either standard rearing (nMS) or a maternal separation (MS) paradigm involving removal of the pups from the dam for 180 min/day over 13 days. This produced a 2 × 2 factorial design (SHR/WKY × nMS/MS) with 5-6 rats/group. Striatal clearance of exogenously applied dopamine was measured via in vivo chronoamperometry, and the difference in dopamine uptake parameters before and after cocaine administration was compared between experimental groups. Cocaine, a potent dopamine transporter inhibitor, reliably increased the clearance time of dopamine though no difference in this parameter was found between SHR and WKY strains. However, developmental stress elevated the cocaine-induced increase in time to clear 50% of exogenously applied dopamine (T50) in SHR but had no effect in WKY rats. These findings suggest that a strain × environment interaction prolongs elevated levels of dopamine thereby potentially increasing the rewarding properties of this drug in SHR.
Read moreThe WPA, within its 2014-2017 Action Plan1, established a network of Collaborating Centres to develop innovative initiatives on education, policy and research in mental health. The aim of this network is to create repositories of information as well as offer practical advice and guidance on teaching, policy and research. The WPA Collaborating Centres have been appointed by the WPA President and Executive Committee for a period of three years in the first instance, according to the following criteria: a) high scientific reputation at national and international levels; b) pre-eminent status in the country's health, research or academic structures; c) high quality of academic and research leadership; d) stability in terms of achievements, staff and resources; e) willingness to deliver the WPA Action Plan; f) clear and appropriate technical expertise. The functions of the WPA Collaborating Centres are to: a) collect and disseminate information on mental health; b) provide training and links to clinical and research centers; c) support capacity building at country or regional level; d) conduct and coordinate educational and research activities with the support of the WPA2. The network includes now seven sites: the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; the Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; the Department of Psychiatry, University of Nairobi, Kenya; the Department of Psychiatry and Mental Health, University of Cape Town, South Africa; the Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt; the Department of Psychiatry, Barts and London School of Medicine and Dentistry, Queen Mary University, London, UK; and the Department of Psychiatry, University of Naples SUN, Naples, Italy. The network started its activities in 2016, adopting the principles of co-creation and the democratization of knowledge. In fact, mutual learning and exchanges are extremely important for developing new solutions that are sustainable and evidence based, and for providing better care for patients in times of economic constraints, shortage of skilled mental health professionals, and legal and policy obstacles to mental health care in all countries3-5. The Centers will provide opportunities for scholarship across high-, middle- and low-income countries, and will disseminate curricula, best clinical practice guidelines, shared policies and high impact research to improve patient care and public mental health. Another priority is to develop shared teaching and learning projects for medical students and psychiatric trainees6, 7. In the future, the network will expand its aspirations by promoting social inclusion, protection of human rights in care environments, and adoption of effective complex biopsychosocial interventions in clinical practice8, 9. Updates on the activities promoted by the WPA Collaborating Centres will be shared and disseminated through policy papers, educational activities and training programs. Kamaldeep S. Bhui1, Andrea Fiorillo2, Dan Stein3, Tarek Okasha4, David Ndetei5, Linda Lam6, Santosh Chaturvedi7, Mario Maj2 1Department of Psychiatry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK; 2Department of Psychiatry, University of Naples SUN, Naples, Italy; 3University of Cape Town, Cape Town, South Africa; 4Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 5Department of Psychiatry, University of Nairobi, Nairobi, Kenya; 6Department of Psychiatry, Chinese University of Hong Kong, Hong Kong; 7National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
Read moreCurrent psychopharmacological nomenclature remains wedded to earlier period of scientific understanding, failing to reflect contemporary developments and knowledge, does not help clinicians to select the best medication for a given patient, and tending to confuse patients as they are being given a drug with a different name compared to their identified diagnosis (e.g. "Antipsychotic" for depression).
Read moreWe found evidence of treatment efficacy for the SSRIs, but it is based on very low- to moderate-quality evidence. Tolerability of SSRIs was lower than placebo, but absolute withdrawal rates were low.While a small number of trials did report treatment efficacy for benzodiazepines, anticonvulsants, MAOIs, and RIMAs, readers should consider this finding in the context of potential for abuse or unfavourable side effects.
Read moreIn this exploratory study, maternal trauma and PTSD were found to be highly prevalent, and preliminary evidence suggested that trauma may adversely affect fetal growth, as measured by birth head circumference. However, these findings are limited by a number of methodological weaknesses, and further studies are required to extend findings and delineate causal links and mechanisms of association.
Read moreThis study tested an intervention program based on a chronic pain management model for pain. We conducted a trial of a 6-week, peer-led exercise and education intervention on pain in amaXhosa women living with HIV/AIDS. Participants were monitored over 15 months of routine care before randomization. The control group was provided with educational workbooks, and the experimental group attended the intervention. Pain was reassessed monthly for 4 months. There was no significant reduction in pain during 15 months of routine care and no difference between groups at any of the time points (d = 0.04). Both groups experienced equivalent pain reduction during the intervention compared with the period of routine care with meaningful reductions in pain at months 3 (Cohen's d = 0.41) and 4 (Cohen's d = 0.59). Provision of a workbook and participating in a 6-week peer-led exercise and education intervention are efficacious methods to treat pain in amaXhosa women living with HIV/AIDS.
Read moreAs very large studies of complex neuroimaging phenotypes become more common,\nhuman quality assessment of MRI-derived data remains one of the last major\nbottlenecks. Few attempts have so far been made to address this issue with\nmachine learning. In this work, we optimize predictive models of quality for\nmeshes representing deep brain structure shapes. We use standard vertex-wise\nand global shape features computed homologously across 19 cohorts and over 7500\nhuman-rated subjects, training kernelized Support Vector Machine and Gradient\nBoosted Decision Trees classifiers to detect meshes of failing quality. Our\nmodels generalize across datasets and diseases, reducing human workload by\n30-70\\%, or equivalently hundreds of human rater hours for datasets of\ncomparable size, with recall rates approaching inter-rater reliability.\n
Read moreWe found that first-rank auditory hallucinations were more prevalent in MAP, whereas first-rank delusions of thought broadcasting were more prevalent in SZ. However, there was a substantial overlap in MAP and SZ for most FRS. This is consistent with the finding that FRS may have limited diagnostic specificity and that there is significant overlap in the symptoms of MAP and SZ. Future research into the neurobiology of delusions and hallucinations needs to take FRS into account.
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