Day 1 :
Keynote Forum
Jason Connor
The University of Queensland, Australia
Keynote: What is the future of alcohol use disorder treatment?
Time : Day 1
Biography:
Jason Connor is a Principal Research Fellow in the Centre for Youth Substance Abuse Research at The University of Queensland, Australia. He also holds a National Health and Medical Research Council (NH&MRC) of Australia Fellowship. He is a clinical psychologist by training and a Fellow of the Australian Psychological Society (APS). Since moving from full-time clinical practice to academia (PhD, 2002), he has published 125 peer reviewed papers in the leading addiction (e.g. Addiction) and medical journals (e.g. Lancet). He has received over $8 AUD million in funding.
Abstract:
In spite of advances in the treatment of Alcohol Use Disorders (AUDs), short-term treatment outcomes remain modest, and longer term prognosis poor. This keynote address argues cross-disciplinary research is essential to the future of Alcohol Use Disorder (AUD) treatment. Four empirical studies are presented as examples, covering research across disciplines of clinical psychology, machine learning, clinical pharmacology and molecular biology that extend knowledge of the etiology and treatment of AUDs. Study 1: Clinical trial that compared (non-linear statistical) machine learning approaches against expert clinical judgment in predicting treatment outcome of a 3 month Cognitive Behavioural Treatment (CBT) AUD treatment program. Study 2: Clinical trial that examined the contribution of adjunctive pharmacotherapy (anti-craving and relapse-prevention agents) to CBT in AUD treatment. Study 3: Cross-sectional and prospective studies that examine the relationship between severity phenotypes and psychological and genetic mechanisms known to be associated with alcohol dependence. Study 4: Preliminary data from a new clinical trial which ‘personalizes’ alcohol dependence treatment on the basis of psychological and genetic risk. To advance outcomes in AUD treatment, addiction science must be more responsive to research design technologies and evidence-based findings from allied disciplines.
Keynote Forum
Igor Elman
Harvard Medical School, USA
Keynote: Elucidating the role of reward mechanisms in pathophysiology and treatment of obesity
Time : Day 1
Biography:
Igor Elman, MD is an Associate Professor of Psychiatry at Harvard Medical School. He was trained at the National Institute of Mental Health and is a Diplomate of the American Board of Psychiatry with a subspecialty certification in Addiction Psychiatry. Presently, he heads a clinical research lab, focused on the role of reward and motivational systems in pathophysiology of severe neuropsychiatric disorders, including addictions, schizophrenia and post-traumatic stress disorder. He is a past recipient of NIDA K23 and R01 Awards. He serves as Editor-in-Chief of the Journal of Psychology Research and Behavioral Management.
Abstract:
Background: Obesity and overeating may be construed as a behavioral addiction. In schizophrenia, obesity is twice as prevalent as in the general public afflicting over 50% of the patients and shortening their lifespan by about 15 years. Although excessive consumption of fast food and pharmacotherapy with second-generation antipsychotic agents (SGAs) has been implicated in the schizophrenia/obesity comorbidity, the pathophysiology of this link remains unclear. The mechanism proposed here is based on the central opioidergic system owing to opioids’ role in: a) enhancing reward features of food; b) boosting orexigenic and suppressing anorexigenic neuropeptides; c) reducing peripheral insulin secretion and d) desensitizing insulin receptors. The purpose of this presentation is to discuss a heuristic value of opioid blockade for patients’ metabolic status. Methods: Translational evidence to be presented in support of the above contention includes a preclinical and two clinical studies. First, four groups of Wistar Han IGS rats were treated for 28 days with an SGA olanzapine, a combination of olanzapine and an opioid receptor antagonist, naltrexone, naltrexone alone or vehicle, and their food consumption and body weight were measured daily for the first nine days and every other day thereafter. Second, a potential mechanism of naltrexone action was explored in 15 patients with heroin dependence who underwent the standard sweet taste test before- and 7 days after the injection of depot naltrexone. Third, we also conducted a double-blind placebo-controlled pilot clinical trial where schizophrenic or schizoaffective patients on a stable dose of olanzapine were randomized in a double-blind fashion to receive naltrexone (n=14) or placebo (n=16). Results: Rats treated with olanzapine and naltrexone were similar to the vehicle-treated animals with respect to food intake and body weight gain, whereas olanzapine treatment alone induced overeating and obesity (p<0.001 group-by-time interaction). Data from heroin dependent human subjects demonstrated a reduction in the hedonic and motivational ratings of sweet solutions (p<0.05) after naltrexone suggesting a potential mechanism of action. On the clinical trial, in comparison to the olanzapine and placebo combination, the olanzapine and naltrexone group displayed a significant decrease in the fat mass (p<0.01), assessed with the biometric impedance analysis and a trend towards improvement in the insulin resistance quantified via HOMA-IR values (p=0.09). Conclusions: Naltrexone addition may result in clinically meaningful attenuation of olanzapine-induced metabolic side effects. Potential mechanisms of naltrexone action may involve diminution of rewarding features of food in conjunction with favorable effects on insulin sensitivity. If confirmed, these results may contribute to the identification of an inexpensive and effective treatment that specifically targets the underlying pathophysiologic effects of SGAs and provides a substantial clinical benefit to the at risk population.
Keynote Forum
Kathy Sexton-Radek
Elmhurst College, USA
Keynote: What are the commonly used sleep medicines and are they always necessary?
Time : Day 1
Biography:
Kathy Sexton-Radek, completed her Doctorate of Philosophy in the area of Clinical Psychology at Illinois Institute of Technology in Chicago, IL in 1988. She interned at Rush Medical Center as a Behavioral Medicine Resident. Dr. Sexton-Radek has been in Academia for 26 years developing and teaching undergraduate and graduate Psychology courses. Her private practice work as Director of Behavioral Health and Wellness for the last 26 years has focused on assessment and treatment in areas of sleep disorders, depression, anxiety disorders, somatic symptoms disorders and Psychological factors affecting medical illness disorders. She is a Certified Behavioral Sleep Medicine specialist and has Sleep Board eligibility.
Abstract:
Hypnotics are listed third in ratings of the most commonly prescribed medications behind cardiovascular and cancer related medications. This popularity appears in the general public as well with store aisles holding some twenty plus types of “get to sleep†over the counter medications. Insomnia is the most prevalent sleep disorderand it drives the number of requests for a hypnotic prescription. This circumstance occurs, despite the empirical support and demonstrated effectiveness of Cognitive Behavioral Therapy for Insomnia. This presentation will provide an overview of commonly prescribed Sleep Disorders medications. In addition, the basic science findings of the effect of various medications on sleep will be addressed.
Keynote Forum
Bryan K Yamamoto
University of Toledo, USA
Keynote: Interactions between methamphetamine and stress: A dangerous combination
Time : Day 1
Biography:
Bryan Yamamoto received his PhD from Syracuse University in Neurobiology after which, he completed a postdoctoral fellowship in clinical pharmacology at the University of Colorado Medical School. He was held at various faculty appointments at the Northeastern Ohio Universities College of Medicine in the Department of Pharmacology, Case Western Reserve University School of Medicine in the Department of Psychiatry, and Boston University School of Medicine in the Department of Pharmacology. He is currently Professor and Chair of the Department of Neurosciences at the University of Toledo College of Medicine and Life Sciences. He has been a member of NIH Study Sections since 1987, an editorial board member of several journals, and a member of several advisory boards of NIH sponsored research centers and programs.
Abstract:
Substance abuse and stress are typically co-morbid conditions but little is known about how the two combined conditions may affect the neurochemistry of the brain. More specifically, our past and current animal studies have shown that chronic stress augments the acute effects of the widespread drug of abuse, methamphetamine on dopamine and glutamate neurotransmission and also exacerbates the long-term depletions of dopamine and serotonin produced by methamphetamine. We have used a chronic unpredictable stress paradigm that varies the type and time of stress exposures to rats. The advantages of this approach are that the unpredictable nature of the exposures to varied stressors approximates encounters with unexpected stressful life events. Moreover, the paradigm is not confounded with learning and adaptation but chronically elevates plasma corticosterone. Using this model, recent findings will be presented that the serial exposure to chronic unpredictable stress and a binge dosing regimen of methamphetamine also compromises the blood-brain barrier. In addition, animal studies will be described which support the role of corticosterone synthesis and inflammation in mediating the combined effects of chronic stress and methamphetamine on neurotransmitters and blood-brain barrier structure and function. These findings support that importance of considering co-morbid conditions when evaluating and translating the neuropharmacological effects of methamphetamine to human methamphetamine abusers.
Keynote Forum
Marcelo Febo
University of Florida, USA
Keynote: Effects of chronic cocaine intake on resting state functional connectivity in mesocorticolimbic circuitry
Time : Day 1
Biography:
Marcelo Febo obtained his PhD degree in Physiology & Biophysics at the University of Puerto Rico Medical School. He then went on to conduct Postdoctoral research at the Center for Comparative Neuroimaging in the Department of Psychiatry of the University of Massachusetts Medical School. His research is focused in examining the neural circuit level changes with exposure to drugs of abuse. His laboratory utilizes high field functional magnetic resonance imaging (MRI), functional connectivity analysis, diffusion MRI and in vivo neurophysiological recordings to achieve this goal. He has been funded early in his career by the National Institute on Drug Abuse to examine the relationship between cocaine sensitization and alterations in maternal brain activity. He is presently Assistant Professor in the Department of Psychiatry and is Program Director of Translational Research Imaging in the University of Florida McKnight Brain Institute.
Abstract:
In 2013, approximately 1.5 million individuals reported cocaine use. A significant percentage of these users may eventually, or already, suffer from a cocaine use disorder. Disruption of widespread brain network interactions is a key pathological signature in a number of psychiatric illnesses, including cocaine addiction. Neuroimaging studies are providing evidence of significant changes in synchronous neural activity across various brain regions of cocaine users. The specific brain regions showing alterations in functional connectivity differ during drug use, abstinence, and relapse. However, data are needed in preclinical models examining large-scale integrative neurobiological processes associated with compulsive drug use during different stages of drug seeking. We will present data on the effects of chronic cocaine self-administration on functional connectivity in a rat model of drug seeking behavior. Imaging on a 4.7 Tesla MRI scanner will be carried out before and after 10 days of 6 hr daily sessions of intravenous cocaine self-administration. It is expected that a high level of cocaine intake will result in powerful effects on functional connectivity in mesocorticolimbic regions. Extended 6 hr access to cocaine may disrupt normal functional connectivity patterns among these structures more severely than with standard 2 hr daily access to the drug. In addition to characterizing functional connectivity changes as a result of cocaine self-administration, we will build on these initial studies to determine whether restings rare functional MRI and functional connectivity analysis can act as a measure or biomarker of efficacy of potential addiction treatments.
Keynote Forum
William S Jacobs
Georgia Regents University, USA
Keynote: Doc, it works- 144 mg of loperamide everyday to get opioid high - A case report
Time : Day 1
Biography:
William S Jacobs, MD is board certified in Anesthesiology, Pain Medicine, and Addiction Medicine. A Phi Beta Kappa, Magna Cum Laude University of Georgia undergraduate and graduate of the Medical College of Georgia, he did his Anesthesiology Residency at the University of Alabama-Birmingham before matriculating to UF for his Addiction Medicine Fellowship. He is currently Associate Professor in Psychiatry and Addiction Medicine: Co-Chief of Pain Medicine at the University of Florida. His work has included serving as Medical Director of multiple addiction treatment programs as well as expert witness work, consulting with state and federal agencies, authoring peer reviewed works and as on pharmacologic studies.
Abstract:
Opioid use disorders are a major public health concern and an ongoing epidemic in the United States. Recent efforts to restrict the diversion of prescription opioids resulted in opiate abusers attempting to find inexpensive and available alternatives for managing withdrawal or for recreational abuse. Loperamide, an OTC antidiarrheal, may give opiod-like effects at very high doses because of its mu receptor agonist activity. This case is reported to create awareness among clinicians about loperamid’s misuse as an opioid substitute. A 27-year-old male, with psychiatric history of opiates, benzodiazepines, and methamphetamine abuse and mood disorder NOS, was presented to the ED for opiate and benzodiazepine detoxification. Three years ago he became sober through intensive outpatient program with buprenorphine maintenance therapy. The patient started taking 144 mg of Loperamide daily after researching it online. The patient relapsed 1.5 years ago using benzodiazepines and methamphetamines but still taking loperamide. He attempted to quit benzodiazepines two weeks prior to admission and was feeling hopeless with passive suicidal ideation. The Patient last used of alprazolam (two 0.5 milligram tablets) and loperamide was >12 hrs prior to the hospital visit. In ROS pt. had depressed mood, anhedonia, feelings of hopelessness, increased thoughts of death, anxiety, diarrhea, nausea, restlessness, diaphoresis, tremulousness, mild tactile hallucinations and problems with initiation/maintenance of sleep. The patient was admitted to a locked inpatient psychiatric unit for stabilization and withdrawal management. Phenobarbital 120 milligram x1 then 60 milligram q. 4 hours was initiated then tapered. Clonidine 0.1 milligram was given q. 4 hours then tapered. Methocarbamol 750 milligram q. 8 hours for muscle cramping, gabapentin 400 milligram three times daily and nicotine patch 21 milligram q 24 hours were also started. GI was consulted because of patient\\\'s chronic diarrhea and loperamide use. Hepatic panel, loperamide level, X-ray of abdomen, ultrasound of abdomen and pelvis, EKG and echocardiogram were ordered. The EKG showed abnormal findings regarding left ventricular hypertrophy and pericarditis but echocardiogram was normal. Ultrasound of abdomen and pelvis and abdominal x-ray showed no significant findings. Hepatic panel did not show any positive findings; the loperamide level was 2.2 ng/ml, blood was taken after 40 hrs of last use of loperamide. The patient improved in next few days in regards to withdrawal symptoms and was discharged to residential treatment. Loperamide is used between 70-100 mg to control withdrawal or for recreational abuse. A daily dose exceeding 16 mg can be dangerous. Cases reported that loperamide use has been associated with toxic megacolon, with cardiac conduction abnormalities and life-threatening ventricular arrhythmias, and death. With the recent efforts to restrict the diversion of prescription opioids, increasing abuse of loperamide as an opioid substitute may be seen. Toxicologists should be aware of the risks of loperamide toxicity, and we urge all clinicians to report such cases to FDA Medwatch
Keynote Forum
Stephen Sroka
Case Western Reserve University, USA
Keynote: The new Rx for addiction: relationships- The power of one to make a difference
Time : Day 1
Biography:
Stephen Sroka is an internationally recognized speaker, trainer, author, teacher and educational consultant on drug education and prevention. He is an Adjunct Assistant Professor, School of Medicine, Department of Family Medicine and Community Health, Case Western Reserve University, and President of his company, Health Education Consultants. He speaks in schools (K-college) and professional communities around the world and often on Native American reservations. He was the keynote speaker at the First International Swine Flu Conference in Washington, DC, which was featured live on C-SPAN. His spirited presentations stressing the Power of One have resulted in guest appearances on many TV programs, including the Oprah Winfrey Show, as well as coverage in many newspapers including USA Today. He received the Outstanding School Health Educator Award from the American School Health Association, was selected the Disney Outstanding Health Teacher of the Year, and was inducted into the National Teachers Hall of Fame.
Abstract:
This is a high-energy, motivational, multimedia presentation that is research-driven and reality-based. It integrates cutting-edge research and humor and inspiring real-life stories to facilitate learning about the importance of relationships and addiction research and therapy. The program is filled with “tips from the trenchesâ€, practical strategies, to help addiction professionals help keep people safe and healthy so that they can live drug free. This session addresses the four challenges of building relationships: Communication, collaboration, culture competency, and caring. It explores the role of social-emotional learning, mental health, the whole person concept, and teambuilding. It offers honesty, humor and hope that everyone can make a difference. The addiction professionals will leave with an unforgettable message filled with an incredible sense of hope and joy that with education, helping one another and believing in yourself, you can change lives. Change is inevitable, growth is optional. You have the Power of One to change the future. Let’s start today!
- Addictions and Addictives
Behavioral and Multimedia Addiction
Alcoholism and Substance Abuse
Location: Prestwick
Chair
Kathy Sexton-Radek
Elmhurst College, USA
Co-Chair
Jason Connor
The University of Queensland, Australia
Session Introduction
Adi Jaffe
Alternatives Behavioral Health LLC, USA
Title: Mindful drinking: A clinical case study of non-abstinence AUD treatment
Time : 11:55
Biography:
Adi Jaffe has received his PhD from the University of California, Los Angeles (UCLA) in 2010. Even before he graduated, his name had become known through his online and academic writing. His views on addiction and his research on the topic have been published in dozens of journals and online publications and he has appeared on several television shows and documentaries discussing current topics in addiction and the problem of addiction as a whole. He also teaches courses at UCLA that address addiction specifically or biological psychology and behavioral neuroscience more generally. His view is a holistic one, drawing from the best and most recent research to bring as complete a solution to addiction clients. At Alternatives, he serves as the Director of Research, education and innovation and is in charge of client monitoring, technology solutions and data collections and outcomes research.
Abstract:
The talk will address non-abstinence treatment options for alcohol use disorder (AUD) within an outpatient setting. General treatment modalities will be discussed along with monitoring and outcome measurement approaches. A clinical case presentation for a male patient (age=29) with severe AUD will be used in the presentation in order to provide examples of current application within an intensive-outpatient setting in Los Angeles, CA. Data obtained over the course of eight (8) months from daily mobile-breathalyzer readings and tailored mobile-assessments will be presented along with more extensive baseline and monthly assessment batteries. Baseline and monthly assessments were comprised of a range of psychological instruments such as the Beck Depression Inventory (BDI-Depression), Barratt Impulsiveness Scale-(BIS Impulsivity), PANAS-X (Affect) and Rumination Responses Scale (RRS-Rumination) with intervals of the Addiction Severity Index (ASI) given at month one (1), three (3) and six (6). All results and analysis were completed using SPSS 20. Our analysis indicated significant decreases in depression, anxiety and negative affect as well as increase in positive affect and general health that continued to significantly improve even after the reintroduction and moderate use of alcohol. Implications for the future of structured non-abstinence treatments for AUD will be discussed and explored.
Sevil Sonmez
University of Central Florida
Title: Bar crawls, foam parties, and clubbing networks: A Mediterranean vacation ritual
Time : 12:20
Biography:
Sevil Sonmez completed her PhD in Tourism Management from Penn State University. She is currently Professor in the Department of Tourism, Events, and Attractions, Rosen College of Hospitality Management, University of Central Florida, Orlando, Florida. Prior to UCF, she served on the faculties of the University of North Carolina Greensboro, Zayed University (UAE), European University of Cyprus, Emory University, and Arizona State University. Her research is interdisciplinary and applied and delves into the nexus of leisure, work, and health. Her work focuses on adverse health consequences of occupational and leisure mobility, occupational health of tourism and hospitality sector employees, and reduction of tourism’s adverse health effects and promotion of its health benefits. Her work has appeared in both tourism/hospitality and health journals and conferences. She is the coeditor of three books: Women as Producers and Consumers of Tourism in Developing Regions, Mediterranean Islands and Tourism Development, and Population Mobility and Infectious Disease.
Abstract:
Mediterranean nightlife destinations spanning across Spain, Italy, Greece, Cyprus, and Turkey draw millions of visitors annually with promises of sun, sea, sand, unrestricted drinking, and nonstop partying. Incidence and prevalence of health and safety risks for young adults of age 18-35, at these resorts has reached epidemic proportions. In these environments young adults engage primarily in binge drinking, recreational drug use, and casual sex. This study is designed to elucidate the physical space of clubbing settings where health and safety risks unfold; delineate the social organization of risk taking in order to identify stakeholders and primary players involved; ascertain risk exchanges and transactions among these populations; and explore potential multifaceted solutions for harm reduction. Ethnographic assessment of risk environments in Ayia Napa, Cyprus included participant and nonparticipant observation, socio-spatial mapping of risk settings, informal discussions, and secondary data collection. Results revealed an array of individual and public health, as well as safety risks exacerbated by characteristics of the spatial environment. Data analysis revealed that excessive drinking often leads to increased hospital visits due to blackouts, alcohol poisoning, substance overdoses, accidents, injuries, fatal falls, and various acts of violence. In addition incidents of unplanned pregnancies, sexual assault, and even death, were revealed during analysis. Recommendations are made for interventions and harm reduction in response to an urgent need to create healthier and safer recreational settings at tourist destinations. Additionally, the use of complexity science perspectives is recommended to better understand the dynamic and complex nature of international nightlife tourism and its health and safety risks.
Rocco de Filippis
Institute of Psychopathology, Italy
Title: Substance use and bipolar spectrum: A naturalistic study
Time : 12:45
Biography:
Rocco de Filippis completed his MD and PhD from Catholic University of the Sacred Heart in Rome. He holds a Master’s degree and he improved respectively in Bipolar Disorders and Addictive behavior in the years 2011/2012. He currently works at the Institute of Psychopathology - Rome as a Psychiatrist and Addictive Medicine, and up to now presented as Scientific Coordinator of CME and Master of Addictive Behaviors; he currently publishes on Bipolar Disorders with high specialization on rapid cycling; he is also an official candidate at the Psychoanalytic Italian Society of the First Italian Center of Rome, and member of IPSO (International Psychoanalytic Studies Organization). He delivered an oral speech at Translational Medicine 2014 in Las Vegas on QTc Prolungation and Psychotropic Drugs.
Abstract:
It a naturalistic study that refers to a highly real context in the clinical field (RealWorld) aimed to highlight some not well-defined aspects of psychiatric comorbidity in addicted patients. The medical literature gives prevalence to data on inpatients while this naturalistic study collects data on the first visit in services dedicated to the treatment of pathological addictions. The sample is made of 519 persons (410 males, 109 females) (79% males, 21% females). The data brings out a prevalence of bipolar spectrum disorders of medium severity in outpatients while in the literature data on inpatients with a high psychopathological severity prevail. The percentages of psychiatric diagnoses recorded are congruous with other published epidemiological works giving importance to an undoubtedly exploratory study made on a quite relevant sample compared with other studies made on quantitatively smaller samples. These people have been visited after their request to be helped with their addiction. Alcohol consumption stands out: It is significant and is present across-the-board as in subjects receiving agonist for opiate addiction. The prevailing input substances are THC and cocaine while in everyday use, alcohol, cocaine and THC are prevalent (without forgetting the poly-use). Other data give an account that is not only psychopathological and about the style of consumption of substances but also social, giving an idea of the social context of patients’ lives (family and society).
Cynthia Stuhlmiler
University of New England, Australia
Title: Fetal alcohol syndrome prevention strategies: Issues and challenges
Time : 14:00
Biography:
Cynthia Stuhlmiller is a Professor of Rural Nursing at the University of New England School of Health. She has been a clinical chair in mental health nursing since 1997 and has held academic appointments in the California, Norway, New Zealand, University of Technology Sydney, Flinders Adelaide, University of Hawaii, and University of Essex United Kingdom. Her clinical and research background includes work in areas of traumatic stress and trauma response, various aspects of mental health including co-morbidities, computer-aided CBT, action-based and PBL learning, clinical supervision, and health self-management. She is involved in a wide variety of local, national and international collaborative projects. She is currently leading a large grant aimed at expanding student clinical placements through a student-led clinic in a rural indigenous community in New South Wales.
Abstract:
Fetal Alcohol Syndrome (FAS) is the most common preventable cause of mental retardation. It affects around 40,000 infants each year and has lifelong implications (SAMS) with 60 million people worldwide living with its defects and disabilities. The costs in health and education services in the USA alone are estimated to be around $5.4 billion per year. FAS is caused by maternal ingestion of alcohol during pregnancy which results in irreversible damage to the developing embryo or fetus and leads to physical, mental, behavioural and/or learning disabilities. Some identifying characteristics of FAS such as low birth weight, prematurity, and microcephaly are present at birth while others, such as distinctive facial features, may become more obvious over time. Although signs of brain damage include delays in growth, development, learning and behavioural abnormalities, affected individuals exhibit a wide range of abilities and disabilities. Australia has among the highest alcohol consumption in the world and between 51%-60% of Australian women report alcohol use in pregnancy. Although indigenous Australian women are reported to be less likely to drink during pregnancy, those who do, drink at a high risk levels. Efforts to prevent FAS that focus on warning women of the danger of alcohol consumption during pregnancy have proven of little value. However approaches that include broader determinants of women’s and children’s health, including overall health, nutrition, experiences of violence and trauma, sexual and reproduction health services and prenatal care seem to have better outcomes. Community-driven policy may also be an effective strategy. In this session, the key issues and challenges regarding FAS prevention strategies will be discussed. The efforts being undertaken in a community project in Australia will be used as a case example.
Christina Santini
Kildehoej Private Hospital, Denmark
Title: Nutrition strategies in recovery
Time : 14:25
Biography:
Christina Santini is a certified Nutritionist from Copenhagen Metropol University in addition to a certified Yoga Therapist from Naam Yoga Healing & Research Center, Los Angeles. She integrates Eastern Medicine with Western nutrition science to balance body, mind+soul, bite by bite. With over 10 years+ experience working with neuroscience, anti-aging, cancer, eating disorders and addictions in private hospitals and anti-aging clinics in Europe and for one of the pioneers in brain health. She is passionate about translating time-tested Eastern holistic health strategies with Western nutrition science into treatment tools that work to balance each individual’s biochemical blueprint. She is co-founder of TANT®-Target Aimed Nutrition Therapy. She is currently developing health apps for target nutrition intervention in addition to private practice in Los Angeles centered on biochemical testing.
Abstract:
Addictions and eating disorders often overlap and based on the latest neuroscientific findings, this presentation will focus on nutrition therapy as it relates to addiction and recovery from a practicing nutritionist’s perspective. No size fits all and no one diet fits all. We are all wired biochemically unique and require a customized approach to feel great in the skin we are in. Addiction is an expression of a severe disconnection from body mind-soul that leads to a lack of nourishment which further makes the individual biochemical vulnerable for chronic addiction, depression, mental illness and general relapse. Christina Santini works specifically with nutrition as it relates to the imbalances associated with certain eating disorders and addictions in order to rebuild biochemical balance in recovery and prevent relapse and cross-addiction. This presentation help in understanding the link between addiction and certain eating disorders, addictive substances in foods that activate same reward circuit as drugs, an ayurvedic perspective on addiction and food energetic and nutrition strategies to rebuild biochemical balance in addiction.
Danielle Rossini-Dib
University of Sao Paulo, Brazil
Title: A naturalistic study of recovering gamblers: What gets better and when they get better
Time : 14:50
Biography:
Danielle Rossini Dib graduated in Psychology. She completed her Master in Sciences and researches mainly in the interface of neuropsychology and impulsivity. These studies were carried out at Institute and Department of Psychiatry, University of São Paulo, Brazil.
Abstract:
Gambling disorder is a behavioural addiction treated with a range from self-help support to more intensive therapy approaches. This is usualy associated to a clinical treatment envolving a better management of comorbidities and experiemental conditions to help control the gambling behaviour proprielly. In this way, gambling recovery has typically been focused in gambling behavior and its consequences. However, others features such as negative affectivity, gambling cognitive distortions, impulsivity and its neurocognitive aspects (cognitive flexibility, planning, inhibitory control, and decision-making) are usually evaluatedat a gamblers profile, but not during and after the treatment. In this study we investigate how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment; a subset of 48 patients was too assigned to cognitive behavioral therapy. From that 113 patients, 72 compleated treatment and was reassessed 6 months after the onset. For to determinate who was recovery or not after the treatement, was used a self-report scale (Gambling Follow-up Scale). Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. However, three outcome variables were strongly related with gambling recovery: Negative affectivity, cognitive distortions, and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making under ambiguos situation task as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment.
Sarah C Herremans
Universitair Ziekenhuis Brussel, Belgium
Title: The predictive value of alcohol-related cues for relapse after accelerated HF-rTMS treatment in alcohol addiction
Time : 15:15
Biography:
Sarah C Herremans is a Psychiatrist at the University Hospital of Brussels, Belgium. She graduated as a medical doctor at the Free University of Brussels in 2006, after which she specialized in psychiatry. She started her PhD in 2011, which she plans to finish in 2015. Her field of research concerns the application of HF-rTMS in alcohol dependent patients.
Abstract:
Background: Alcohol addiction is a chronic relapsing disorder. The application of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) could possibly serve as a new treatment option for alcohol addiction. To day, it is unknown which patients might benefit from this intervention. The underlying neurobiology of relapse is complex; previous research implicates the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), ventral striatum (VS) and precuneus. Consequently, we explored if baseline differences in brain activity during an alcohol-related cue-exposure, between relapsers and abstainers, treated with accelerated HF-rTMS could possibly serve as a biomarker predicting future relapse. Methods: Before the start of the HF-rTMS treatment, which was administered as an intensive protocol (consisting of 15 active sessions spread over one week), patients were confronted with an alcohol-related cue-exposure. Because it is unclear whether a block or event-related paradigm is more suitable to identify imaging biomarkers, patients were confronted with both of them in a consequent manner. Relapse, defined as the consumption of any amount of alcohol, was assessed four weeks after the stimulation. We performed whole brain and subsequent regions of interest (ROI) analyses of vmPFC, ACC, VS and precuneus. Results: Fourteen against six patients had relapsed. Only the block paradigm could demonstrate brain activity differences between relapsers and abstainers at baseline. Whole brain analysis showed the implication of the reward system, while additional ROI analysis demonstrated ACC activity differences between relapsers and abstainers during the exposure to the alcohol cues. Conclusions: ACC activity at baseline could possibly serve as a biomarker to identify alcohol-dependent patients at risk for relapse after HF-rTMS treatment. Block paradigms are more sensitive than event paradigms in identifying imaging biomarkers for relapse.
Chun-Bae Kim
Yonsei University, Republic of Korea
Title: Does South Korea have hidden female smokers? Discrepancies in smoking rates between self-reports and urinary cotinine level
Time : 16:10
Biography:
Myung-Bae Park is a candidate of PhD from Yonsei University and major in health policy now. He has an experience in Korea Ministry of Health & Welfare. Then, he received the annual grand prize article at Korean Society for Health Education and Promotion on 2009. Now he is working as a Researcher at the Dept. of Preventive Medicine, Wonju College of Medicine, Yonsei University. Chun-Bae Kim completed his MD from Chung-Ang University and PhD from Yonsei University in Korea. He is working as a Professor at the Dept. of Preventive Medicine, Wonju College of Medicine, Yonsei University. Also, he is participating at the convergence research in the Institute for Poverty Alleviation and International Development, Yonsei University. Previously, he has studied at University of Minnesota School of Public Health and is a visiting Professor. He has received many honor and awards including MARQUIS Who’s Who in the World (29th Edition 2012).
Abstract:
Female smoking is perceived very negatively in East Asian countries such as South Korea, Japan, and China, as well as in Islamic countries. These countries’ self-reported surveys (SRs) tend to produce results that underestimate the number of smokers, owing to the social desirability response bias. The present study seeks to assess South Korea, Europe, and the Americas, by comparing data from SRs with those from urinary cotinine samples. Current smoking rates were calculated using the SRs and the urinary cotinine concentration (UCC) methods according to socioeconomic factors. In order to examine response accuracy regarding current smoking status in the SRs, participants who both completed the SRs and acquired UCC results were subject to analyses of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the difference ratio (DR) with respect to gender, age, region, economic level, household status, and the presence of chronic disease. Based on self-reports, the current smoking rate among women was 7.1% (official smoking rates), while that according to the UCC was 18.2%; the rates for men were 47.8% and 55.1%, respectively. The sensitivity of males was 0.8553, the specificity 0.9768, PPV 0.9783, NPV 0.8465, and the DR was 1.143. The sensitivity for females was 0.3670, the specificity 0.9956, PPV 0.9486, NPV 0.8761, and the DR was 2.600. These results exhibit a very low response alignment rate compared to males. This study shows that the actual female smoking rate is significantly higher than that reported officially, but also that the gap is decreasing steadily. Females exhibited a higher rate of false responses, which resulted in an underestimation of the female smoking rate.
Talakad N Sathyaprabha
National Institute of Mental Health and Neurosciences, India
Title: Structural correlates of dysregulated cardiac autonomic function in offspring exposed to alcohol during antenatal period
Time : 16:35
Biography:
T N Sathyaprabha is a Professor in the Department of Neurophysiology, NIMHANS Bangalore, India. She had published over 70 manuscripts in international journals and presented several lectures and research work in international scientific conferences. She is an eminent member of many professional bodies including Third World Organization for women, Indian Academy of Neurosciences, Association of Physiologist and Pharmacologists of India, Neurological Society of India, Indian Academy of Neurology.
Abstract:
Background: Several lines of investigations have shown the deleterious effect of an alcohol on the autonomic nervous system. Also, evidences have shown altered brain volume in children who were exposed to alcohol in utero. It remains unknown whether any brain structural alterations correlate with cardiac autonomic regulation. In this study we measured the cardiac autonomic functions and brain volumes in children who were exposed to alcohol in the antenatal period and compared them with non-exposed control children. Methods: Twenty eight children (age: 9±2 years) in the antenatal alcohol exposed group and age, gender matched 30non exposed healthy volunteers as a control (age: 10±2 years) were recruited. HRV parameters were recorded and analyzed in the time and frequency domains using customized software. Magnetic resonance imaging was acquired as per standard protocol. Data was analyzed using both manual and automated morphometric methods. Result: Low frequency power, normalized units (nu) and low frequency to high frequency ratio were significantly higher in the antenatal alcohol exposed children compared to the controls suggesting asympathetic predominance. Decrease in the gray matter volume was noted in right fusiform gyrusin prenatally alcohol exposed children when compared to controls. A positive correlation was noted with high frequency power and cingulate gyrus volume (p<0.001). The low frequency (nu) also showed a positive correlation with the amygdala volume p<0.001. Conclusion: In this study we provide evidence for the deleterious long lasting effect of antenatal exposure of alcohol on cardiac autonomic regulation. Neuroimaging data supports the notion that structural aberration in amygdala and cingulate gyrus might have role in the dysregulation of cardiac autonomic function. Further prospective studies are needed to confirm the causal relationship between antenatal alcohol exposure, brain volume changes and autonomic dysregulation.
Danielle Rossini-Dib
University of Sao Paulo, Brazil
Title: A naturalistic study of recovering gamblers: What gets better and when they get better
Biography:
Danielle Rossini Dib graduated in Psychology. She completed her Master in Sciences and researches mainly in the interface of neuropsychology and impulsivity. These studies were carried out at Institute and Department of Psychiatry, University of São Paulo, Brazil.
Abstract:
Gamling disorder is a behavioural addiction treated with a range from self-help support to more intensive therapy approaches. This is usualy associated to a clinical treatment envolving a better management of comorbidities and experiemental conditions to help control the gambling behaviour proprielly. In this way, gambling recovery has typically been focused in gambling behavior and its consequences. However, others features such as negative affectivity, gambling cognitive distortions, impulsivity and its neurocognitive aspects(cognitive flexibility, planning, inhibitory control, and decision-making) are usually evaluatedat a gamblers profile, but not during and after the treatment. In this study we investigate how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment; a subset of 48 patients was too assigned to cognitive behavioral therapy. From that 113 patients, 72 compleated treatment and was reassessed 6 months after the onset. For to determinate who was recovery or not after the treatement, was used a self-report scale (Gambling Follow-up Scale). Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. However, three outcome variables were strongly related with gambling recovery: negative affectivity, cognitive distortions, and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making under ambiguos situation task as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment.
Dulciane Nunes Paiva
Graduate Stricto Sensu in Health Promotion,Brazil
Title: The influence of active and passive smoking on the cardiorespiratory fitness of adults
Biography:
Dulciane Nunes Paiva is a Graduate Stricto Sensu in Health Promotion,Brazil. His research interest include smoking, nicotine addiction.
Abstract:
Background: Cardiorespiratory impairment increases morbidity and is an independent predictor of all-cause mortality, where it reduced by the inhalation of cigarette smoke. However, the effects of passive smoking on cardio respiratory fitness are rarely addressed. Objective: To analyze the influence of active and passive smoking on cardiorespiratory responses in asymptomatic adults during a sub-maximal-exertion incremental test. Methods: The participants (n=43) were divided into three different groups: Active smokers (n=14; aged 36.5±8 years), passive smokers (n=14; aged 34.6±11.9 years) and non-smokers (n=15; aged 30±8.1 years). They all answered the Test for Nicotine Dependence and underwent anthropometric evaluation, spirometry and ergospirometry according to the Bruce Treadmill Protocol. Results: Maximum consumption of oxygen (VO2 max) differ statistically among active and non-smokers groups (p=0.03), however, there was no difference between the passive and active smokers groups (p=0.88). Negative and significant correlations occurred between VO2max and age (r=-0.31, p=0.03), percentage of body fat (r=-0.44, p=0.01), and waist circumference (WC) (r=-0.46, p=0.01). Conclusion: VO2 max was significantly higher in non-smokers compared to active smokers and decreased with increasing age, percentage of body fat and WC.
Priya Mohan
Rajiv Gandhi University of Health Sciences, India
Title: Tobacco deaddiction – A missing link
Biography:
Dr. Priya M. has completed M.D.S.(Oral Medicine and Radiology) from Rajiv Gandhi University of Health Sciences, Bangalore. Has been practicing General Dentistry for the Past 12 years at self-owned ‘Mohan Dental Clinic’ and is a consulting oral diagnostician and radiologist. Also has 6 years of experience in teaching undergraduate and post graduate dental students. Has major interest in oral cancer and tobacco research also conducts tobacco deaddiction and prevention programs. Has been speaker and poster presenter at National, Asian and International conferences, authored scientific articles in national and International Journals. Is a member of the International advisory board of Indian Journal of Mednodent and Allied Sciences.
Abstract:
Tobacco, the major aetiological for most non communicable diseases is an established fact. In India it is the prime cause of oral cancer, the most common cancers, Pondicherry has one of the highest incidence of mouth cancer in the world among males -7.6 per 100,000. 34.6% adults use tobacco, unlike western countries apart from cigarette, indigenous smoking forms and use of smokeless tobacco with/without areca nut, psychoactive substance are used and continues to increase 2-3% every year. Also India has the 2nd highest prevalence of dual users, especially younger age group and develops higher degree of dependence. Unchecked availability of tobacco has led to initiation at as early as 5 years of age and addiction by 10-14 years. 46.6% of smokers and 45.2% of smokeless tobacco users planned to quit, however tobacco cessation - supportive system for deaddiction or prevention is lacking and also relapse is common among those who quit. Dentists form the premier group in identifying tobacco habit related oro-dental changes, but feasibility of tobacco prevention, cessation and deaddiction programs in real life dental setting are questionable. Though India played leadership role in tobacco control among developing countries, implementation of the legislation is ineffective and a major challenge too. Tobacco being easily accessible and affordable, the socio-economically disadvantaged groups are easily vulnerable, limited public healthcare services and unaffordable private healthcare corners them to disease burden further undermining their quality of life. This paper presents the current state of tobacco induced burden, ineffective tobacco cessation programs and importance of deaddiction support system as a strategy for tobacco control in India.
Kumar Gaurav Chhabra
Jodhpur Dental College General Hospital, India
Title: Exploring the predictors of quitting tobacco usage among patients attending a private dental institution- A survey from Jodhpur, India
Biography:
Kumar Gaurav Chhabra has completed Bachelor of Dental Surgery form SJM Dental College and Hospital, Chitrdurga, Karnataka, India in 2007 and Masters of Dental Surgery in Public Health Dentistry from SDM Dental College and Hospital, Dharwad, Karnataka, India. His interest on tobacco cessation made him to write his first manuscript in 2011 and subsequently in 2014 attended workshop on Tobacco Intervention Initiative organized by Indian Dental Association and was awarded a certificate of TII Specialist. He was guest speaker at the workshop organized by Jodhpur School of Public Health, Rajasthan, India on the topic “Ill effects of Tobaccoâ€. Till now 14 people has successfully quit the habit of tobacco because of his tobacco counseling and intervention.
Abstract:
Background: Burden of tobacco epidemic has swiftly moved to developing countries making the exploration of predictors of quitting tobacco usage extremely important. Aim: To assess the willingness to quit tobacco use and to ascertain the predictors of quitting tobacco as well as tobacco dependency by employing Fagerstrom scale. Methods: The study consisted of 252 subjects visiting the Public Health Dentistry department in a Dental institution JDCGH (Jodhpur Dental College General Hospital), Rajasthan, India. Data on demographic information, tobacco usage and quitting, information on reasons for quitting like; self-concepts, social concerns, legal issues, and health concern was collected by interview schedule method. Results: Overall 76% of the study participants were planning to quit. Demographic variables like age, marital status and religion were significant predictors of planning to quit tobacco usage (p≤0.05). Significant relationship was observed on Fagerstrom Scale with place of residence, type of tobacco use and frequency of tobacco use (p≤0.05). The most frequent cited reason for quitting tobacco usage was spitting and ash dropping which was embarrassing in-front of others (75.65%) and least reported reason was future health concerns (33.16%). Conclusions: Most of the respondents had favorable attitude towards quitting tobacco usage and social concern was the main predictor of quitting tobacco usage. Less reported reasons like legal issues and health concerns have to be explored in depth. The present study highlights the need for more researches exploring the predictors of quitting tobacco usage in India and further nationwide study.
T Nagamma
Manipal University, India
Title: Status of oxidative stress and antioxidant levels in smokers with breast cancer from western Nepal
Biography:
T Nagamma completed her MSc (Medical Biochemistry) from Manipal University and is pursuing PhD from LNM University, India. At present she is working as Senior Grade Lecturer in Department of Biochemistry, Melaka Manipal Medical College (Manipal campus), Manipal University, Karnataka, India. She has also worked as Medical Biochemistry teacher and Biochemistry Lab in charge for seven years in Manipal College of Medical Sciences, Pokhara, Nepal. She has been teaching biochemistry to undergraduate medical, dental and allied health sciences students for the past eleven years. Apart from teaching, she has published more than thirteen research articles in several national and international journals and has also published a book in MCQs in Biochemistry with explanatory answers.
Abstract:
This study was conducted in Manipal Teaching Hospital, Pokhara, Nepal. Breast cancer is the second most common cancer in Nepal. The major risk factors contributing to breast cancer are menarche at early age, having first pregnancy at late age, obesity, lifestyle changes and family history. Smoking is one of the major lifestyle risk factor. The tobacco leaf contains about 7000 toxic chemical species, 20 of which are established as mammary carcinogens. Smokers are more exposed to free radicals. These free radicals cause oxidative damage to lipids, proteins and DNA that can results in cancer. Study included a control group of 42 females (non-smoking healthy women) and test group was divided into two groups Group I consisting of 46 female breast cancer patients who were smokers and Group II consisting of 42 non-smoking breast cancer patients. Detailed history of the patients was collected with the help of pre-test proforma. Plasma levels of malondialdehyde (MDA), total antioxidant activity (TAA), which represents its total dietary antioxidants, vitamin C and α- tocopherol were estimated by standard methods. The plasma MDA, TAA, vitamin C and α- tocopherol were respectively. Vitamin C, α- tocopherol and TAA were significantly reduced whereas MDA was significantly raised in Group-I when compared to controls and Group-II. We observed a significant rise in oxidative stress and low levels of antioxidants in breast cancer patients with smoking habit. It is well known that free radicals facilitate the progression of breast cancer, possibly increases the risk of progression to the next stage. The key issues like how the smoke is affects the oxidative stress and it increasing the incidence of breast cancer in Nepali women will be discussed during presentation.