Scientific Program

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Day 2 :

Keynote Forum

Wai Kwong Tang

Professor, The Chinese University of Hong Kong, China

Keynote: Evidence of Brain Damage in Chronic Ketamine Users – a Brain Imaging Study
Alcoholism 2017 International Conference Keynote Speaker Wai Kwong Tang photo
Biography:

WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Abstract:

Background and objectives:

The objectives of this study were to ascertain the pattern of grey and white matter volume reduction and regional metabolic and activation abnormalities in chronic ketamine users, and to evaluate the correlations between these brain abnormalities and cognitive impairments in chronic ketamine users in Hong Kong.

Design:

Cross-sectional observational study.

Setting:

Counselling Centre for Psychotropic Substance Abusers in Hong Kong.

Participants:

One hundred and thirty-six participants were recruited from October 2011 to April 2014. The participants were divided into two groups: ketamine users (79) and healthy controls (57).

Main outcome measures:

Psychiatric assessments included screening with self-rating questionnaires and face-to-face interviews. All of the participants completed a detailed cognitive battery that covered general intelligence, verbal and visual memory, executive functions, motor speed and language. All of the participants underwent magnetic resonance imaging of the brain. 

Results:

Many of the participants in the ketamine group also frequently used cocaine and cannabis. Among the ketamine users, 12.6% were diagnosed with a mood disorder and 8.9% with an anxiety disorder. The participants in the ketamine group had worse performance than the healthy controls on tests of general intelligence, verbal, visual and working memory and executive functioning.

In terms of grey matter volumes, the right orbitofrontal cortex, right medial prefrontal cortex, left and right hippocampus and possibly the left orbitofrontal cortex were smaller in the ketamine group. In contrast, the volumes of the left basal ganglia, left putamen and possibly the left caudate were higher in the ketamine group. In terms of white matter volumes, the ketamine group had a lower periventricular white matter volume in the right hemisphere. The grey matter volumes of the left and right orbitofrontal cortex, right medial prefrontal cortex, left basal ganglia and left putamen, and right periventricular white matter volume were negatively correlated with the severity of ketamine dependence. The hippocampal volumes were correlated with performance on the arithmetic, information and digit span tests. The periventricular white matter volume also correlated with the information score.

A functional connectivity examination of the default mode network revealed significantly decreased connectivity in the medial part of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral gyrus rectus, left superior temporal pole, left inferior temporal gyrus, bilateral angular gyrus and bilateral cerebellum crus II in the ketamine group. This group also displayed increased connectivity in the bilateral precuneus and right inferior occipital gyrus.

Conclusions:

The results provide imaging evidence of brain damage in chronic ketamine users. Chronic ketamine use was associated with reduced grey and white matter volumes in certain regions of the brain. Chronic ketamine use was also associated with altered functional connectivity with the default mode network. Abnormal brain structures and altered functional organisation of the brain network may underlie the hypersensitivity towards drug related cues but weakened cognitive control in those with ketamine addiction. Longitudinal or prospective studies would help to strengthen the evidence on the reversibility of the structural and functional brain damage caused by ketamine.

Keynote Forum

Gary Hulse

Professor, The University of Western Australia, Australia

Keynote: Oral and Sustained Release Naltrexone: Improving Clinical Outcomes for Management of Problem Alcohol Use
Alcoholism 2017 International Conference Keynote Speaker Gary Hulse photo
Biography:

Prof. Hulse is based at the School of Psychiatry QE11 Medical Centre University of Western Australia. His research career has been directed at developing evidence based information which will enhance clinical practice, and has in the last several years had a particular focus on assessing the safety and efficacy of sustained release naltrexone as a management tool for substance dependence. He has arguably published more than anyone else globally on sustained release naltrexone for the management of heroin dependence, much of this on the Australian naltrexone implant.

Abstract:

Three oral pharmacotherapies (acamprosate, disulfiram, and naltrexone) are commonly used for the management of alcohol abuse or dependence. Naltrexone is an opioid antagonist which primarily, but not exclusively, targets the μ-opioid receptor. Naltrexone likely exerts its actions by blockade of the high concentration of μ-opioid receptors located in areas of the brain that have been implicated in the reward pathway associated with alcohol. Despite being a relatively effective and safe treatment1, the clinical management of alcohol abuse/dependence by oral naltrexone can be compromised due to the patient’s noncompliance with daily use of this medication2, 3. Over the past decade an increasing body of research has suggested that the use of sustained release depot naltrexone preparations can overcome this issue and deliver improved clinical outcomes4. However, at the same time, research findings from diverse areas of pharmacogenetics, neurobiology and behavioural psychology have also been converging to identify variables including genetic markers, patient psychosocial characteristics and drug use history differences that play a major role in mediating the response of alcohol abuse/dependent persons to treatment by naltrexone4,5. The establishment of clinical procedures to maximise use of oral formula, and characterization of clinical markers to identify those patients who are most likely to benefit from naltrexone will ultimately provide significant benefit to both patients and clinicians by optimizing treatment outcome.

  • Addiction | Addictive Disorders | Alcoholism | Addiction Medicine | Addiction Nursing | Drug Addiction | Marijuana and Opioid Addiction | Child & Adolescent Substance Abuse | Depression & Anxiety Disorders | Eating Disorders | Behavioral Addiction | Gambling Addiction | Mental Health and Substance Abuse | Liver Cirrhosis | Addiction Treatment and Rehabilitation | Group Therapies | Rehabilitation Therapies
Location: Classroom

Session Introduction

Athukoralage Bandara

National Dangerous Drugs Control Board of Sri Lanka, Sri Lanka

Title: Relationship between heroin dependency and the desire levels of the heroin users
Speaker
Biography:

Former Director (Treatment, Rehabilitation & Research), National Dangerous Drugs Control Board of Sri Lanka. Initiated pioneering projects in drug abuse prevention/information, research, treatment and rehabilitation. Main interests are in the fields of treatment methods and intervention research.

Abstract:

The heroin dependency develop with the perceptions persuade by the drug user through past experiences. The drug users, peers, people in the community and even some service providers develop associations with heroin. Most of the associations connect with primary human motives as well as secondary and social motives of the human beings. The drug users internalize the associations in to their unconscious minds and project perceptions towards drug use. The perceptions create high level of desire to consume a particular drug and develop psychological dependency. There is no absolute truth in those perceptions but the drug dependents believe that there is a real relationship between the drug and the associate factor.

The working sample of 120 selected from the heroin dependents were admitted for the residential at the Galle treatment and rehabilitation centre. The control group of 20 clients has been selected from another treatment and rehabilitation centre situated in Kandy. The very first day after the admissions, the desire levels of the heroin dependents have been measured using appropriate indicators. During the period of the residential treatment programme, the counselors extensively used individual and group counseling sessions as well as group discussions to change the perceptions, illogical thinking patterns and myths of the heroin users. The past experience re-examine technique was vastly used to re- examine the past experiences of the heroin use of the clients. For the control group we did not do any therapeutic interventions to influence their perceptions, illogical thinking patterns and beliefs of myths. After completion of the treatment programme, using the same set of indicators the desire levels of the both groups were measured. After analyzing the data I found that the desire levels of the working group had been reduced immensely and the clients who belong to the control group has not projected much reduction in their desire levels.

Regular monthly follow-up programmes were conducted for both groups for one year and at the end of the year I found that those who have reduced the desire levels were living longer periods without consuming heroin and those who have not reduced the desire levels relapsed within few months. The clients who belong to the control group were unable to reduce their desire levels, relapsed immediately after releasing from the treatment centre.

Finally I found strong evidence to prove the hypothesis, that there is a positive relationship between desire levels and heroin dependency. The replications of similar programmes are widely open for further research.

Key words:  Desire levels, dependency, Perceptions, association

Speaker
Biography:

Dr. Seyed Amir Jazaeri was born in Iran. He finished M.A. and B.A. degree in Iran, Ph.D. in Psychology in India and Postdoc in Malaysia. He has his expertise in addiction treatment and psychotherapy with alcohol and drug addiction. He finished an acupuncture training course in The Faculty of Homeopathy Medicine, Department of Chinese Acupuncture under supervision of Professor. Dr. Nick Omar at Kuala Lumpur, Malaysia and started to use Psychological acupuncture on addiction and psychotherapy with addicts in University of Malaya Center of Addiction Sciences (UMCAS) and Dr. Nick Omar clinic in Kuala Lumpur. This approach is responsive to psychological disorders and addiction treatment and has a different way of focusing on psychotherapy.

Abstract:

Statement of the Problem:  Substance use disorder (SUD) is a major health issue; huge scientific evidence supports the efficacy of psychological acupuncture in the treatment of opiate/alcohol dependence. Psychological Acupuncture therapy (PAT) has been used to treat substance abuse (drug, alcohol) for many years. From Psychological point of view, Psycho-acupuncture (PAT) can be used as an adjunct treatment for alcohol/drug addiction and psychological disorders associated with addiction. This study conducted in Malaysia and Iran to examine the effectiveness of psychological acupuncture on alcohol and drug addiction (heroin/opiate). 

Methodology & Theoretical Orientation: The purpose of this study was to examine the effectiveness of Psychological acupuncture for heroin/opiate addicts and alcohol abusers on methadone maintenance by measuring the daily consumption of methadone, variations in the 36-item Short Form Health Survey-36 (SF-36) and Pittsburgh Sleep Quality Index (PSQI) scores, and heroin craving.

This study was conducted in Malaysia and Iran. In Malaysia the first part of study was conducted in The Faculty of Homeopathy Malaysia, Department of Chinese Medicine Acupuncture, Kuala Lumpur, under supervision and guidance of Prof. Dr. Nick Omar with 12 heroin addicts and alcohol abusers (n=12) from Malaysia. Second part of this study was conducted in Iran, Mashhad with 13 heroin/opiate addiction and alcohol dependency in Malak Abad Psychological Services (a private research office) (n=13). Psychological acupuncture applied/conducted by Prof. Dr. Nick Omar and the author of this paper (Dr. Seyed Amir Jazaeri) followed the instructions and guidance of Prof. Dr. Nick Omar to conduct/apply psychological acupuncture on patients in the study in Malaysia and Iran.

Participants in the one controlled group (which did not received Psychological acupuncture therapy) and  two intervention groups (which received Psychological acupuncture therapy and Cognitive behavioral therapy) rated their degree of craving for substance on a scale of 1-10 and anxiety levels on a scale of 1-4 (total score 20-80) before and after each intervention session. Mixed effects regression models were used for analysis.

Patients received three sessions of Psychological acupuncture therapy weekly for 8 weeks (two months). For patients who were under MMT (methadone maintenance therapy) from week 2 onwards, the daily dose of methadone was reduced by a significantly greater amount with Psychological acupuncture compared with patients in controlled group which received no Psychological acupuncture treatment. Psychological acupuncture therapy (PAT) was also associated with a greater improvement in sleep latency at follow-up. All adverse events were mild in severity. Acupuncture appears to be a useful adjunct to methadone maintenance therapy (MMT) in heroin addiction.

Findings: This study showed that psychological acupuncture therapy (PAT0 and Cognitive behavioral therapy (CBT) were potentially effective in reducing alcohol craving and withdrawal symptoms and could be considered as an additional treatment choice and/or referral option within national healthcare systems in Malaysia and Iran.

Conclusion & Significance: Substance addiction is a complex problem and effective treatment remains a challenge. My study findings add to the scientific evidence of implementation and effectiveness of Psycho acupuncture to treat drug/alcohol addiction.

Findings demonstrate the value of attending Psychological acupuncture therapy in intervention sessions, as well as the other psychological therapies techniques.

Molobe Ikenna Daniel

Unified Initiative for a Drug-Free Nigeria, Nigeria

Title: Sexual Behaviour and Abuse of Drugs among Urban Teenagers in Lagos
Speaker
Biography:

Molobe Ikenna is a Public Health Consultant and Researcher. He has spent major part of his career in public health intervention activities having worked with both local and international organizations. He has wide ranging experience in the development of social intervention programs on drugs and substance abuse for young people. Ikenna is a senior proof-reader of the International Journal of Health and Education, Lead Guest Editor of Special Issue on Addiction and Substance Abuse of Science Journal of Public Health (SJPH), and reviews research papers for other international journal publications. He is also a member of the editorial board of the Journal of Scientific Research and Studies. Molobe Ikenna has been invited as a speaker at a number of conferences on drugs and substance abuse, and has published in peer reviewed journals and other appropriate arenas. He is the author of Hunters, a story of teenage drug abuse. He is a Co-founder/Trustee of Unified Initiative for a Drug-Free Nigeria, and a member of World Federation against Drugs (WFAD). He received his Masters degree in Public Health from the Department of Community Health, University of Lagos; and his Bachelors degree in Microbiology from Nnamdi Azikiwe University Awka. He also holds a National Diploma in Science Laboratory Technology from the Institute of Management and Technology, Enugu.

 

Abstract:

Sexual dependence and abuse of drugs including the abuse of sexual stimulants and abortion drugs has been observed among the urban teens. This finding was observed through personal encounters and follow-up investigations while working with teenagers in selected communities of Lagos State. Many youngsters are engaging in risky sexual activities while abusing both prescribed drugs and psychotropic substances to enhance their sexual performance. Most of these sexual activities have resulted to high risk of teenage pregnancy abortion with misuse and abuse of drugs and substances to prevent pregnancy or induce the abortion. In most cases, the male partner responsible contributes or influences the use of these drugs and substances for the prevention of pregnancy or induced abortion. It was also found that these teen surf on the internet to discover abortion pills and have been able to obtain these pills from the pharmacy shops without doctor’s prescription. The most abortion pills that have been found used by these teens are Mifepristone and Misoprostol. Some of the affected teens that have committed an unsafe abortion are experiencing post abortion syndrome while passing through physical and emotional trauma thereby resort to drugs and substance abuse, and some had educational setback or have dropped out from the school. It was found that teens use drugs such as Viagra, Marijuana and local herbal substances mostly to stimulate or boost their sexual performance. They purchase these drugs through street drug hawkers. Tramadol is widely abused by these teens to delay ejaculation and prolong intercourse. This Tramadol is mostly abused without knowledge of the effect and health implications of the use. It was also observed that teens have developed a strong network of sex engagements on social media using most especially Facebook account to connect to others and negotiate for physical visits or arrangement for sexual intercourse. In this process they also discuss or exchange information on various drugs and substances they can use to stimulate their sexual urge. This study was carried out in Lagos Urban community which revealed the risk sexual behavioral activities engaged by youngsters.

Keyword: Sexual Behavior, Teens, Drugs and Substance Abuse, Abortion, Lagos

Speaker
Biography:

Prof. Hulse is based at the School of Psychiatry QE11 Medical Centre University of Western Australia. His research career has been directed at developing evidence based information which will enhance clinical practice, and has in the last several years had a particular focus on assessing the safety and efficacy of sustained release naltrexone as a management tool for substance dependence. He has arguably published more than anyone else globally on sustained release naltrexone for the management of heroin dependence, much of this on the Australian naltrexone implant.

 

Abstract:

Oral naltrexone has been used effectively to manage problem opiate1, and alcohol 2 use but patient noncompliance limits its utility1,2. Over the past decade an increasing body of research has suggested that the use of sustained release depot naltrexone preparations can overcome this issue and deliver improved clinical outcomes. These preparations commonly involve the use of naltrexone polymer/co-polymer base formulations administered subcutaneously or intramuscularly and depending on the formulation and mode of administration can deliver levels of blood naltrexone for between 30 to 180 days 3,4.  At the same time, research findings from pharmacogenetics  has also converged to identify variables including genetic markers and drug use history differences that play a major role in mediating the response to treatment by naltrexone5. The establishment of clinical procedures to maximise use of oral and sustained release formulations, and characterization of clinical markers to identify those patients who are most likely to benefit from naltrexone will ultimately provide significant benefit to both patients and clinicians by optimizing treatment outcome.

Speaker
Biography:

My primary research interests have focused on the neural substrates of stress, that is, the neural circuitry underlying stress responses, role of immune systems in stress response, and developing novel antidepressants using applications of herbal medicines. It is the goal of my research in particular, to elucidate both the effects and the mechanisms of action of the herbal medicine, using animal models of stress-related diseases such as anxiety, depression, chronic fatigue or insomnia which can be tested clinically

Abstract:

The immune system and the central nervous system (CNS) form a bi-directional communication network through cytokines which act as signaling molecules of the immune system as well as producing neuroendocrine, neuroimmune, and behavioral changes in response to a variety of stress stimuli. It has been known that activation of the central innate immune system or exposure to stress can disrupt balance of anti-/ proinflammatory cytokines. However the mechanism by which these cytokines regulate the hypothalamic-pituitary-adrenal (HPA) axis is still unclear. To understand the role of cytokines on stress-induced neuroinflammation, we investigated the role of pro- and anti-inflammatory cytokines in the modulation of depressive-like behaviors, the hormonal and neurotransmitter systems in rats. Single exposure of stress resulted in an increase of corticotrophin-releasing factor expression in the paraventricular nucleus of the hypothalamus, adrenocorticotropin hormone and the final hormone of HPA-axis, corticosterone levels in the serum. Peripheral and central productions of pro-inflammatory cytokines, IL-1β and IL 6 were significantly increased during stress, whereas anti-inflammatory cytokine, IL-4 was reduced after stress stimulation.

Based on these animal models, we have screened and evaluated anti-stress and anti-depressant effect of several herbal formula such as soyo-san, a traditional medicinal formula, a mixture of 9 crude drugs including Paeoliae Radix Alba, Atractylodis Macrocephalae Phizoma, Angelicae Gigantis Radix, Poria, Liriopis Tuber, Bupleuri Radix, Menthae Herba, Glycyrrhizae Radix, Zingiberi Rhizoma Recens which have been clinically used for treating mild depressive disorders. Soyo-san inhibited stress-induced inflammatory responses, IL-1β production in the brain as well as effectively reduced behavioral and patho-physiological depression-like responses. 

These data suggest that stress may potentate inflammation through interaction of cytokines with activation of the HPA axis and stress-related disorders may be influenced by imbalance of pro and anti-inflammatory cytokines. In addition, the immunerestorative compounds such as soyo-san may be useful as powerful therapeutic candidate for treatment of stress-related diseases such as depression.

Speaker
Biography:

I am Renu Singh PhD student in Department Of Anatomy, All India Institute of Medical Sciences having knowledge in molecular biology techniques such as DNA isolation, polymerase chain reaction, gel electrophoresis, restriction digestion and various other techniques. Besides that I have experience of microbiology and culture techniques. 

Abstract:

Alcohol dependence (AD) a neuropsychiatric disorder involves complex interaction of genes and the environment leading to a negative impact on personal, social and economic status of life. Genes of the monoamine (dopamine and serotonin) pathways regulate the release of various neurotransmitters in the brain and studies report on an association of single nucleotide polymorphisms (SNPs) in these genes with AD. The purpose of the study was to identify presence of SNPs in the monoamine   pathway genes in AD subjects. Methodology: A total of 110 alcohol dependent males from the Department of Psychiatry (based on DSM-IVR criteria) and 100 healthy males from the general population (controls) formed the study group. Subjects were interviewed using the semi-structured questionnaire and WHO ASSIST and 5 ml peripheral blood was drawn after taking informed consent. Six SNPs of dopamine pathway DRD4 120bp duplication, DRD3 Ser9Gly, DRD2 Taq1α, COMT V158M, COMT-287A>G, DRD4 -521C/T and two of pathway HT1B G861C and HTR3B Tyr129Ser were analyzed by PCR/RFLP. Genotype frequencies were assessed using chi-square test and association with clinical parameters by SPSS v20.0. Findings: Of all the studied SNPs – COMT Val158Met and HTR3B Tyr129Ser showed significant association with AD (p=0.03). Other SNPs studied DRD4 120bp duplication (p=0.17), DRD3 Ser9gly (p=0.185), DRD2 Taq1a (p=0.27), COMT-287 A>G (p=0.12), DRD4 -521C/T (p=0.48) did not show any association. Correlation of clinical features of the AD subjects showed an association of HTR1B G861C with quantity of alcohol consumed per day (p=0.05) and COMT -287A/G with liver function (SGPT p=0.04).  Conclusion and Significance: The present study is indicative of the role of COMT Val158Met and HTR3B Tyr129Ser with AD and suggests that SNPs of the monoamine pathway genes may influence alcohol related behavior in dependent individuals.

Speaker
Biography:

 Ranjan Gupta is pursuing his PhD under Dr. Arundhati Sharma, Department of Anatomy, AIIMS  on the  “Epigenetic changes of Dopaminergic pathway genes and association of GRIN2A gene polymorphism with Alcohol Dependence”. During this period, he has mastered the Molecular biology techniques of Polymerase chain reaction (PCR), Methylation specific PCR, Real Time PCR, Restriction fragment length polymorphism (RFLP) and DNA sequencing along with data analysis and interpretation through various bioinformatics tools. He is working in the field of addictive disorders and specifically investigating variations in genes and methylation status in the promoter regions of genes in the specific neurotransmitters in alcohol and opioid dependence.

Abstract:

Heroin dependence (HD) is a complex disorder leading to disruptions in particular circuits of the brain, influenced by both environmental and genetic factors. Heroin interacts with the different brain neurotransmitters affecting the normal functions including learning, memory, cognition etc. The presence of polymorphisms in the glutamate pathway has been reported to increase the risk of addiction.  Aim: To identify an association of GRIN2A gene polymorphisms of glutamate pathway with HD and correlate with clinical parameters. Method: The study was in accordance with the declaration of Helsinki and approved by the Institute ethics committee.  A total of 103 HD patients were recruited as per DSM-IVR criteria from the NDDTC, AIIMS. 100 healthy volunteers from the general population formed the control group. Genomic DNA from peripheral blood samples was processed for PCR followed by restriction digestion to screen for presence of polymorphisms i.e. rs11866328, rs1071502, rs1375067, rs1530669, rs12325652, rs16966381, rs1104068, rs16966448, rs9927871 and rs1366076 of GRIN2A gene of glutamate pathway. Genotype frequency and the difference between patient and control were assessed by chi-square test of significance and the results were correlated with duration, age at onset of heroin use, the quantity of heroin consumed and WHO ASSIST score. Statistical analysis was done by SPSS V21.0. Result: Mean age at first use, duration of heroin intake and ASSIST score were 25.49±0.78, 8.52±0.84 and 29.82±0.60 years respectively. None of the SNPs showed any significant difference in genotype and allele frequency between the patients and controls. GRIN2A polymorphisms rs1530669 and rs1071502 showed significant association with the heroin intake (g/day) (p<0.05). A positive association with WHO ASSIST was observed with rs11866328 and rs12325652 (p<0.05). Conclusion: This is the first study which reports on the association of GRIN2A receptor polymorphisms with heroin dependence among the Indian population.

Biography:

Walter H White graduated from the California Institute of Technology. He is the co-founder of Gray Matter. He co-founded the Center of Enhanced Treatments with Jesse Pinkman. His area of research deals with the effect of drug use of employees on the efficiency of the businesses. 

Abstract:

Statement of the Problem: The drug use presents many problems for the users. Majority of the drug users are employed during or at least in the initial stages of their addiction. The drug use among employees presents many problems for the business owners including lower efficiency and job performance, trust between employee and employers, and decreasing chance of promotion. Many employers seek to eliminate or replace the employers that have drug use. This is done to ensure higher job performance. However, the employers have spent money and time to train these employees and eliminating them may not be in the best interest of the companies. The Sinaloa Foundation which is active in pharmaceutical industry, have very strict rules on drug use among its employees. Any employee with drug use problem will face termination. However, it might be beneficial for the employers to invest in rehabilitation of such employees. In this paper, we present the results of using aquatic treatment on the employees with substance dependency in recurrent drug use and job performance. The case study was carried out with instruction of Center of Enhanced Treatments (CET) using 35 participants of Sinaloa Foundation. The treatment included aquatic inhalation relatedly, i.e. 5 times, for a short period of time, i.e. up to 10 min, depending on the substance dependency of the participants. The number of days that the participants stayed drug free and their job performance was recorded after two weeks from the treatment. The results are presented in Figure 1. The results suggest that the longer the treatment is the participants will stay away from drug use. However, this relationship plateaus after 3 minutes. On the other hand, the job performance of the participants peaks with treatments around 2 minutes. Effectively, the job performance of the participants with longer than 4-minute treatment is negligible.  These preliminary results seem to suggest that the optimum the duration for the treatment is around 2-3 minutes.  In the future work, we will study the overall effects of the treatment of the heath being of the participants and the financial gain of the company from implementing treatment approach instead of elimination approach.

Speaker
Biography:

Prof. Hulse is based at the School of Psychiatry QE11 Medical Centre University of Western Australia. His research career has been directed at developing evidence based information which will enhance clinical practice, and has in the last several years had a particular focus on assessing the safety and efficacy of sustained release naltrexone as a management tool for substance dependence. He has arguably published more than anyone else globally on sustained release naltrexone for the management of heroin dependence, much of this on the Australian naltrexone implant.

 

Abstract:

Oral naltrexone effectively antagonizes heroin1, but patient noncompliance limits its utility2. The use of sustained-release naltrexone preparations that commonly involve the use of naltrexone polymer/co-polymer base formulations administered subcutaneously or intramuscularly may overcome this limitation3, 4.  Study data indicate that these formulations are both relatively safe, and effective in reducing craving and blocking the effects of any heroin used, and depending on the formulation and mode of administration can deliver clinically effective levels of blood naltrexone for between 30 to 180 days5. This period can then be used, with the assistance of psycho-social services, as a window of opportunity to move patients away from heroin use and back towards mainstream integration. Therefore, sustained-release naltrexone implants appear to provide a new treatment option for patients with heroin dependence, particularly for those seeking an alternative to opioid agonist maintenance.

Biography:

Jesse R Pinkman graduated from the California Institute of Technology. He is the co-founder of Gray Matter. He co-founded the Center of Enhanced Treatments with Walter White. His area of research deals with the effect of drug use of employees on the efficiency of the businesses.

Abstract:

Accurately modeling and discharge play a pivotal role in predicting the peak savings of demand response buildings. Considerable studies have been conducted on the transient thermal behavior of building envelopes, much of which has focused on the thermal mass effects of building envelopes and floors. However, it is unclear how to precisely describe the cooling storage effects of irregular internal mass such as furniture. Energy Plus and other simulation tools have internal mass models, but these models require ambiguous inputs such as internal mass surface area, thickness, volume and thermal properties. These inputs are impossible to obtain due to the irregular shapes and random spatial distributions of internal mass. In this paper, the novel “Effective Area” method is proposed that improves the theory of the conventional “Equivalent Slab” method. The new method establishes a relationship between the actual furniture and the equivalent furniture through a converted coefficient in the dynamic heat transfer equations. Experiments are conducted to test and verify the accuracy of the new method and to calculate common parameters, such as the converted coefficient and the distribution density of the irregular internal mass in some typical office setups.