Functional brain connectomes reflect acute and chronic cannabis use.

Resting state fMRI has been employed to identify alterations in functional connectivity within or between brain regions following acute and chronic exposure to Δ9-tetrahydrocannabinol (THC), the psychoactive component in cannabis. Most studies focused a priori on a limited number of local brain areas or circuits, without considering the impact of cannabis on whole-brain network organization. The present study attempted to identify changes in the whole-brain human functional connectome as assessed with ultra-high field (7T) resting state scans of cannabis users (N = 26) during placebo and following vaporization of cannabis. Two distinct data-driven methodologies, i.e. network-based statistics (NBS) and connICA, were used to identify changes in functional connectomes associated with acute cannabis intoxication and history of cannabis use. Both methodologies revealed a broad state of hyperconnectivity within the entire range of major brain networks in chronic cannabis users compared to occasional cannabis users, which might be reflective of an adaptive network reorganization following prolonged cannabis exposure. The connICA methodology also extracted a distinct spatial connectivity pattern of hypoconnectivity involving the dorsal attention, limbic, subcortical and cerebellum networks and of hyperconnectivity between the default mode and ventral attention network, that was associated with the feeling of subjective high during THC intoxication. Whole-brain network approaches identified spatial patterns in functional brain connectomes that distinguished acute from chronic cannabis use, and offer an important utility for probing the interplay between short and long-term alterations in functional brain dynamics when progressing from occasional to chronic use of cannabis.

Teacher plants - Indigenous Peruvian-Amazonian dietary practices as a method for using psychoactives.

ETHNOPHARMACOLOGICAL RELEVANCE: Indigenous groups of the Amazon have developed intricate methods for the application of psychoactives, among which particularly the dieta or diet method of Peruvian-Amazonian traditional medicine stands out. It is a retreat-like intervention involving lengthy periods of social, behavioural, and alimentary restrictions, while ingesting specially prepared plant substances. The interplay of the dietary conditions and plants ingested sensitizes the dieter to receive healing, strength, guidance, and knowledge. From a clinical scientific point of view, the method has remained largely underexplored, but seems more pertinent than ever given the increasing interest in Amazonian psychoactive preparations including ayahuasca (Banisteriopsis caapi) and the burgeoning field of psychedelic-assisted therapies in general. AIM OF THE STUDY: This study offers a descriptive account and emic interpretation of the Peruvian-Amazonian dieta. More specifically we document in detail the procedure, its context and purpose of application, effects, modes of action, adverse effects, and risks, from the perspectives of a sample of Peruvian traditional healers. The Peruvian-Amazonian dieta is a multi-purpose method for making use of medicinal plants, many of which (but not all), are psychoactive; the current work especially focuses on its therapeutic applications in conjunction with psychoactives. METHODS: We interviewed 16 healers working in the Ucayali, San Martín, and Loreto provinces of Peru using a semi-structured interview approach. Interviews were audio-recorded and transcribed verbatim. The extensive data derived from these interviews were analysed by means of computer-assisted manifest qualitative content analysis using a theory-advancing approach. Over 500 coded text segments were categorized, resulting in 7 main theme clusters and corresponding sub-themes. RESULTS: The interviewed healers described a complex intervention with multifaceted applications (treatment, prevention, training) and effects in various domains (body, mind, spirit, energy). The process was portrayed as transformative, with benefits attributed to the effects of the so-called teacher plants in conjunction with the diet's conditions, along with the skill of the healer guiding the intervention. Further, a detailed risk assessment revealed sophisticated safety measures and tools designed to address adverse responses. The importance of adequate training of the healer that administers the diet was particularly highlighted in this context. CONCLUSIONS: The dieta is a central therapeutic concept and tool in Peruvian-Amazonian traditional medicine and a unique method for using psychoactive plants. Multidisciplinary health research that includes traditional treatment methods from Indigenous cultures, Amazonian and other, should not be neglected in the current global interest in psychedelic therapies; such research may in the long-term contribute to a more inclusive psychedelic research paradigm as well as healthcare practice in countries where rich traditional healing systems exist, and perhaps beyond. It may also contribute to the recognition of the Indigenous healers as not only historical forerunners, but also current leading experts in psychedelic medicine.

Treatment Options for Motor and Non-Motor Symptoms of Parkinson's Disease.

Parkinson's disease (PD) usually presents in older adults and typically has both motor and non-motor dysfunctions. PD is a progressive neurodegenerative disorder resulting from dopaminergic neuronal cell loss in the mid-brain substantia nigra pars compacta region. Outlined here is an integrative medicine and health strategy that highlights five treatment options for people with Parkinson's (PwP): rehabilitate, therapy, restorative, maintenance, and surgery. Rehabilitating begins following the diagnosis and throughout any additional treatment processes, especially vis-à-vis consulting with physical, occupational, and/or speech pathology therapist(s). Therapy uses daily administration of either the dopamine precursor levodopa (with carbidopa) or a dopamine agonist, compounds that preserve residual dopamine, and other specific motor/non-motor-related compounds. Restorative uses strenuous aerobic exercise programs that can be neuroprotective. Maintenance uses complementary and alternative medicine substances that potentially support and protect the brain microenvironment. Finally, surgery, including deep brain stimulation, is pursued when PwP fail to respond positively to other treatment options. There is currently no cure for PD. In conclusion, the best strategy for treating PD is to hope to slow disorder progression and strive to achieve stability with neuroprotection. The ultimate goal of any management program is to improve the quality-of-life for a person with Parkinson's disease.

Introducing sexual dysfunction in mental care.

Introduction: People with any psychiatric disorder tend to have difficulties in responding sexually. However,sexual dysfunction (SD) is usually under-recognized, even the tightly hormonal and neuronal common connexions through the brain-sex axis. Multiple sources of resistance to SD assessment and intervention persist. Areas covered: The present review aims to underline the feasibility to introduce SD evaluation in patients with any psychiatric disorders, evaluating the potential mutual benefits of their management. Expert opinion: Women and men living with mental disorders frequently display sexual difficulties; however, some of them consider sexuality as a relevant parameter of their quality of life. In fact, SD as a side effect is a frequent reason for stopping the intake of medication. What is more, a holistic approach integrating sexual function could foster a better understanding of mental pathologies due to a common origin of pathogenesis. This could improve care quality, in keeping with the global tendency toward the development of personalized medicine. Consistently, the integration of SD assessment is highly recommended in mental health, all the more so when a psychotropic drug is prescribed. An expected consequence would be a reconstruction of the healthcare professional's consideration for the sexuality of people experiencing mental disorders.

[Argentinian women and the uses of drugs: A sociohistorical analysis of female drug use in Argentina (1860-1930)]. / Mujeres argentinas y usos de drogas: análisis sociohistórico del uso femenino de sustancias psicoactivas en Argentina (1860-1930).

This article describes cases presented by experts from the legislative and medical-legal fields regarding the use of psychoactive substances among Argentinian women from 1878 to 1930. Background information is presented regarding the relationship between women and the use different drugs, medical interventions on the female body where psychoactive substances were used are analyzed, and experts' descriptions of cases of female drug users are detailed. Experts' discourses during this period did not attempt to comprehend the specificities of female consumption, but were rather used to position the issue of drug use as a social problem. This was done using three prototypes: the victim of a sick husband; the prostitute who encourages drug use among the weak in spirit (natural-born criminals); and the virtuous young woman who succumbs to drug addiction in spite of her father's rule. Each figure reinforces the need for state intervention and increased social control.

Este trabajo describe casos expuestos por expertos de los ámbitos legislativo y médico-legal periodístico, en los que se reporta el consumo de sustancias psicoactivas por parte de mujeres de Argentina, entre 1878 y 1930. Se presentan antecedentes sobre mujeres y usos de distintos fármacos, se analizan las intervenciones médicas que utilizan sustancias psicoactivas sobre el cuerpo femenino, y se detallan los casos de mujeres consumidoras desde las miradas expertas. En este periodo, los discursos expertos no buscaron comprender la especificidad femenina del consumo, sino promover el tema drogas como un problema. Esto se produce utilizando tres prototipos: la víctima de un marido enfermo, la prostituta que envicia a los débiles de espíritu (criminal nata), y la joven virtuosa que contraviene la ley del padre y sucumbe en la toxicomanía. Cada figura refuerza la necesidad de intervención estatal y control social.

Ayahuasca's 'afterglow': improved mindfulness and cognitive flexibility in ayahuasca drinkers.

RATIONALE: There is a growing body of evidence demonstrating the therapeutic potential of ayahuasca for treating depression and anxiety. However, the mechanisms of action involved in ayahuasca's therapeutic effects are unclear. Mindfulness and cognitive flexibility may be two possible psychological mechanisms. Like other classic psychedelics, ayahuasca also leads to an 'afterglow' effect of improved subjective well-being that persists after the acute effects have subsided. This period may offer a window of increased therapeutic potential. OBJECTIVE: To explore changes in mindfulness and cognitive flexibility before and within 24 h after ayahuasca use. METHODS: Forty-eight participants (54% female) were assessed on measures of mindfulness (Five Facets Mindfulness Questionnaire (FFMQ)), decentering (Experiences Questionnaire (EQ)), and cognitive flexibility (Cognitive Flexibility Scale (CFS)), and completed the Stroop and Wisconsin Picture Card Sorting Task (WPCST) before drinking ayahuasca, and again within 24 h. RESULTS: Mindfulness (FFMQ total scores and four of the five mindfulness facets: observe, describe, act with awareness, and non-reactivity) and decentering (EQ) significantly increased in the 24 h after ayahuasca use. Cognitive flexibility (CFS and WPCST) significantly improved in the 24 h after ayahuasca use. Changes in both mindfulness and cognitive flexibility were not influenced by prior ayahuasca use. CONCLUSIONS: The present study supports ayahuasca's ability to enhance mindfulness and further reports changes in cognitive flexibility in the 'afterglow' period occur, suggesting both could be possible psychological mechanisms concerning the psychotherapeutic effects of ayahuasca. Given psychological gains occurred regardless of prior ayahuasca use suggests potentially therapeutic effects for both naïve and experienced ayahuasca drinkers.

Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment.

RATIONALE: 5-methoxy-N,N-dimethyltryptamine is a psychotropic substance found in various plant and animal species and is synthetically produced. 5-methoxy-N,N-dimethyltryptamine is used in naturalistic settings for spiritual exploration, recreation, or to address negative affect and mood problems. However, scientific knowledge on the effects of 5-methoxy-N,N-dimethyltryptamine in humans is scarce. OBJECTIVES: The first objective was to assess the effects of inhalation of vaporized synthetic 5-methoxy-N,N-dimethyltryptamine on neuroendocrine markers. The second objective was to assess effects of the substance on affect and mindfulness. In addition, we assessed whether ratings of subjective measures were associated with changes in stress biomarkers (i.e., cortisol) and immune response (i.e., IL-6, CRP, IL-1ß), as well as the acute psychedelic experience. METHODS: Assessments (baseline, immediately post-session, and 7-day follow-up) were made in 11 participants. Salivary samples were collected at baseline and post-session and analyzed by high-sensitivity enzyme-linked immunosorbent assay (ELISA). RESULTS: 5-methoxy-N,N-dimethyltryptamine significantly increased cortisol levels and decreased IL-6 concentrations in saliva immediately post-session. These changes were not correlated to ratings of mental health or the psychedelic experience. Relative to baseline, ratings of non-judgment significantly increased, and ratings of depression decreased immediately post-session and at follow-up. Ratings of anxiety and stress decreased from baseline to 7-day follow-up. Participant ratings of the psychedelic experience correlated negatively with ratings of affect and positively with ratings of non-judgment. CONCLUSION: Inhalation of vaporized synthetic 5-methoxy-N,N-dimethyltryptamine produced significant changes in inflammatory markers, improved affect, and non-judgment in volunteers. Future research should examine the effect of 5-methoxy-N,N-dimethyltryptamineamine with healthy volunteers in a controlled laboratory setting.

Medicalization and Indigenous Health: An analysis of the consumption of psychotropics by the Xukuru de Cimbres indigenous people. / Medicalização e Saúde Indígena: uma análise do consumo de psicotrópicos pelos índios Xukuru de Cimbres.

OBJECTIVE: To investigate the process of medicalization among the Xukuru indigenous people of Pesqueira (PE), Brazil following the 2003 conflict. METHOD: This is a descriptive, cross-sectional, quantitative study developed with the indigenous attended at the Xukuru de Cimbres basic center. The final sample consisted of 75 individuals who used psychotropic drugs. Data were analyzed by SPSS version 18.0, using the chi-square test. RESULTS AND DISCUSSION: We observed that 8% of the studied population use psychotropic drugs, and the most used is BZD (78.67%). Regarding age, 68% are young adults and 26.67% are elderly. The income of 81.33% of households is more than one minimum wage. As for marital status, 50.85% and 66.67%, respectively of the indigenous group using BZD and other psychotropic drugs are married. CONCLUSION: The study outlined the profile of the Xukuru de Cimbres indigenous people who used psychotropics and showed a fragmented mental health care focused on the disease and the use of medication. Results reveal a socioeconomically vulnerable adult population, a pattern of chronic use of psychotropic drugs and distancing from traditional indigenous healing, typical of the health medicalization process.

O objetivo deste artigo é investigar o processo de medicalização dos indígenas do povo Xukuru de Pesqueira, PE, após o conflito ocorrido em 2003. Estudo descritivo, quantitativo, desenvolvido com indígenas atendidos no polo base Xukuru de Cimbres. A amostra final foi composta por 75 usuários em uso de medicamentos psicotrópicos. Os dados foram analisados no SPSS versão 18.0, utilizando a prova do qui quadrado. Observou-se que 8% da população estudada faz uso de psicotrópicos, sendo os mais usados os BZD (78,67%). Com relação à idade, 68% são adultos jovens e 26,67% são idosos. A renda de 81,33% das famílias perfaz mais de um salário mínimo. Com relação ao estado civil, do grupo de indígenas que faz uso dos BZD e outros psicotrópicos, 50,85% e 66,67%, respectivamente, são casados. O estudo delineou o perfil dos índios Xukuru de Cimbres usuários de psicotrópicos e evidenciou uma assistência à saúde mental fragmentada, focada na doença e no uso da medicação. Os achados revelam uma população adulta vulnerável do ponto de vista socioeconômico, um padrão de cronificação do consumo dos psicotrópicos e o distanciamento das práticas de curas tradicionais indígenas, característicos do processo de medicalização da saúde.

Medicalização e Saúde Indígena: uma análise do consumo de psicotrópicos pelos índios Xukuru de Cimbres / Medicalization and Indigenous Health: An analysis of the consumption of psychotropics by the Xukuru de Cimbres indigenous people

Resumo O objetivo deste artigo é investigar o processo de medicalização dos indígenas do povo Xukuru de Pesqueira, PE, após o conflito ocorrido em 2003. Estudo descritivo, quantitativo, desenvolvido com indígenas atendidos no polo base Xukuru de Cimbres. A amostra final foi composta por 75 usuários em uso de medicamentos psicotrópicos. Os dados foram analisados no SPSS versão 18.0, utilizando a prova do qui quadrado. Observou-se que 8% da população estudada faz uso de psicotrópicos, sendo os mais usados os BZD (78,67%). Com relação à idade, 68% são adultos jovens e 26,67% são idosos. A renda de 81,33% das famílias perfaz mais de um salário mínimo. Com relação ao estado civil, do grupo de indígenas que faz uso dos BZD e outros psicotrópicos, 50,85% e 66,67%, respectivamente, são casados. O estudo delineou o perfil dos índios Xukuru de Cimbres usuários de psicotrópicos e evidenciou uma assistência à saúde mental fragmentada, focada na doença e no uso da medicação. Os achados revelam uma população adulta vulnerável do ponto de vista socioeconômico, um padrão de cronificação do consumo dos psicotrópicos e o distanciamento das práticas de curas tradicionais indígenas, característicos do processo de medicalização da saúde.

Abstract Objective: To investigate the process of medicalization among the Xukuru indigenous people of Pesqueira (PE), Brazil following the 2003 conflict. Method: This is a descriptive, cross-sectional, quantitative study developed with the indigenous attended at the Xukuru de Cimbres basic center. The final sample consisted of 75 individuals who used psychotropic drugs. Data were analyzed by SPSS version 18.0, using the chi-square test. Results and Discussion: We observed that 8% of the studied population use psychotropic drugs, and the most used is BZD (78.67%). Regarding age, 68% are young adults and 26.67% are elderly. The income of 81.33% of households is more than one minimum wage. As for marital status, 50.85% and 66.67%, respectively of the indigenous group using BZD and other psychotropic drugs are married. Conclusion: The study outlined the profile of the Xukuru de Cimbres indigenous people who used psychotropics and showed a fragmented mental health care focused on the disease and the use of medication. Results reveal a socioeconomically vulnerable adult population, a pattern of chronic use of psychotropic drugs and distancing from traditional indigenous healing, typical of the health medicalization process.

Cannabis use correlates with aggressive behavior and long-acting injectable antipsychotic treatment in Asian patients with schizophrenia.

Background: Although cannabis use has been linked with schizophrenia in a dose-response pattern, to our knowledge, the relationship between cannabis and schizophrenia has rarely been reported in Asian population. Aim: We compared the clinical characteristics and psychotropic prescription patterns between cannabis users and non-users among Asian patients with schizophrenia. Moreover, we aimed to identify the independent correlates of cannabis use in these subjects. Methods: We performed the analysis of the data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP), a collaborative consortium survey used to collate the prescription patterns for antipsychotic and other psychotropic medications in patients with schizophrenia in Asia. We included 132 schizophrenia patients in the group of lifetime cannabis use and 1756 in the group that had never used cannabis. A binary logistic model was fitted to detect the clinical correlates of lifetime cannabis use. Results: Adjusting for the effects of age, sex, geographical region, income group, duration of untreated psychosis, and Charlson comordity index level, a binary logistic regression model revealed that lifetime cannabis use was independently associated with aggressive behavior [adjusted odds ratio (aOR) = 1.582, 95% confidence interval (CI) = 1.006-2.490, p = .047] and with long-acting injectable antipsychotic treatment (aOR = 1.796, 95% CI = 1.444-2.820, p = .001). Conclusion: Our findings indicate a close link between lifetime cannabis use and aggressive behavior. The use of long-acting, injectable antipsychotics preferentially treats the aggressive behavior cannabis users among patients with schizophrenia in Asia, especially, the South or Southeast Asia.

The Association between Cannabis Product Characteristics and Symptom Relief.

Federal barriers and logistical challenges have hindered measurement of the real time effects from the types of cannabis products used medically by millions of patients in vivo. Between 06/06/2016 and 03/05/2018, 3,341 people completed 19,910 self- administrated cannabis sessions using the mobile device software, ReleafApp to record: type of cannabis product (dried whole natural Cannabis flower, concentrate, edible, tincture, topical), combustion method (joint, pipe, vaporization), Cannabis subspecies (C. indica and C. sativa), and major cannabinoid contents (tetrahydrocannabinol, THC; and cannabidiol, CBD), along with real-time ratings of health symptom severity levels, prior-to and immediately following administration, and reported side effects. A fixed effects panel regression approach was used to model the within-user effects of different product characteristics. Patients showed an average symptom improvement of 3.5 (SD = 2.6) on an 11-point scale across the 27 measured symptom categories. Dried flower was the most commonly used product and generally associated with greater symptom relief than other types of products. Across product characteristics, only higher THC levels were independently associated with greater symptom relief and prevalence of positive and negative side effects. In contrast, CBD potency levels were generally not associated with significant symptom changes or experienced side effects.

Phantom menace: novel psychoactive substances and the UK Armed Forces.

Novel psychoactive substances (NPS) encompass a large group of synthesised compounds specifically designed to mimic traditional recreational drugs. Current UK Armed Forces compulsory drug testing does not screen for these substances, making them tempting to the small proportion of UK Armed Forces personnel who indulge in recreational drug use. The acute and chronic sequelae of NPS misuse are widely variable and associated with high morbidity. In this paper, we discuss NPS pharmacology and clinical presentation. We describe toxidromes and management of patients who have misused NPS.Finally, we reflect on the legal, ethical and military consequences of NPS misuse for both the service person misusing NPS and the Military Physician providing their care.

Evaluation of reinforcing and aversive effects of voluntary Δ9-tetrahydrocannabinol ingestion in rats.

Edible cannabis-infused products are an increasingly popular method of using cannabis in the United States. Yet, preclinical research to determine mechanisms underlying abuse of Δ9-tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis, has focused primarily on the effects of parenteral administration. The purpose of this study was to examine the rewarding and aversive effects of oral THC in a novel rodent voluntary ingestion model. Adult male and female Sprague Dawley rats were given access to sucrose-sweetened solutions during daily sessions. A range of THC concentrations, each paired with a unique flavor previously tested alone, was introduced into these solutions for four-session exposure periods and drinking volumes were measured. Injected (i.p.) THC doses were also paired with unique flavors to compare the effects of route of THC administration on drinking. Introduction of THC into sucrose solutions dose-dependently decreased drinking upon initial exposure, though drinking generally increased in subsequent sessions. By contrast, i.p. THC produced sustained dose-dependent decreases in drinking in rats of both sexes. Subsequent exposure to paired flavors in the absence of THC resulted in further decreases in drinking, suggesting route-specific aversion. Additional testing using saccharin-sweetened solutions in a two-bottle choice paradigm was also conducted, with THC producing sustained dose-dependent decreases in drinking after initial exposure in rats of both sexes. Though self-administration of ingested THC was not demonstrated, evidence of route-specific THC aversion was observed, which suggests that certain routes and/or rates of THC administration may mitigate some of its aversive effects.

Attendance of children and adolescents with psychoactive substance use disorders performed by Psychosocial Care Centers in Brazil, 2008-2012. / Atendimentos de crianças e adolescentes com transtornos por uso de substâncias psicoativas nos Centros de Atenção Psicossocial no Brasil, 2008-2012.

OBJECTIVE: to describe the profile of care for children and adolescents withpsychoactive substance use disorders performed by the Brazilian Psychosocial Care Centers (Centros de Atenção Psicossocial - CAPS) from 2008 to 2012. METHODS: a descriptive study with data from the SUS Outpatient Information System (Sistema de Informações Ambulatoriais do Sistema Único de Saúde - SIA/SUS) and the system of National Registration of Health Establishments (Cadastro Nacional de Estabelecimentos de Saúde - CNES). RESULTS: a total of 151.330 attendances were observed, 81.2% were males and 99.2% were in the age range of 10 to 19 years; the main causes were polydrug use (56.7%), cocaine (15.6%), marijuana (15.6%) and alcohol (9.0%); the CAPS for Alcohol and other Drugs (CAPS AD) accounted for 81.8% of the records; from 2008 to 2012, the attendance rate from 39.6 to 76.7/100 thousand inhabitants. CONCLUSION: there was an increase in the attendance rates, observing the predominance of males, age range of 10 to 19 years and disorders due to polydrug use.

Does Jacobson's relaxation technique reduce consumption of psychotropic and analgesic drugs in cancer patients? A multicenter pre-post intervention study.

BACKGROUND: Cancer patients often suffer from emotional distress as a result of the oncological process. The purpose of our study was to determine whether practice of Jacobson's relaxation technique reduced consumption of psychotropic and analgesic drugs in a sample of cancer patients. METHODS: This was a multicenter pre-post intervention design. Participants were 272 patients aged over 18 years attending 10 Spanish public hospitals with oncological pathologies and anxiety symptoms. The intervention consisted of a protocol of abbreviated progressive muscle relaxation training developed by Bernstein and Borkovec. This was followed up by telephone calls over a 1-month period. The intervention was performed between November 2014 and October 2015. Sociodemographic variables related to the oncological process, mental health variables, and intervention characteristics were measured. RESULTS: A reduction in the consumption of psychotropic and analgesic drugs was observed throughout the follow-up period. Improvement was observed throughout the 4-week follow-up for all the parameters assessed: anxiety, relaxation, concentration, and mastery of the relaxation technique. CONCLUSIONS: The practice of abbreviated Jacobson's relaxation technique can help to decrease the consumption of psychotropic and analgesic drugs. Patients experienced positive changes in all the evaluated parameters, at least during the 1-month follow-up. To confirm these findings, additional long-term studies are needed that include control groups. TRIAL REGISTRATION: ISRCTN 81335752 , DOI 10.1186/ISRCTN81335752 17. Date of registration: 22/11/2016 (retrospectively registered).

Analysis of the Uptake, Metabolism, and Behavioral Effects of Cannabinoids on Zebrafish Larvae.

The Cannabis sativa plant contains numerous phytocannabinoids and terpenes with known or potential biological activity. For decades, plant breeders have been breeding the Cannabis plant to control for a desired ratio of the major cannabinoids. A high-throughput in vivo model to understand the relationship between the chemical composition of different strains and their therapeutic potential then becomes of value. Measuring changes in the behavioral patterns of zebrafish larvae is an established model with which to test the biological activity of neuroactive compounds. However, there is currently little information regarding the uptake kinetics and metabolism of compounds by larvae. In this study, we chose to compare the uptake kinetics and metabolism of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) alone or in combination with their effects on larval behavior. We have shown that both compounds have distinct behavioral patterns and concentration response profiles. Additionally, the uptake kinetics observed for each compound appears to correlate with the change in behavior observed in the behavioral assays. When combinations of THC and CBD were tested there were shifts in both the behavioral activity and the uptake kinetics of each compound compared with when they were tested alone. Finally, the THC/CBD-derived metabolites detected in the larvae are similar to those found in mammalian systems. This study thus provides a model for further testing of additional cannabinoids and potentially plant extracts.

Medicinal foods and beverages among Maasai agro-pastoralists in northern Tanzania.

ETHNOPHARMACOLOGICAL RELEVANCE: Pastoralist Maasai populations of east Africa use several different wild plants as dietary and medicinal additives in beverages (soups and teas), yet little is known about how the plants used and the rationales for use compare and contrast across different Maasai beverages, including how gender specific dietary and health concerns structure patterns of intake. AIM OF THE STUDY: We investigated three Maasai beverages: almajani (tea or herbal infusion); motorí (traditional soup); and okiti (psychoactive herbal tea). In order to build knowledge about the cultural functions of these Maasai food-medicines and their incidence of use we also investigated use rationales and self-reported frequencies of use. We conclude by examining gender differences and the possible pharmacological antimicrobial activity of the most frequently used plants. MATERIALS AND METHODS: Research was conducted in 2015, with a population of semi-nomadic agropastoralist Maasai residing in northern Tanzania. Data were collected using key informant interviews, plant collections, n = 32 structured surveys, and n = 40 freelist interviews followed by a literature review to determine the known antimicrobial activity of the most used plants. RESULTS: We identified 20 plants that Maasai add to soup, 11 in tea, and 11 in the psychoactive tea, for a total of 24 herbal additives. Seven plant species were used in all three Maasai beverages, and these clustered with 10 common ailments. Based on self-reports, women use the beverages less frequently and in smaller amounts than men. There were also several gender differences in the plants that Maasai add to motorí and their associated use rationales. CONCLUSIONS: There are several intersections concerning the plant species used and their associated rationales for use in almajani, motori, and okiti. Moving outward, Maasai beverages and their additives increasingly involve gender specific concerns. Female use of food-medicines, relative to men, is structured by concerns over pregnancy, birth, and lactation. The frequent consumption of herbal additives, many of which contain antimicrobial compounds, potentially helps modulate infections, but could have other unintentional effects as well.

Interventions to Improve Medicines Management for People with Dementia: A Systematic Review.

BACKGROUND: The importance of optimising medicines management for people with dementia has been emphasised through research and policy. However, evidence is currently lacking regarding how to achieve this in this patient population. OBJECTIVE: The aim was to assess the effectiveness of medicines management interventions for people with dementia living in their own home or a care home, with or without nursing care. METHODS: A systematic literature search was conducted in February 2016 across six electronic databases and three trial registries. Inclusion criteria were randomised controlled trials of medicines management (prescribing, dispensing, adherence, and/or review) interventions for people with dementia living in their own homes or care homes, with or without nursing. An assessment of quality was conducted for all studies, using the Cochrane tool for assessing the risk of bias. All outcomes were considered using a narrative approach. RESULTS: Overall, 1365 articles were identified, with three studies eligible for inclusion (n = 475 participants). The studies were heterogeneous both in terms of intervention components, setting, and outcomes used. Aspects of medicines management targeted included medication review, adherence, and administration. Improvements in psychotropic prescribing were observed; however, the interventions had limited effects on other outcomes such as wellbeing, falls and dementia severity. CONCLUSION: This review highlights the limited number of studies examining medicines management interventions for people with dementia. Of the work that has been conducted to date, emphasis has been placed on psychotropic drug use. Future research must target community-dwelling dementia patients and take a holistic approach to medicines management.

Prevalence of mind and body exercises (MBE) in relation to demographics, self-rated health, and purchases of prescribed psychotropic drugs and analgesics.

This study aims to identify any differences regarding gender, age, socioeconomic status (SES), self-rated health, perceived stress and the purchase of prescribed drugs among people who practice mind and body exercises (MBE) extensively compared to people who do not. METHODS: The study includes 3,913 men and 4,803 women aged 20-72 who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH). The respondents were divided into three groups depending on frequency of MBE practice (never/seldom/often). Measures regarding MBE practice, health behaviors, self-rated health, and illnesses were drawn from the SLOSH questionnaire, while more objective measures of socioeconomic status and education were derived from registry data. In addition, data on purchases of prescription drugs for all respondents were included in the study. These data were obtained from the Swedish Prescribed Drug Register, which contains information about prescription drugs dispensed at Swedish pharmacies. Separate analyses were performed for mental MBE (mindfulness, meditation, relaxation techniques) and physical MBE (yoga, Tai Chi, Qi Gong), respectively. RESULTS: A high intensity MBE practice is cross-sectionally related to poor self-assessed health (sleeping problems, pain, depressive symptoms, mental disorders), high levels of stress, and high levels of purchases of psychotropic drugs and analgesics. These cross-sectional relationships are generally stronger for mental MBE than for bodily-directed MBE. More women than men are practicing MBE on a regular basis, and physically active people participate to a greater extent in MBE compared with the physically inactive. CONCLUSION: Overall, the study shows that frequent participation in mind and body exercises is associated with high levels of purchases of psychotropic drugs and analgesics as well as with poor self-assessed health and high levels of stress. However, since this is a cross-sectional study, it is impossible to establish cause and effect, and to further investigate the associations found; longitudinal studies that can account for temporality between covariates and MBE use are needed.