Schizophrenia and bipolar disorder are two severe mental disorders that affect more than 65 million individuals worldwide. The aim of thisproject was to find co-prediction mechanisms for genes associated with schizophrenia and bipolar disorder using a multi-omics data set and a transparent machine learning approach. The overall purpose of theproject was to further understand the biological mechanisms of these complex disorders. In this work, publicly available multi-omics data collected from post-mortem brain tissue were used. The omics types included were gene expression, DNA methylation, and SNP array data. The data consisted of samples from individuals with schizophrenia, bipolar disorder, and healthy controls. Individuals with schizophrenia or bipolar disorder were considered as a combined CASE class. Using machine learning techniques, a multi-omics pipeline was developedto integrate these data in a manner such that all types were adequately represented. A feature selection was performed on methylation and SNP data, where the most important sites were estimated and mapped to their corresponding genes. Next, those genes were intersected with the gene expression data, and another feature selection was performed on the gene expression data. The most important genes were used to develop an interpretable rule-based model with an accuracy of 88%. The model wasthen visualized as a network. The graph highlighted genes that may be of biological importance, including CACNG8, RTN4, TERT, OSBPL8, and ANTXR1. Moreover, strong co-predictions were found, most notable between CNKSR4 and KDM4C in CASE samples. However, further investigations would need to be performed in order to prove that these are real biological interactions. Through the methods developed and the results found in this project, we hope to shed new light towards analyzing multi-omics data as well as to reveal more about the underlying mechanisms of psychiatric disorders.

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, and a shortage of resources in general. The current study aimed to determine the extent of mental health training that rural PCPs receive regarding patients with SMI, as well as to evaluate their perceptions, knowledge, and experiences with these patients and understand providers’ perceptions regarding rates of patients with SMI who present to primary care clinics in rural settings. The current study used a sample of rural primary care providers (N = 90) , surveyed via USPS mail. Results indicated significant differences in reported mental health training among providers from different disciplines. Greater reported mental health training significantly predicted lower levels of stigma, more correctly identified medical conditions comorbid with SMI, and greater reported comfort and confidence in treating patients with SMI. Providers reported differences in the number of patients with and without SMI seen in rural clinics. Implications for these findings are discussed.

Earlier this decade, “bath salts” were popularized as legal alternatives to the pyschostimulants cocaine and the amphetamines. These products contained synthetic cathinones including 3,4-methylenedioxypyrovalerone (MDPV), 4-methylmethcathinone (mephedrone), and 3,4-methylenedioxymethcathinone (methylone). Studies indicate that the cathinones have similar pharmacology to controlled psychostimulants, increasing levels of dopamine (DA) in the synaptic cleft. Most preclinical investigations have only assessed the effect of these synthetic cathinones independently; however, case reports and DEA studies indicate that “bath salts” often contain mixtures of these substances. Therefore, in a recent study by our laboratory, we examined effects of individual versus combined exposure to MDPV, mephedrone, and methylone. Interestingly, an enhanced effect on the levels of DA was observed, as well as significant alterations in locomotor activity following co-exposure to the cathinones. In this study, we examine whether the enhanced effects of the drug combination were due to pharmacokinetic (PK) interactions. It is known that many of the same cytochrome P450 (CYP) isoenzymes metabolize each of these three drugs. Therefore, it is probable that the drugs’ PK would differ when administered individually as compared to in combination. We hypothesize that combined exposure to MDPV, mephedrone, and methylone will result in increased drug concentrations and enhanced total drug concentrations when compared to individual administration. The pharmacokinetics of MDPV, mephedrone, and methylone in the brain and plasma were examined following intraperitoneal injection in mice. Briefly, adolescent male Swiss-Webster mice were injected intraperitoneally with either 10 mg/kg MDPV, 10 mg/kg mephedrone, 10 mg/kg methylone, or 10 mg/kg combined MDPV, mephedrone, and methylone. Following injection, brains and plasma were collected at the following time points: 1, 10, 15, 30, 60, and 120 minutes. Samples were then flash-frozen and stored at -70°C until analysis. Drugs were extracted via solid-phase extraction and concentrations were determined using a previously validated and published high pressure-liquid chromatography tandem mass spectrometry (LC-MS/MS) method. Following intraperitoneal administration, all drugs quickly crossed the blood-brain barrier and entered the brain. Peak drug concentrations, time to peak concentration, drug half-lives, and total drug exposure (as measured by area under the curve) are compared when drugs were given individually versus in combination. These data provide insight into the consequences of co-exposure to popular “bath salt” products.

Rapidly Dissolving Polymeric Microneedle Skin Patch of Naloxone for Opioid Overdose Treatment Tijani Akeemat1, Maria J. Peláez2, Prashant Dogra2,3, Ashana Puri1 1 Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614. 2 Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, TX 77030, USA 3 Department of Physiology and Biophysics, Weill Cornell Medical College, New York, NY 10065, USA Worldwide opioid abuse affects over 16 million people. A major cause of death in abusers is overdosing. Naloxone (NAL) is an opioid inhibitor that reverses its respiratory depressing effect. The use of this drug is limited mostly to invasive delivery: intravenous (IV), intramuscular (IM) and subcutaneous (SC) due to its significant hepatic clearance and poor oral bioavailability (2%). These routes are painful and worse still is the need for frequent injections for patient stabilization due to the short half-life of NAL. Non-invasive intranasal forms exist but this is fraught with a couple of limitations such as nasal damage and epistaxis. The need for alternatives without these limitations is thus evident. The feasibility of the use of metal microneedles (MNs) for the transdermal delivery of NAL was demonstrated in-vitro and through in-vitro in-vivo correlation modeling in our lab. The goal of the current study was to design a rapidly dissolving polymeric MN patch with delivery and pharmacokinetic (PK) properties comparable to that seen with the commercially available NAL products, eliminating their highlighted limitations. NAL loaded rapidly dissolving polyvinyl pyrrolidone-based MN arrays (500 µm, 100 needles) were fabricated by the mold casting technique. The permeation profile of fabricated MNs over a predetermined time were assessed via an in-vitro permeation set up using porcine ear skin. Samples were analyzed via HPLC. To improve on drug flux and amount permeated, the effect of increasing MN length and density (no. of needles/unit area) were assessed by fabricating MNs 300 µm longer and those with density double that of the initial array. Factors such as drug load and polymer strength influenced the needle fabrication. Compared to passive permeation, a reduced lag time of about 15 min was observed with a significant drug flux of 15.09 ± 7.68 g/cm2/h seen in the first 1 h (pin-vitro in-vivocorrelation we were able to predict an optimized design of the patch that can reproduce the clinical PK of NAL obtained with commercial devices. Increasing needle density and/or patch area was found to be of greater significance. Overall, drug flux seen over 1 h depicts the applicability of fabricated needles in opioid overdose emergencies with delivery properties comparable to that with IM and IN delivery.

Background: The proportion of people with mental disorders in treatment is relatively small in low and middle income countries. However, little is known about patterns of recent service use in a country like South Africa. Methods: A nationally representative household survey of 4,351 adult South Africans was carried out. Twelve-month DSM-IV disorders were determined using the WHO composite international diagnostic interview (CIDI). Prevalence and correlates of treatment were assessed among respondents with anxiety, mood and substance use disorders. Results: One-fourth (25.5%) of respondents with a 12-month disorder had received treatment in the past 12 months either from a psychiatrist (3.8%), nonpsychiatrist mental health specialist (2.9%), general medical provider (16.6%), human services provider (6.6%), or complementary-alternative medical (CAM) provider (5.9%). Only 27.6% of severe cases had received any treatment. In addition, 13.4% of respondents with no disorder had accessed services in the past year. Blacks were significantly more likely than other racial groups to access the CAM sector while Whites were more likely to have seen a psychiatrist. Conclusions: The majority of South Africans with a 12-month mental disorder have unmet treatment needs. In addition to a greater allocation of resources to mental health services, more community outreach and awareness initiatives are needed.

Research on rates of HIV testing among individuals diagnosed with Bipolar Disorder (BPD) is limited, while HIV infection continues to rise among BPD individuals. The problem is that BPD individuals are at high risk for HIV infection due to non-adherence to treatment for bipolar disorder and manic episodes that can lead to high-risk behaviors. The goal of the study was to examine the association between selected demographic variables, having a bipolar diagnosis, engaging in high-risk behaviors, inability to afford treatment for bipolar disorder, non-adherence to treatment for bipolar disorder, and substance abuse, and their relationship to obtaining an HIV test (the dependent variable) for individuals with BPD. The epidemiologic triangle model served as the theoretical model to assist with interpreting findings. Data collected from 383 BPD diagnosed individuals from the 2007 National Health Interview Study were analyzed using binary logistic regression, chi-square, and multiple logistic regression methods. The results indicated that all 5 behavioral independent variables were significantly associated (p=.000) with obtaining an HIV test. Significant associations were also found for demographic variables (race, gender, and homelessness) as confounding factors that influenced HIV testing among BPD individuals. Implications for positive social change are increased education on the risks of HIV infection and the need for appropriate HIV testing among BPD diagnosed individuals in an effort to protect the health and welfare of this vulnerable population.

Over the past two decades an increasing number of theorists and practitioners have called for a thorough rethinking of the underlying assumptions of the concept of rrental illness and the traditional psychiatric nodes of responding to mental disorders. The work of this group of writers has come to be referred to as the "antipsychiatry" literature. The insights of this perspective center largely about a rejection of those theories and methods of treatment that are based upon the medical model. Many writers point to the use of traditional psychiatric practice as an oppressive instrument of social control. While much of this perspective is directed toward the analysis of specifically sociological factors there have been few attempts by sociologists to provide focus for the claims that have been made. This paper proposes a synthetic sociological framework with the intention of providing sociological focus for the otherwise disparate insights found within this literature. A general model is constructed by incorporating aspects of the labeling perspective, the sociology of knowledge, and Marxian analysis. The model provides the analytical tools for investigation of the manner in which "mental illness" as a concept, and the phenemenon which it allegedly describes, are rooted in the nature of everyday life. The framework that is developed places particular emphasis upon the political dimensions . of everyday life. This dimension is especially useful in explicating the role of labeling as a device to discredit the claims of .people as they attempt to identify the oppressive aspects of .their social environment. The nature .of socialization within Western culture is analyzed in terms of the various factors which are instrumental in the mystification of consciousness and its relationship to "mental illness." The observation is made that the majority of the claims that are proffered by the "antipsychiatrists" are devoid of a firm empirical foundation in that they rely primarily upon findings from case studies and a series of loose inferences. An attempt is made to overcome this problem by mapping out the empirical points of departure for the model by developing a set of testable propositions and corollaries. It is concluded that a radical sociology of knowledge framework does provide a useful method of conceptualizing the "antipsychiatry" literature from a sociological perspective. The validity of the claims themselves, however, must wait until much more of the empirical evidence is in. It is pointed out that extreme caution be taken to avoid contentions to the effect that all mental disorders can be fruitfully Suggestions are made as to the likelihood that some diagnostic categories, more than others, may be subject to analysis by this model. It is implied that further research into the role of biopsychological factors will undoubtedly show the interactive effects of such factors with defective socialization and oppressive social relationships.

The geographical focus of this study is on that section of Southeast Portland which has been designated by the Office of Econom1c Opportunity as a poverty pocket because of an incidence of low-income families exceeding ~. (See Figure 2, Appendix A.) As such, the area is under the jurisdiction of the Portland Metropolitan Steering Committee, the OEO community action agency for Portland. Under the auspices of this agency, the four neighborhoods in the area (Brooklyn, Buckman, Richmond and Sunnyside) in 1966 formed a separate non-profit delegate agency which was named Portland Action Committees Together, Incorporated (PACT). PACT originally was responsible for administering War on Poverty programs through three neighborhood centers in the area. Its functions have changed but it still remains very much involved, even providing the terms by which the area is known: the PACT target area. The particular focus of the study has to do with the mental health of elementary School age children in the PACT target area. The original, and still primary, purpose of this study was to provide a statistical data base for a grant proposal to fund a children's mental health service agency in the PACT target area of Southeast Portland. Since the original conception by Jack Tovey of the Child Psychiatry Department, University of Oregon Medical School, and PACT staff, the plan has been subsumed under the planning auspices of the Comprehensive Mental Health Planning Committee, a group whose aim is to work toward expanding and consolidating mental health services in all dimensions for the Southeast Portland area.

The purpose of this evaluative study was to develop and implement a program evaluation design for a model of early mental health intervention to primary grade level classrooms .in a public elementary school. The design reflects a formative evaluation study, providing information for current and future programming and is manageable to implement, thus facilitating longitudinal data collection. This therapeutic model of classroom intervention stresses the integration of children’s social, emotional and intellectual development and proposes a collaborative approach between therapist and educator. Levels of intervention for collaborators include (1) children identified as requiring therapeutic approaches to social-emotional difficulties experienced in the classroom, (2) all children in the classroom and, (3) the classroom milieu. The overall goal is to promote optimal growth at all levels. The program evaluation design includes a format for monitoring the service delivery system of the model and to identify procedural and collaborative discrepancies. Information regarding collaborators' perceptions of identified children is collected from written intervention plans. Assessment of the frequency and nature of peer interactions was accomplished in this study through an observational technique in the classrooms. A teacher attitude questionnaire was administered at the end of the school year to obtain information about teacher receptivity of the program and suggestions for future restructuring of service delivery. Additional data was collected from the school's files regarding teachers' rating of children as to their current and anticipated social-emotional and learning difficulties. The results of the information collected reflect a general awareness, acceptance and support of the collaborative approach on the part of teachers participating in the program. As a direct result of the evaluation process, several issues of programming were raised and proposed for future decision-making.

The purpose of the present study was to investigate the presence or absence of a phonological recoding strategy in the mentally retarded population by using a memory matching exercise with visual stimuli. Pictures of common objects were divided into eight pictures with names that sound alike (homophonous) and eight with names that do not sound alike (non-homophonous). The null hypothesis tested was: No statistically significant difference will be found between mentally retarded and normal subjects in the development and use of a phonological recoding strategy for a short-term memory task, when the subjects are matched for receptive vocabulary age.