At the BAP meeting my friend and colleague Ben Ainsworth kindly reminded me that I haven’t posted anything on the EUSARNAD blog yet. I love British people because they are so polite and proactive that you can only feel guilty and try to accomplish what they ask you to do, even in this really hot midsummer afternoon in Milano. So I will try to let you have a glimpse of my EUSARNAD experience.

I had a great time meeting and working with fellow EUSARNAD researchers (and friends!) Natalie Cuzen and Christiane Nday

I was really lucky as I heard about the research network directly from Professor David Baldwin whilst at a conference in Roma. I already had an interest in anxiety disorders so I (actually pretty bluntly) asked Professor Baldwin to join his team in Southampton. While in the UK  I met Natalie Cuzen, a South African psychologist involved in the scheme. Natalie and me, well, we became good friends while preparing our talk for the ICOCS congress in Vienna (nothing like your first talk at an international meeting can teach you what anxiety really is…Natalie fixed her presentation all the morning before while I had a candy apple overdose at the Prater…but this is another story I’ll tell you in the future).

So when I flew to Cape Town I already had some friends to help me settle. While there I was given the opportunity to work on something completely new for me: epidemiology and statistics. I was a bit skeptical at the beginning. I was so used to medical tools like proteins, cytokines, molecules that I kind of lost the perspective on our job: to understand and create solutions to help people enjoy a fullfilling life.

While trying to find my way with a literature search on “mental health literacy in anxiety” I had a great help from Katherine Sorsdahl that was my mentor while in Groote Schuur. Katherine was a great source of informations on South Africa populations, on their attitude related to alcohol and substance consumption, and on the actual access that people can have to health care. This is the good and bad about South Africa: it give you the feeling of a place where the future is happening and still have to face a troublesome past.

The townships in South Africa (this is a photo of Khayelitsha) have disproportionate levels of crime, alcoholism and mental health problems. But they are also full of a liveliness and vibrancy like nowhere else.

All this raised in me a lot of huge questions: what’s the point in having new treatments, knowledges and really detailed information about every little piece of the brain if a large part of the world population can’t access this, doesn’t want to or doesn’t trust health care at all? Numbers have the power to show you in which direction you are going more efficiently than experience itself. But an experience can give you a new perspective.

That’s what happen to me during a trip with Katherine and Ben in the township of Khayelitsha. Katherine was invited by an NGO to teach brief psychological interventions in the field of alcool abuse to people having some kind of social role in the township. Policemen, teachers, social workers, were there to learn the administration of the AUDIT questionnaire and how to provide a first line help to people facing an addiction.   This is just one of the strategies studied to work with few resources on a large scale. This is what health literacy does.

We were lucky enough to attend a small talk in Khayelitsha for locals who want to help reduce the impact of the high levels of alchohol abuse in the township

So, despite feeling much more comfortable while dealing with patients or protein expression (!),the work in EUSARNAD in Cape Town reminded me to look at the big picture of mental disorders. And that big answers to big questions come from big networks.

😉

– Lotte

After spending 4 weeks in Cape Town in January as a EUSARNAD-exchangee, followed by another 2.5 weeks of traveling, I had completely fallen in love with South Africa and, in particular, with the Mother City (that’s Cape Town!).

In the course of my 4 week stay at the Department of Psychiatry of the Groote Schuur hospital it became clear that the project I had been working on with Jean-Paul Fouché for over a year (starting with his visit to Leiden a year earlier), was not progressing as quickly as we would like. Setting up an international database of Social Anxiety Disorder MRI data comes with politics, logistics, analysis plans, quite a few renowned research centres worldwide, and requires a fair amount of patience. I soon realised that this ‘mega-analysis’ project would benefit from fulltime attention. Fortunately, the supervisors agreed and I left Cape Town feeling hopeful to return some time. Mind you, I had to come back, since I had not even been to Robben Island yet!

And I was lucky… A mere day after setting foot on Dutch soil, I got the green light to continue working on the mega-analysis in Cape Town, where all Social Anxiety Disorder MRI data was transferred. Fast-forward 4 months including a visit from Ben Ainsworth to Leiden, and here I am again, in one of the most exquisite cities in the world, feeling like the luckiest girl in the world. True, Europe is currently in a massive heat wave and after a cold and wet spring, my timing of leaving The Netherlands could have been better. Especially since it is winter in South Africa, which means I have gone straight back to the cold and rain… But who can say that when they walk out their door en look left they see the ocean, look right see Table Mountain and the Twelve Apostles, and look ahead to see Lion’s Head?! And, rather importantly, I am thrilled to work on the social anxiety mega-analysis because to me, it is simply one the most interesting projects on the planet.

I was very excited to see my colleagues at the Groote Schuur again, with whom I got along very well during my previous visit. These included some other EUSARNAD researchers such as Sonja Pasche, Jean-Paul Fouché, Anne Uhlmann, Sarah Heany, and Coenie Hattingh. All of the colleagues were very welcoming and it was almost as if I had never left. Meetings with the department allowed me to get an idea of the exciting studies that the groups are doing here – many of which involve anxiety, and I can’t wait to learn more. But most importantly, JP and I are about to sink our teeth in the social anxiety mega-analysis, which will undoubtedly prove to be challenging as well as interesting.

Although I am only a few weeks into my 6-month stay in Cape Town it felt like home from the very beginning. The experience so far is already wonderful, and I can only look forward to what is yet to come!

– Nienke

From the natty acronym ‘EUSARNAD’ it’s pretty apparent that most of the collaborative programs are cross-continental, between the European Union (that’s the ‘EU’ part) and South Africa (you might have guessed, the ‘SA’). But the idea behind it is not just to allow researchers to complete current research in environments, using techniques and tools they wouldn’t usually have access to, but also to allow those researchers to build links and create communicative networks that might yield future collaboration.

It took a while before I was able to manage to cycle around on the bike I was kindly leant without reducing the people around me to breathless laughter at my incompetence…

A case in point was my trip to Leiden University Medical Centre. At Southampton, we have a number of projects that EUSARNAD takes an interest in, from developing new experimental models of anxiety (the ‘7.5% CO2 model’) to using these models to evaluate various psychological and pharmacological anxiety treatments.

One aspect of our department that we are currently developing is the use of neuroimaging to further evaluate models/treatments. Neuroimaging, using Magnetic Resonance Imagining (MRI) is much touted as a way to ‘look inside a living brain’.  While, as with any scientific tool, there are certain caveats to it’s usefulness, it’s certain that it’s an extremely powerful tool which will, as methods are refined, become more and more useful over the coming decades. I learnt some MRI techniques under the tutelage of JP Fouche at the CUBIC institute, and when I came back to Southampton I was determined to create an opportunity to use these skills.

I didn’t realize it at the time, but the EUSARNAD scheme had already given me everything I needed. I met Nienke Pannekoek and Steven van der Werff at the University of Cape Town while I was there, and it was immediately obvious that we shared a lot of beliefs about the future of anxiety research. We kept in touch, and when Nienke suggested that I spend some time at the LUMC, I jumped at the chance. She offered me the opportunity to meet the rest of her department, learn some of the MRI analysis methods they were familiar with, and observe some of their experimental techniques.

This picture was actually one I took to use as navigation – (un)fortunately Leiden is so full of historical sites and striking architecture that it wasn’t that helpful!

Although I was only working in the LUMC for two weeks, I really was given an insight into a busy clinical facility that makes the most of its excellent neuroimaging facilities.  I observed and took part in studies, I attended presentations, and I was given ample opportunity to poke my nose into anywhere I fancied.  Furthermore, the LUMC researchers were interested in the work we’re doing in Southampton, and the different cognitive, clinical and experimental methods we employ. This mutual interest really does bode well for future work together, and is a perfect example of the EUSARNAD scheme achieving its goals.

(Even this post was a collaborative effort between me (Ben) and Nienke Pannekoek).

I headed off from the University of Cape Town to the UK at the beginning of June to do my EUSARNAD stint at the University of Bristol, under the supervision of Prof. Glyn Lewis. I was to spend 4 weeks in the lovely South-Western city of Bristol, learning how to do relatively complex statistical analyses on the impressive ALSPAC cohort.

The ALSPAC study or as it’s affectionately known, Children of the 90s, is a long-term health research project which recruited pregnant mothers between 1991 to 1992, exclusively from the AVON county in the South West of the UK. The researchers collected vast amounts of environmental and genetic data from the 14 000 mothers and their babies throughout their development. Today, those babies are all grown up and have kids of their own, who are also part of the study. In any case, the aim of my visit was to use some of the ALSPAC data to determine whether genetic variants interacted with stressful childhood events to result in adolescent alcohol use, and whether those gene-environment interactions are mediated by anxiety symptoms. What a mouthful! Needless to say, most of my trip was spent trying to get to grips with using the required statistical programs and dealing with multiples of multiples of variables. Thanks to Andrew Crawford and Sarah Lewis, this process was not too hard.

As for the rest of the title, when I was not grappling with the complexities of statistical analyses, I visited the Clifton Downs lookout point which has a beautiful view of the famous Clifton suspension bridge, a Bristol landmark. For anyone travelling to that part of the world I would highly recommend a trip to Bath Spa which is one train stop away from Bristol. There I got to explore the fascinating Roman Baths and the former home of Jane Austen. So fascinating! All in all, Bristol was a memorable experience and 4 weeks went way too quickly!

– Shareefa

I came across the EUSARNAD programme at the IADS conference in the middle of February at Stellenbosch, where I had also the opportunity to meet most of the EUSARNAD exchange trainees in South Africa. After Professor David Baldwin’s talk, at the conference, I was amazed about the opportunities that EUSARNAD offers to scientists in the neuroscience field, and I approached David for more information….

Before I realized it, six weeks later,there  I was in the Estonian Genomic Center in the University of Tartu. The weather was awful, cold and snowing – in South Africa, the temperature was 30 Celsius! Nevertheless, I had a really warm welcome and full assistance to start my attachment at the Estonian Genomic Center (EGC). The EGC Bioinformatics and Lab managers, Dr Reedik Magi and Dr Lili Milani, respectively, smoothed my integration into high throughput sequencing technologies & data analysis by offering me a “personal” bioinformatician and wet lab RNA-seq technicians!

So, already approaching the end of my attachment, I can assure you that it is worth it to be here in Estonia! Alongside the scientific exposure to high throughput sequencing technologies through training, conferences and talks from international well known researchers in the field (all taking place in the EGC) I had a chance to have fruitful discussiosn on potential future collaborations between the University of Cape Town and University of Tartu. Moreover, my article is about to be published soon in the EUSARNAD series in Human Psychopharmacology.

I also spent some time taking advantage of the location of Estonia – weekend gateways are cheap and really interesting from a tourism point of view! I could visit other “neighbour” cities outside Estonia like Helsinki, Stockholm and Saint Petersburg. What can I say? I am really happy about my current scientific adventure!

– Christiane

(Please forgive the abysmal punnage – I really struggled there!)

When I arrived home from South Africa, I was determined to make some of the lessons stick. Some of them did; I kept on top of the staggeringly fast developments that are published in neuroimaging journals, as well as keeping in touch with friends who are working at the forefront of HIV-related cognitive deficits. Both of these are rewarding on a professional and personal level, and it’s been nice to have such clear markers of the time I spent away.

But, as you’d expect, distractions at home beckoned. The hazy back-end of a glorious Cape Town summer was in stark contrast with one of the coldest March/Aprils on record in the UK, and I regularly arrived at Highfield completely drenched before starting work on the dratted thesis. I’m sure everyone is well aware of the stereotypical caffeine-fuelled thesis-deadline-approaching doctoral student, and I (glumly) made no ground in disproving this.

Still, it’s done now, and I’ve had the good fortune to be awarded an MRC Centenary Award to further some of the cool stuff that I came across on the way. As well as writing publications to disseminate some of the findings from our lab, I’ve been involved in some exciting new collaborations.

One of these (a real tongue-twister: “respiratory psycho-neuro-immunology”) is an exciting venture that will examine some of the anxiety-reducing psychological interventions and how they could potentially help sufferers of COPD and asthma. Notably, the time I spent in South Africa, meeting and discussing ideas with the other EUSARNAD trainees, has had a direct effect on how I feel during these preliminary discussions. Rather than being overwhelmed by the rapidfire slingshotting of (occasionally radical!) ideas from some of the more senior group members, I feel able to participate and contribute. It’s a rewarding feeling!

But the most pressing collaboration, and the one that has currently got me writing this on a train to Gatwick at 5.35am, is with researchers at the Leiden University Medical Centre, in the Netherlands. At the end of April (actually, the day after the thesis was submitted, so I was feeling the requisite caffeine comedown)

Nienke Pannekoek (another EUSARNAD researcher, who I met at the IADS 2013 conference in Cape Town) came to Uni. Southampton to talk about her research at LUMC with Nic Van der Wee.

The idea of potential collaboration was something we had discussed since IADS, and I was given the chance to spend a few weeks in Leiden to see what research they were doing, and to talk about on-the-go projects in Southampton. While not strictly ‘EUSARNAD business’, I think it’s worth mentioning as it really is a direct product of the work we did out in South Africa, and just goes to show how effective the Anxiety Disorders Network really is!

– Ben

I have a brain! I mean I’ve always had a brain but now courtesy of Dr Samantha Brooks and her team, I have proof! I was a “healthy” volunteer for her study investigating addiction and so went over to the CUBIC centre at Tygerberg Hospital to have an MRI scan. It has been fascinating to learn about the different approaches used to improve our understanding of psychiatric disorders and definitely one of the main positives for me coming out here.

Despite plans to dive with sharks and jump out of a plane at 10,000ft, my nerves are currently being occupied by my upcoming seminar. I was kindly invited to speak at the lunch-time Human Genetics Series and so will be “entertaining” my audience about my EUSARNAD experience as well as my PhD work on predicting antidepressant-induced adverse effects. Fingers crossed it goes well!

Those of us who were lucky enough to be able to attend the IADS Conference 2013 (in Stellenbosch) had the pleasure of attending the first EUSARNAD international colloquium

After initial introductions, researchers towards the end of their placements were given opportunities to comment on the work they had done. One of the things that really struck me (it was literally the first day of my placement – so I kept a relatively low profile!) was that sharing experiences like this means that we can all learn from the experiences of others. I only had a limited time at the University of Cape Town, so advice from those who had been-there-and-done-that was incredibly useful. This really sums up the whole collaborative process behind EUSARNAD.

Experiences like this are really important for the research group – as well as giving you an opportunity to meet both experienced mentors and enthusiastic researchers, getting everyone together into the same room really creates a sense that you are working together as part of something exciting.

You can read the Colloquium Report May 2013 here.

With an incomplete thesis looming over my head (and the first twinges of ‘The Fear’ starting to rear their ugly heads late at night), this morning I thought to myself “oooh – I need to write another EUSARNAD entry. After I’ve cleaned the house. And checked my email. Again.”

I really have been incredibly busy here in Cape Town. Whether that’s due to the aforementioned Fear, or just a comparison against the phenomenally laid-back Cape-Townians, I’m not sure. But Cape Town has just been providing opportunity after opportunity to learn new skills as a psychologist (and, dare I say it, now a low-flying neuroscientist…), from having hands-on experience with a human brain in the UCT Neuroanatomy department to visiting the infamous Khaylitsha township on the outskirts of Cape Town.

I was lucky enough to be working in Groote Schuur Hospital, Cape Town, during Brain Awareness week – and I got this awesome hat to prove it!

In return for kitting me out with this array of new skills, knowledge and contacts, I have been helping UCT out with a ‘mega-analysis’ of MRI data at the CUBIC institute. It’s really been a useful process for me too – while everyone has been more than helpful in explaining different three-letter acronyms of neuroimaging (and there are a lot – check out page two of this document), the opportunity to actually get stuck in and do something has really allowed me to grasp some of the more unfamiliar concepts.

Typically, MRI information stays within the institute that actually did the research – it’s confidential data about participants, it’s expensive, and everyone has their own ways of doing things (which, in the current academic/financial evironment, people sometimes want to keep close to their chest). But really, there’s no reason why MRI data can’t be shared amongst researchers providing that no data about the participant is attached to it. A EUSARNAD research group lead by Dan Stein is doing just this – turning a collection of smaller studies (10 – 30 individuals) to one ‘mega-analysis’ (around 300 people).

EUSARNAD members get a hands-on learning experience of the human brain (“the texture of a reasonably overripe ripe avocado”…!

But there are some hazards with an undertaking of this scale. Different scanner set-ups, different MRI sequences and different sample populations will all have an impact on results, and it’s important to be aware of these things. That’s why every single scan is being thoroughly quality checked by hand (ok, mostly by computer program, and a little bit by hand), segment-by-segment, until the researcher is happy that all of the data is of good enough quality to draw a meaningful finding about sufferers of social anxiety disorder.

But it doesn’t stop there. The scale of the collaboration means that the quality checking is being done many times over, by a different researcher each time, at a different institution. This isn’t wasted effort – even if it turns out that every researcher churns out identical outputs (which they probably won’t). Every nuance of each quality-checking process of every brainscan is meticulously noted down, allowing a comparison of each researcher. What’s great about this is that it will provide some hard evidence of the pros and cons of sharing MRI data on such a grand scale – and hopefully will promote more collaboration like EUSARNAD in the future.

– Ben

After the 11 hour flight to Cape Town I headed to the Green Elephant hostel which was to be my home for the next month or so. The next morning I was straight into business meeting up with the head of psychiatry, Dan Stein, and head of genetics, Raj Ramesar. Despite it being less than 10 minute walk to Dan’s office I still arrived dripping with sweat and was very grateful to be sat directly under the air conditioning unit!

Unlike previous EUSARNADians (not sure if this will catch on!) my interest is in psychiatric genetics. I am working with Shareefa on a cohort of individuals with Alcohol Use Disorder (AUD) with measures of anxiety symptoms. It’s exciting stuff as investigating unique genetic profiles in the South African population has the potential to discover valuable insight into the genetics of psychiatric disorders.

Everyone in the Human Genetics department was incredibly friendly and when I found out that “cake” was an official bullet point on their induction checklist, I knew I would enjoy working here.

Towards the end of my first full week in Cape Town the other Hum Gen students organised a hike up Lion’s Head followed by some Fro-Yo. We successfully climbed the “chains” to the summit and were awarded with spectacular views of Cape Town, Table Mountain and the surrounding area as the African Sun set on the horizon. However, our journey to the summit took longer than expected and so I’m yet to enjoy the taste sensation of Fro-Yo!

I would say the end of my first full week has been a success!

– Andy (Uni. Bristol)