As I’m writing this I’m on the train back to Southampton and its almost 1am. The reason I’m coming home so late is not frivolous first year party escapades, rather it’s a late night in the sleep laboratory in Portsmouth. And that’s one of the reasons I’m here – to experience the running of sleep laboratories in an international context.

The sleep laboratory at the University of Cape Town is brand new. We managed to build it when our department moved from one side of the campus to the other. It has a control room, two dedicated sleep study rooms complete with beds, polysomnographs, intercoms and cameras. Members of the UCT Sleep Sciences team have trained locally but it’s important to know that our lab meets international standards. I’m here in Southampton to check whether our laboratory set-up and techniques of electrode placement and scoring polysomnography are correct, and to pick up some tips.

Queen Alexander Hospital, where I attended the night-time sleep studies and outpatients sleep clinic.

My experiences here so far have been incredibly positive. I’ve met with Dr Cathy Hill who is taking me under her wing to show me the world of clinical sleep disorders in children. I’m attending her clinic and a sleep course she’s giving later in my month’s stay. I am also going to get involved in writing a paper on sleep at high altitude and whether this affects cognitive functioning. I’ve also been working with the sleep technologist at Cathy’s laboratory – Johanna, who has been wonderful in helping me go through sleep scoring.

And now I’ve been to the Queen Alexander Hospital’s laboratory, which also sees clinical patients. There I’ve been working with a technologist, who’s actually from my home country, South Africa. We’ve been in the laboratory together doing sleep polysomnographic set-up. I’ve picked up some handy tips and have also been reassured that what I know is indeed useful.  Furthermore I’ve started to do some work with Dr Hazel Everit and a number of other collaborators on a Chochrane review of anti-depressant treatment in insomnia.

The team here at the University of Southampton has been incredibly welcoming and supportive. Professor Baldwin has shown me around and introduced me to many of his colleagues, and facilitated lots of meetings, case presentations and journal and film club meetings, which have been wonderfully stimulating.

Another big part of my time here is spent with Professor Baldwin seeing clinical psychiatric outpatient cases, which has been extremely valuable. As part of my clinical training back home, I’m seeing patients with brain injury. However, I don’t get to see a lot of psychiatric cases, so this exchange is filling an important clinical gap for me. I’m seeing a variety of cases including individuals who are diagnosed with anxiety and mood disorders. I may also see patients with psychotic disorders as well as observe a session of ECT (electro-convulsive therapy).

On a personal front I’ve also managed to catch up with some family here – taking long walks in the British countryside. We even managed to get a good day of whether in – perfectly sunny skies.

So far it’s been an exciting time! Looking back at the 10 days I’ve been here I can’t believe how much has happened already and I’m excited for the upcoming 18 days – its certainly
going to be busy – just the way I like it!

– Gosia

Quicker than I could say ‘Smörgåsbord’, I was whisked away to Sweden- the land of pickled herring, the Vikings, ABBA, and Alfred Nobel- for my month long attachment.

Arriving at the University of Gothenburg

I was sent to the very scenic Gothenburg on the west coast. Autumn is a particularly beautiful season. I have never seen such beautiful hues of reds and oranges before! The stunning architecture and leafy city made for a wonderful and colourful backdrop to my month long stay.

The local architecture.

Despite the icy cold weather, I had a very warm welcome when I arrived at the University of Gothenburg’s Department of Pharmacology. The department is most proud of their Nobel Prize winner, Arvid Carlsson, for his work on the neurotransmitter dopamine. After a tour of the department and a brief lecture on Carlsson’s work, it was down to business. I was offered two projects to join- a rat study and a genetics study. I said yes to both. I was particularly excited to work on the rat study as I had never been involved in any animal research. Apprehensive at first, I learnt how to habituate research rats to being held by humans (this was my first time holding a rat!). One particularly inquisitive rat decided to nibble on my finger, tearing the glove and breaking my fingernail in the process! But that didn’t discourage me- it was all in the name of science! Once the rats were habituated, baseline startle and freeze measurements were taken then the rats were fear conditioned and further measurements were taken. This was a great experience as I have never been exposed to this type of research before.

The Department of Pharmacology, where I worked during my placement

My hosts were always friendly and helpful. For example, during fika (Swedish coffee break), everyone in the department would sit around a table drinking (strong!) coffee, eating kanelbullar (Swedish cinnamon buns) and talking about their research. It was during these fikas that I learnt the most. If someone ran into trouble with their research, everyone would give advice and suggest possible alternatives. No matter what the original topic of conversation was, it would always revert back to research.  It was an amazing academic environment to be in.

A ‘Kanelbullar’ the size of a plate!

My month-long stay has left a lasting impression on me. I’ve made new friends, acquired new knowledge, tried new foods, learnt a few Swedish words, and got horribly lost a number of times. It has been an amazing experience! Tack för denna möjlighet!

– Sheri

In June 2012, jaded from my recent Master’s dissertation submission, I set off to the UK for my much anticipated EUSARNAD attachment. Much like Ben’s experience (EUSARNAD researchers clearly never miss a beat), on arrival I was transported directly to my base at the University of Hertfordshire in Hatfield – six months’ worth of luggage in tow – to attend a Good Clinical Practice seminar. I was unfazed by the day-long seminar, however, and instead delirious with excitement for what lay ahead.

My primary professional base was the Mental Health Unit at the Queen Elizabeth II Hospital in Welwyn Garden City, a short bus ride (and disastrously long bicycle ride, as I would later discover) from Hatfield. Under the mentorship of Prof Naomi Fineberg, we established an ambitious study to examine the clinical and cognitive profiles of patients with comorbid obsessive-compulsive disorder (OCD) and alcohol abuse. Selecting this decidedly understudied clinical group, we knew from the outset that we had our work cut out for us – OCD patients are notoriously avoidant and hence difficult to maintain as research participants. Adding substance addiction to the mix calls for creative and tenacious participant recruitment and retention strategies.

I can say without doubt, however, that the value of the data that we collected on this elusive but clinically important group far outweighs any difficulties that we may have experienced in the process. Thanks to Prof Fineberg’s collaborative links at the University of Cambridge, we were able to include in our study a test that involved administration of small electric shocks – dubbed “irritating snaps”- to the wrists. Dubious as it may sound (and I admit that I was hesitant at first), the snaps were fairly innocuous with participants calibrating the shock intensity themselves. Encouragingly, preliminary data from this task, together with our other assessments, have already revealed some interesting interactions between habit, OCD and addiction, and we look expectedly toward the results of ourongoing work.

In the space of six months, and in between research endeavours, I had the opportunity to travel to Harrogate for the BAP meeting, Vienna for the ICOCS and ECNP meetings (where Lotte and I shared a fabulous rooftop apartment for a week), Winchester for a cultural awakening and jam making experience hosted by David Baldwin and Julia Sinclair, and the Scottish Highlands for a wholly unofficial but wonderfully fulfilling quest to my ancestral roots.

In the time following my attachment, I’ve also presented some EUSARNAD work at IADS and NPSA in Cape Town, as well as at EPA in Nice. In an effort to explore the many historical towns within Hertfordshire during my stay, I tracked down a local cycling advocate group which happened to be lead by members both twice my age and my fitness level. As the honorary member of this group, I found myself on several reasonably short and civilised bicycle rides in the Hatfield-St Albans-Welwyn Garden City region, as well as one unexpected occasion (note: I am a novice and nervous rider at the best of times) where I was unintentionally swept away on a 80km round trip to Aspenden. On the upside, this resulted in a special mention in the group’s riding blog, and you can read about it here: http://www.southhertsctc.org.uk/Cycle/weekend-rides/blog/2012-ride-reports/nov-2012/26novhatfieldtoaspenden.

Predictably, the ten months since my return home to Cape Town could not hope to compare to the hype and travel abundance of my six month EUSARNAD attachment in the United Kingdom; indeed, my attachment set a rather lucrative travel benchmark. I can say, however, that my stay was an enlightening experience on many accounts, and that the personal and professional networks that sprang from my attachment have proved over and again to be mixing pots for new and exciting (ad)ventures.

–       Natalie

Young residents and psychiatric patients have a lot in common. A paranoid attitute towards their colleague, repetitive patterns, obsessive checking behaviours, intrusive thoughts (will my patient survive?!) and they both spend the summer near their usual hospital. Sometimes practically inside it. So I was particularly glad to leave my Department for a few days and attend the annual BAP summer meeting thanks (thanks!) to the University of Southampton. The BAP meeting was in Harrogate, a place with the right atmosphere for a novel by one of the Brontë sisters. I had never been that far north.

The conference gave me a chance to get away from my usual work

The British Association of Psychopharmacology support various educational programs so not surprisingly there were many researchers under 35 attending, among them some other EUSARNAD exchangees such as Ben Ainsworth and Andy Crawford. It’s a great opportunity to make friends and meet like-minded young researchers as well as gaining  wisdom from some of the more experienced members. One of my personal highlights of the meeting was the Blogging service, managed by Suzi Gage, a  PhD student from the University of Bristol whose blog appears in the Guardian website.

It’s impossible to attend all of the sessions, but I gave it my best go, including an introduction to computational modelling in psychiatry that left me pretty interested and with many doubts at the same time (and also a little dazed!). A session of particular interest to me anxiety disorders session was chaired by David Baldwin and David Nutt, hosting one of the EUSARNAD mentors as a speaker, Nick Van der Wee, with a talk on possible improvements in drug treatment in anxiety disorders. The whole symposium focused on experimental medicine with Gerry Dawson illustrating the P1vital programme and Sally Adams from Bristol showing the results of her group’s studies on cognition and face-processing.

The University of Southampton’s Matt Garner revealed the results on his development of an experimental model of GAD – I had the chance to see the CO2 model while in Southampton last summer and I was surprised about this efficient way to provoke an anxious state in healthy controls, which is useful for better understanding of GAD. The poster sessions were pretty crowded and someone even had an interest in my work (!) on the duration of untreated illnesses.

The Southampton University BAP Delegation, including EUSARNAD members Carlotta Palazzo, Ben Ainsworth and Professor David Baldwin (as well as some members-to-be)

During the last evening, a formal dinner was held in Harrogate theatre where many young researchers, both undergraduate and postgraduate, received awards and recognition for their achievements over the last couple of years. Later on, the Lifetime Achievement Award was  this year dedicated to Charles Marsden, who gave a great speech covering his impressive and eclectic career. Overall, it was a really interesting conference and I felt pretty lucky to have the chance to attend, and meet so many people who were previously just named authors on journal articles I read! And, let’s say it: how many of you guys have a photo taken by David Nutt?

– Lotte

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