Background
The core clinical symptoms of addiction include an enhanced incentive for drug taking (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased stress reactivity. Symptoms related to impaired self-control involve reduced activi...ty in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC) and other brain areas. Behavioral training such as mindfulness meditation can increase the function of control networks including those leading to improved emotion regulation and thus may be a promising approach for the treatment of addiction.
Methods
In a series of randomized controlled trials (RCTs), we tested whether increased ACC/mPFC activity is related to better self-control abilities in executive functions, emotion regulation and stress response in healthy and addicted populations. After a brief mindfulness training (Integrative Body-Mind Training, IBMT), we used the Positive and Negative Affect Schedule (PANAS) and Profile of Mood States (POMS) to measure emotion regulation, salivary cortisol for the stress response and fMRI for brain functional and DTI structural changes. Relaxation training was used to serve as an active control.
Results
In both smokers and nonsmokers, improved self-control abilities in emotion regulation and stress reduction were found after training and these changes were related to increased ACC/mPFC activity following training. Compared with nonsmokers, smokers showed reduced ACC/mPFC activity in the self-control network before training, and these deficits were ameliorated after training.
Conclusions
These results indicate that promoting emotion regulation and improving ACC/mPFC brain activity can help for addiction prevention and treatment.
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Since the 1960s, the Tanzanian government has been striving to improve access to quality healthcare, including primary care. However, tuberculosis (TB) remains a significant public health concern, with an estimated prevalence rate of 528 cases per 100,000 people. However, currently, only 36% of TB c...ases are detected, leaving many undiagnosed within the community. Challenges include low community awareness, long distances to diagnostic centres and delayed health-seeking behaviour.
To address these issues, the Ministry of Health (MOHCDGEC) adopted the ENGAGE TB approach, involving NGOs, civil society organisations (CSOs) and other non-state actors in community-based TB activities. This has increased the number of active organisations from five to approximately twenty.
Building on this success, the Ministry has developed national operational guidelines for community-based TB, TB/HIV and drug-resistant TB interventions, with the aim of improving collaboration between communities and health facilities. These guidelines will be updated regularly, and stakeholders are urged to comply fully with them and support TB control efforts.
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