Determinants of attitude to volunteering in psychiatry: results of a public opinion survey in Switzerland

BACKGROUND: The United Nations proclaimed 2001 the "International Year of Volunteers". Little is known about factors influencing the attitude to volunteering in psychiatry. However, knowledge about these factors is important as target groups to be addressed by an awareness and promotion campaign could be identified. AIMS: To determine the influence of demographic, psychological and sociological factors on the attitude to volunteering in psychiatry. METHODS: Multiple logistic regression analysis of the results of an opinion survey conducted on a representative population sample in Switzerland (n = 1737). RESULTS: Public attitude is mostly positive. It depends, however, on the form of volunteering. Two explanatory models for volunteering in psychiatry were found: first, the "antipathetic person" having social distance to and negative stereotypes towards the mentally ill. Second, the "people with social responsibility and commitment" who have former experience in volunteering, a positive attitude to community psychiatry, interest in mass media, a social profession and perceive discrimination of mentally ill persons. Age and gender are significant predictors. CONCLUSIONS: An awareness and promotion campaign to use the vast potential of people willing to volunteer in psychiatry can be primarily focused on those with a basic interest in social issues. Volunteering must be limited in time and responsibility. Contacting people with a positive attitude by mass media is a promising way.     

Genes associated with pro-apoptotic and protective mechanisms are affected differently on exposure of neuronal cell cultures to arsenite. No indication for endoplasmic reticulum stress despite activation of grp78 and gadd153 expression

The effect of arsenite exposure on cell viability, protein synthesis, energy metabolism and the expression of genes coding for cytoplasmic (hsp70) and endoplasmic reticulum (ER; gadd153, grp78, grp94) stress proteins was investigated in primary neuronal cell cultures. Furthermore, signs of ER stress were evaluated by investigating xbp1 mRNA processing. Arsenite levels of 30 and 100 microM induced severe cell injury. Protein synthesis was reduced to below 20% of control in cultures exposed to 30 and 100 microM arsenite for 1 h, and it remained markedly suppressed until 24 h of exposure. Arsenite induced a transient inhibition of energy metabolism after 1 h of exposure, but energy state recovered completely after 3 h. Arsenite exposure affected the expression and translation of genes coding for HSP70 and GRP78, GRP94, GADD153 to different extents. While hsp70 mRNA levels rose drastically, approximally 550-fold after 6 h exposure, HSP70 protein levels did not change over the first 6 h. On the other hand, gadd153 mRNA levels rose only approximately 14-fold after 6 h exposure, while GADD153 protein levels were markedly increased after 3 and 6 h exposure. HSP70 protein levels were markedly increased and GADD153 protein levels decreased to almost control levels in cultures left in arsenite solution for 24 h, i.e. when only a small fraction of cells had escaped arsenite toxicity. Arsenite exposure of neurons thus induced an imbalance between pro-apoptotic and survival-activating pathways. Despite the marked increase in gadd153 mRNA levels, we did not observe signs of xbp1 processing in arsenite exposed cultures, indicating that arsenite did not produce ER stress.     

In vitro radiosensitivity measured in lymphocytes and fibroblasts by colony formation and comet assay: comparison with clinical acute reactions to radiotherapy in breast cancer patients

PURPOSE: To compare colony-forming and comet assays on fibroblasts and lymphocytes of 32 breast cancer patients irradiated after breast-conserving operations and to correlate the results with acute clinical radiation reactions in the skin. MATERIAL AND METHODS: Skin fibroblasts were isolated and cultivated before radiotherapy and lymphocytes were drawn prior to the first and directly after the final external irradiation. The colony-forming assay was performed with fibroblasts and the comet assay with lymphocytes and fibroblasts of breast cancer patients according to standard protocols. The clinical radiation reactions of the patients were graded according to the RTOG system. RESULTS: No significant correlation (p =0.09) was detected between clinical acute skin reactions and the in vitro clonogenic data in fibroblasts. Results of the comet assay in lymphocytes, however, showed a significant correlation (p <0.05) with the clinical data when patients were divided into two groups with average and elevated acute reactions. Apart from initial damage, fibroblasts did not show significant differences between the two patient groups. Repeated comet assays in lymphocytes of the same patient drawn before treatment and before and after external radiotherapy demonstrated good reproducibility of the test and no significant impact of preceding radiation treatment. There was a good correlation (r =0.65) between the comet assay results in fibroblasts and lymphocytes of the same individual. CONCLUSIONS: In this cohort of patients, a significant correlation between the in vitro results of the comet assay in lymphocytes and clinical acute reactions was detected. The results of the comet assay and of fibroblast colony formation did not correlate with in vitro radiosensitivity.     

Plasma concentration of ropivacaine after intercostal blocks for video-assisted thoracic surgery

Background. Absorption of local anaesthetics following intercostalblocks is rapid. Therefore, plasma concentrations of ropivacaineduring intercostal blocks with ropivacaine 2, 5, 7.5 and 10mg ml^–1 (ropivacaine 5 ml injected into each of four intercostalspaces) in patients undergoing video-assisted thoracic surgerywere determined. Methods. After informed consent and ethics committee approval,64 patients were randomly allocated to four groups for intercostalnerve block (ropivacaine 2, 5, 7.5 or 10 mg ml^–1 at theend of surgery). Central (mixed) venous and arterial plasmasamples were collected before the start of intercostal application,and 2, 5, 10, 15, 20, 30, 45, 60 and 90 min afterwards. Plasmaconcentrations of ropivacaine were measured by high performanceliquid chromatography. Results. Maximum venous plasma concentrations occurred afterthe mean times of 10.7 (range, 5–15), 10.8 (5–20),11.3 (5–20) and 12.2 (5–45) min, respectively foreach group. The groups had mean concentrations of 1.3 (SD, 0.6;range, 0.3–2.3), 2.1 (1.0; 0.5–4.5), 2.4 (1.0; 1.2–5.1)and 2.5 (0.9; 1.7–5.6) µg ml^–1, respectively.Maximum arterial plasma concentration following 1.0% ropivacaineoccurred after 16 (5–45) min with a mean of 2.3 (0.6;1.5–3.6) µg ml^–1. No signs of central nervoussystem or cardiac toxicity were observed. Conclusions. After intercostal blocks the absorption of ropivacaineis rapid compared with other techniques for regional anaesthesiaand results in relatively high venous and arterial plasma concentrations,especially if a dose of 100 mg or more is used. Br J Anaesth 2002; 89: 251–3     

Polymorphisms in genes related to oxidative stress (CAT, MnSOD, MPO, and eNOS) and acute toxicities from radiation therapy following lumpectomy for breast cancer.

PURPOSE: Because radiotherapy exerts cytotoxic effects via generation of massive oxidative stress, we hypothesized that catalase, manganese superoxide dismutase, myeloperoxidase (MPO), and endothelial nitric oxide synthase (eNOS) genotypes might result in greater risk of radiotoxicity. EXPERIMENTAL DESIGN: Cases (n = 446) were Caucasian women with breast cancer who received radiotherapy following lumpectomy. Genotypes were determined by matrix-assisted laser desorption/ionization time-of-flight. The development of acute reactions (moist desquamation) associated with genotypes was modeled using the Cox proportional hazards model, accounting for cumulative biologically effective radiation dose. RESULTS: Genotypes associated with higher levels of reactive oxygen species (ROS) were not associated with risk of radiotoxicity. However, relationships between overweight/obesity [body mass index (BMI), >25] and radiotoxicity risk seemed to be modified by eNOS and MPO genotypes associated with higher generation of nitric oxide and ROS, respectively. Women with high BMI (>25) and eNOS GG genotypes were at more than a 6-fold increase in risk (hazard ratio, 6.39; 95% confidence interval, 2.53-16.15) compared with those with BMI <25, and for MPO, those with high BMI (>25) and GG genotypes also had greater risk of radiotoxicity (hazard ratio, 3.61; 95% confidence interval, 1.78-7.35) compared with those with BMI <25. Overweight/obesity was not a strong risk factor among women with other eNOS and MPO genotypes. Exploratory analysis using classification and regression trees indicated that total number of risk alleles contributed, in part, to acute toxicity outcomes among a subgroup of women. CONCLUSIONS: Associations between BMI and radiotoxicity risk may be most apparent among women with genotypes related to higher levels of oxidative stress. Regression trees may be useful in future studies to examine the contributions of multiple factors to individual susceptibility to adverse effects of cancer treatment.     

Anaesthesia for caesarean section — a German survey

Background: Anaesthetic practice for caesarean section has changed during the last decades. There is a world-wide shift in obstetric anaesthetic practice in favour of regional anaesthesia. Current data concerning anaesthetic practice in patients under-going caesarean section from Germany are not available. A comparison with figures from the UK, USA, Norway and other European countries might be of general interest.
Methods: Questionnaires on the practice of anaesthesia for caesarean section and anaesthetic coverage of the obstetric units were sent to 1178 university, tertiary care, district, community and private hospitals in Germany.
Results: The 532 completed replies of this survey represent 46.9% of the German obstetric units. Most hospitals (42.3%) have delivery rates between 500 and 1000 per year. General anaesthesia is the most common anaesthetic technique for elective (61%), urgent (83%) and emergency caesarean section (98%). Epidural anaesthesia is performed in 23% of scheduled and 5% of non-scheduled caesarean sections, and spinal anaesthesia in 14% and 10%, respectively. Acid aspiration prophylaxis before elective caesarean section is used in 68.7% of the departments. The majority of the departments provide a 24-hour anaesthetic coverage; however, in only 6.2% of the units, this service is assigned to obstetric anaesthesia, exclusively.
Conclusion: Compared to data from 1978, anaesthetic practice for caesarean section has changed with an increase in regional anaesthesia. However, German anaesthetists prefer general anaesthesia for caesarean section. In contrast, anaesthetists in other countries predominantly use regional techniques, and the difference to German practice is striking. International consensus discussion and recommendations as well as comparable European instruments of quality control in obstetric anaesthesia are desirable.     

Beitrag zur Ätiologie der Lichtdermatosen

Ohne ZusammenfassungMit 4 Textabbildungen.