Desire for information about drugs: a survey of the need for information in psychiatric in-patients

Background Promoting therapy adherence requires understanding various psychosocial parameters, including patients need for information. Drug information adapted to patients needs may empower them and increase their confidence in drug therapy. Objectives: To explore psychiatric in-patients information preferences and to test the reliability of a Dutch version of the Intrinsic Desire for Information (IDI) scale in psychiatric institutions in Flanders.Methods Standardised interviews were conducted with psychiatric patients in 11 hospitals. The interview consisted of the IDI-scale and five open questions. Patient demographics collected were sex, age, number of medicines taken, diagnosis, number of admissions during the past year, marital status, education level and occupation.Results 279 patient interviews were completed. A factor analysis on the original 12-item scale yielded 3 factors. An abbreviated scale was derived from the first factor (F1). This 6-item scale measured extent of information desired: (EID) and consisted of six items (Cronbachs = 0,73). A second factor (F2) measured information provider preference (IPP) ( = 0,56) and a third factor (F3) measured inhibited information desire (IID) ( = 0,69). EID was associated with number of medicines taken, duration of hospitalisation and marital status.Conclusion The internal reliability of the EID-factor appears to be reproducible in the specific setting of psychiatric hospitals. It may be useful to help healthcare professionals develop pharmaceutical care towards psychiatric patients. Validation of the scale remains to be completed. Information need in psychiatric in-patients measured by the EID-score was comparable to the need measured in general hospitals during earlier research in England. Targeted information services seem to be desirable to enhance therapy adherence and quality of life in psychiatric patients.     

Sunscreen use and skin protection behavior on the Belgian beach

BACKGROUND: Public health campaigns encourage the public to protect themselves against skin cancer by using sunscreens and taking other protective measures. However, it is difficult to estimate the level of awareness among the general public. METHODS: This study explores the prevalence and predictors of solar protection behavior in a community sample of beachgoers. During the months of May, June, July and August 2001 a total of 360 participants (145 men and 215 women) were randomly selected from several Belgian beaches in and around the city of Ostend, Belgium. The solar protection behavior of each participant was assessed by direct observation and interview. RESULTS: The risk awareness percentages were 70.6% for skin cancer, 60.8% for sunburn and 25.0% for skin aging. These percentages were considerably higher in the female participant group than in the male group. Sunscreen cream was the most popular preventive behavior, especially in the female population, whereas the alternative protective measures (limited exposure during peak sun hours, the use of shade and the use of protective clothing and hats) were more popular in the male group. CONCLUSIONS: While solar protection has become part of routine beach behavior, there is room for improvement by more frequent application of sunscreen cream, the use of a higher sun protection factor (SPF) (15+), timed sunbathing, more use of clothing and hats and more seeking of shade. The results of this study can assist in evaluating the effectiveness of current sun-protection campaigns and health education programs.     

Rating data are underrated: Validity of US expectancy in human fear conditioning

Background and objectivesHuman fear conditioning is widely regarded as one of the prime paradigms for the study of fear and anxiety disorders. We provide an evaluation of a commonly used subjective measure in the human fear conditioning paradigm, namely the US-expectancy measurement.MethodsWe assess the validity of US-expectancy with respect to conditions of pathological fear and anxiety using four established criteria for scrutiny of a laboratory test or model (i.e., face validity, diagnostic validity, predictive validity, construct validity).ResultsArguably, there is sufficient evidence for the face validity, diagnostic validity, predictive validity and construct validity of the US-expectancy measure.LimitationsPresumed limitations of the US-expectancy measure, including its susceptibility to experimental demand and memory bias, are discussed.ConclusionsThe US-expectancy measure is a valuable measurement method that can be effectively used in research that aims to enhance our understanding of fear and anxiety disorders.     

Differential potentiation by calcium antagonists of neuromuscular blockade induced by pancuronium and succinylcholine in cats in vivo

Summary The effects of several calcium antagonists (verapamil, nicardipine and two diltiazem isomers, d-cis and l-cis diltiazem) alone and associated to non-depolarizing (pancuronium) and depolarizing (succinylcholine) neuromuscular blockers, were evaluated on sciatic nerve-tibialis anterior muscle preparations from cats in vivo. The calcium antagonists used (at 0.1 and 0.5mg/kg iv) did not modify the height of muscular twitches elicited indirectly. However, these agents potentiated in a dose-dependent way the neuromuscular blockade induced by iv pancuronium (2–40g/kg) and succinylcholine (6–200g/kg). The order of potency in increasing the effects of pancuronium was nicardipine d-cis diltiazem verapamil, whereas the order of potency in enhancing succinylcholine effects was d-cis diltiazem verapamil nicardipine. The effects of diltiazem were stereoselective, thus the potentiation induced by d-cis diltiazem was significantly greater in all cases than that induced by l-cis diltiazem, which suggests that calcium channel blockade plays a role in these interactions. However, other mechanisms such as calcium antagonists-induced nicotinic receptor desensitization may also be involved.     

Generation of CD8 suppressor factor and β chemokines, induced by xenogeneic immunization, in the prevention of simian immunodeficiency virus infection in macaques

Previous xenogeneic immunization experiments in rhesus macaques with simian immunodeficiency virus (SIV) grown in human CD4⁺ T cells consistently elicited protection from challenge with live SIV. However, the mechanism of protection has not been established. We present evidence that xenogeneic immunization induced significant CD8 suppressor factor, RANTES (regulated upon activation, normal T cell expressed and secreted), macrophage inflammatory protein (MIP) 1α, and MIP-1β (P < 0.001 - P < 0.02). The concentrations of these increased significantly in protected as compared with infected macaques (P < 0.001). Xenogeneic stimulation in vitro also up-regulated CD8 suppressor factors (SF; P < 0.001) and the β chemokines which were neutralized by antibodies to the 3 β chemokines. Recombinant human RANTES, MIP-1α and MIP-1β which bind to simian CCR5, suppressed SIV replication in a dose-dependent manner, with RANTES being more effective than the other two chemokines. The results suggest that immunization with SIV grown in human CD4⁺ T cells induces CD8-suppressor factor, RANTES, MIP-1α and MIP-1β which may block CCR5 receptors and prevent the virus from binding and fusion to CD4⁺ cells.     

Recurrence of blackwater fever: triggering of relapses by different antimalarials

Five cases of blackwater fever (BWF) are described, all of whom had a history of recent quinine therapy. In two cases a second haemolytic crisis was induced by halofantrine, in one case also a third. Increasing frequency of this syndrome with its dramatic clinical presentation is to be expected as imported P. falciparum infection, parasite resistance to chloroquine and the use of quinine and other related antimalarials become more frequent.