Opinie polskich psychiatrów o psychiatrii i własnej roli zawodowej

Cel: Psychiatria jako dziedzina medycyny i wiedzy podlega społecznej ocenie. Psychiatrzy, jako jej kluczowi reprezentanci, dzielą często dyskryminujące doświadczenia z osobami chorującymi psychicznie. Celem pracy była analiza stosunku polskich psychiatrów wobec psychiatrii i własnej roli zawodowej. Metody: Badaną grupą byli polscy psychiatrzy. Zastosowano sondaż diagnostyczny, wykorzystując kwestionariusz do samodzielnego wypełnienia. Analizie poddano 232 ankiety. Wyniki: W opinii większości badanych psychiatrów (62,9%) przeważająca część społeczeństwa ma świadomość, że psychiatria jest dziedziną medycyny. Znaczny odsetek (47%) ocenia, że przeciętny obywatel uważa leczenie psychiatryczne za bardzo mało skuteczne bądź nieskuteczne. Zdaniem 53,8% badanych od 40% do 100% społeczeństwa kojarzy leczenie psychiatryczne z przemocą. W opinii znaczącej liczby badanych (84,1%) niewielka część społeczeństwa (do 40%) uważa, że psychiatria jest dziedziną oddziaływań magicznych. Część badanych (8,6%) uważa, że większość społeczeństwa (ponad 60%) jest przekonana, że psychiatria jest wykorzystywana do ochrony osób, które naruszyły prawo. W opinii 46,5% badanych mniejsza część społeczeństwa (do 40%) jest przekonana, że psychiatrzy upodabniają się do swoich pacjentów. Większość (56,9%) uznaje, że prestiż psychiatrii w opinii lekarzy innych specjalności jest niski lub bardzo niski. Według 62,5% badanych psychiatrów skuteczność leczenia psychiatrycznego w opinii lekarzy innych specjalności jest oceniana jako przeciętna, lecz większość (67,2%) ich koleżanek i kolegów jest zadowolona z wyboru tej specjalności medycznej. Zdecydowana większość (96,1%) wyraziła zadowolenie z własnego wyboru tej specjalności lekarskiej. Zdaniem zdecydowanej większości (76,8%) poziom emocjonalnego obciążenia związanego z pracą psychiatry jest wysoki albo bardzo wysoki. Większość respondentów (64,3%) ocenia, że poziom odpowiedzialności prawnej związanej z pracą psychiatry jest ponadprzeciętny. Zdecydowana większość ankietowanych (86,6%) stwierdza, że nakłady na finansowanie psychiatrii są zaniżone w porównaniu z innymi dziedzinami medycyny. Większość ankietowanych (87,5%) uważa za częstą lub bardzo częstą praktykę dyskryminującego traktowania osób leczonych psychiatrycznie przez lekarzy innych specjalności. Wnioski: Polscy psychiatrzy uważają psychiatrię za niedocenianą i dyskryminowaną dziedzinę medycyny, wyrażając jednocześnie duże zadowolenie z wyboru tej specjalności lekarskiej.Purpose: Psychiatry as a discipline of medicine and science is subject to constant social assessment. Psychiatrists – its key representatives – often share discriminating experiences with mentally-ill patients. The aim of the paper is to analyse the attitude of Polish psychiatrists towards psychiatry and their own professional role. Methods: The studied group consisted of Polish psychiatrists. A diagnostic survey in the form of a questionnaire to be filled-in individually was used and 232 questionnaires underwent the final analysis. Results: According to the majority of psychiatrists (62.9%), the greater part of the society is aware of the fact that psychiatry is a discipline of medicine; 47% of psychiatrists believe that an average citizen considers psychiatric treatment to be either only slightly effective or ineffective at all. According to 53.8% of the respondents, 40 to 100% of the society associates psychiatric therapy with violence. In the opinion of the majority of respondents (84.1%), a small part of the society (up to 40%) believes that psychiatry is a field of magical influences. A small part of the studied doctors (8.6%) claim that most of the society (60% and more) thinks that psychiatry is used to protect individuals who break the law. According to 46.5% of the respondents, a smaller part of the society (up to 40%) claims that psychiatrists become similar to their patients. Most of them (56.9%) think that the prestige of psychiatry in the eyes of doctors of other specialisations is low or very low. According to 62.5% of the studied psychiatrists, doctors of other specialisations think that the effectiveness of psychiatric treatment is average, although most of their colleagues (76.2%) are satisfied with the choice of this specialisation. A vast majority (96.1%) expressed satisfaction with their own choice of medical specialisation. According to the great majority (76.8%), the level of emotional burden related to the work of a psychiatrist is high or very high. Most of the respondents (64.3%) estimate that the level of legal responsibility related to the work of a psychiatrist is more than average. A vast majority of the studied persons (86.6%) claim that financial outlays designated to psychiatry are lower as compared to other disciplines of medicine. Most of the respondents (87.5%) believe that doctors of other specialisations often or very often treat mentally- ill patients in a discriminating manner. Conclusions: Polish psychiatrists believe that psychiatry is an undervalued and discriminated discipline of medicine. At the same time, they express high level of satisfaction with their choice of this medical specialisation

A Casting Mould for Rapid Tube Hydroforming Prototyping

In recent years, hydroforming has clearly expanded its range of industrial applications due to the growing interest in products which combine high strength with low weight. A current limitation of this technology was its economically justified production volume since the costs of producing tools eliminates the possibility of using hydroforming technology in prototype and single part production. The paper presents a freshly patented solution that allows for single part hydroforming. The new technology combines traditional hydroforming machines with a new approach to tool production. The new rapid die is made quickly and cheaply. The use of materials known from the production of foundry moulds causes the die to deform during hydroforming, but it is a controlled deformation. Thanks to the use of numerical modelling, the deformation of the mould cavity is predicted and taken into account at the design stage. The article presents important issues that need to be considered in the design of this innovative process

Sekwencjonowanie genomu/eksomu człowieka - aspekt bioetyczny

In recent years we have observed a technological revolution in genetics. For years molecular diagnostics in genetic disorders were limited to a single gene or to a group of genes. The technological breakdown in molecular genetics relies on the change of perspective from the analysis of a single gene to the whole genome sequencing (WGS) or whole-exome sequencing (WES). The exome is defined as a coding part of the genome consisting of the coding parts (exons) of all genes. Thus, at present geneticists have access to the whole genome instead of separate/selected genes. Clinical genetics in the era of genomic sequencing has to cope with new challenges concerning the confidentiality of genetic data, genetic discrimination, genetic and clinical determinism, or incidental findings detected in genome analysis. This short review attempts to demonstrate the ethical challenges faced in the era of genome sequencing

The attitudes of Polish psychiatrists toward people suffering from mental illnesses

Introduction. Stigmatizing convictions, emotions and behaviors toward the mentally ill have impact on the social distance and more acute course of the illness. Research shows that the sufferers are the object of stigmatization also by representatives of medical professionals, including psychiatrists. Aim. The aim of the study was to examine the opinions of Polish psychiatrists regarding the mentally ill and to compare them with similar studies in the general population. Material and method. Polish psychiatrists were the investigated group. A diagnostic survey was conducted with a self-completion questionnaire. 232 questionnaires were analyzed. Results. The results were compared with the general population. 61.5% of the respondents (59% in the general population) believe that a person who is mentally ill has a chance of recovery and 79% (vs. 77%) that coercion in Polish psychiatry is used frequently enough. 95% (vs. 75%) consider mental illness a health problem which is concealed from the others. 43% (vs. 56%) believe that mental illness significantly reduces the ability of regular employment, 13.5% (vs. 30%) believe that it reduces the ability to work in a team and 33% (vs. 71%) that it reduces the ability to do work which requires a lot of self-reliance. 16% (vs. 22%) is opposed to having institutions for the mentally ill near their place of residence. Psychiatrists more often declared a close friendship with people suffering from mental illness (87.5% vs. 32%), and a positive attitude toward the mentally ill and their participation in social life (86.5% vs. 65%). Conclusions. 1. A relatively large group of the investigated psychiatrists compared with the general population has a family member suffering from a mental illness or they themselves suffer from mental illness. 2. Despite their education and professional mission, Polish psychiatrists present similarly stigmatizing attitudes toward the mentally ill as does the general population. 3. Through their attitudes, Polish psychiatrists co-create a support system, but also participate in the process of stigmatization

Pathogenic Effect of GDAP1 Gene Mutations in a Yeast Model

The question of whether a newly identified sequence variant is truly a causative mutation is a central problem of modern clinical genetics. In the current era of massive sequencing, there is an urgent need to develop new tools for assessing the pathogenic effect of new sequence variants. In Charcot-Marie-Tooth disorders (CMT) with their extreme genetic heterogeneity and relatively homogenous clinical presentation, addressing the pathogenic effect of rare sequence variants within 80 CMT genes is extremely challenging. The presence of multiple rare sequence variants within a single CMT-affected patient makes selection for the strongest one, the truly causative mutation, a challenging issue. In the present study we propose a new yeast-based model to evaluate the pathogenic effect of rare sequence variants found within the one of the CMT-associated genes, GDAP1. In our approach, the wild-type and pathogenic variants of human GDAP1 gene were expressed in yeast. Then, a growth rate and mitochondrial morphology and function of GDAP1-expressing strains were studied. Also, the mutant GDAP1 proteins localization and functionality were assessed in yeast. We have shown, that GDAP1 was not only stably expressed but also functional in yeast cell, as it influenced morphology and function of mitochondria and altered the growth of a mutant yeast strain. What is more, the various GDAP1 pathogenic sequence variants caused the specific for them effect in the tests we performed. Thus, the proposed model is suitable for validating the pathogenic effect of known GDAP1 mutations and may be used for testing of unknown sequence variants found in CMT patients

Validation of the Pathogenic Effect of IGHMBP2 Gene Mutations Based on Yeast S. cerevisiae Model

Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is a heritable neu- rodegenerative disease characterized by rapid respiratory failure within the first months of life and progressive muscle weakness and wasting. Although the causative gene, IGHMBP2, is well defined, information on IGHMBP2 mutations is not always sufficient to diagnose particular patients, as the gene is highly polymorphic and the pathogenicity of many gene variants is unknown. In this study, we generated a simple yeast model to establish the significance of IGHMBP2 variants for disease development, especially those that are missense mutations. We have shown that cDNA of the human gene encodes protein which is functional in yeast cells and different pathogenic mutations affect this functionality. Furthermore, there is a correlation between the phenotype estimated in in vitro studies and our results, indicating that our model may be used to quickly and simply distinguish between pathogenic and non-pathogenic mutations identified in IGHMBP2 in patient

The GDAP1 p.Glu222Lys Variant-Weak Pathogenic Effect, Cumulative Effect of Weak Sequence Variants, or Synergy of Both Factors?

Charcot–Marie–Tooth disorders (CMT) represent a highly heterogeneous group of diseases of the peripheral nervous system in which more than 100 genes are involved. In some CMT patients, a few weak sequence variants toward other CMT genes are detected instead of one leading CMT mutation. Thus, the presence of a few variants in different CMT-associated genes raises the question concerning the pathogenic status of one of them. In this study, we aimed to analyze the pathogenic effect of c.664G>A, p.Glu222Lys variant in the GDAP1 gene, whose mutations are known to be causative for CMT type 4A (CMT4A). Due to low penetrance and a rare occurrence limited to five patients from two Polish families affected by the CMT phenotype, there is doubt as to whether we are dealing with real pathogenic mutation. Thus, we aimed to study the pathogenic effect of the c.664G>A, p.Glu222Lys variant in its natural environment, i.e., the neuronal SH-SY5Y cell line. Additionally, we have checked the pathogenic status of p.Glu222Lys in the broader context of the whole exome. We also have analyzed the impact of GDAP1 gene mutations on the morphology of the transfected cells. Despite the use of several tests to determine the pathogenicity of the p.Glu222Lys variant, we cannot point to one that would definitively solve the problem of pathogenici