Verandering in crisisinterventie en acute psychiatrie: Amsterdamse consulten in 1983 en 2005.

achtergrond Sinds 1992 stijgt het aantal inbewaringstellingen (ibs'en) in Nederland opvallend. In Amsterdam is er zelfs sprake van een verdrievoudiging. Psychiatrische behandeling in de Amsterdamse klinieken dreigt gedomineerd te worden door dwang. doel Een beeld krijgen van de veranderingen in de acute psychiatrie die hebben bijgedragen aan de stijging van het aantal dwangopnames met ibs. methode Vergelijken van een cohort (n = 460) consulten verricht door de stedelijke crisisdienst in 1983 met een cohort (n = 436) consulten verricht in 2004-2005 op de volgende variabelen: werkwijze van de crisisdienst, kenmerken van de patiënten, diagnose en uitkomst van de consulten. resultaten Vergeleken met 1983 waren er in 2004-2005 meer diensten betrokken bij psychiatrische patiënten in acute situaties in het publieke domein. Het aantal patiënten dat via de politie kwam, verdubbelde. De consulten, die in 1983 uitsluitend werden gedaan op de plek waar de patiënt verbleef, werden in 2004-2005 voor 60% op het bureau van de dienst gedaan. Het aantal patiënten met een psychose in de cohort nam toe van 52,0 naar 63,3%. Er was een toename van ibs opnames (van 16,7 naar 20,0% van de interventies) en een scherpe daling van vrijwillige opnames (van 25,7 naar 7,6%). Het totale aantal opnames na een consult daalde van 42 naar 28%. conclusie De outreachende dienst met een eerstelijnskarakter van 1983 is veranderd in een gespecialiseerde psychiatrische ehbo met een bescheiden outreachende functie. De vrijwillige opname is vrijwel verdwenen bij de crisisdienst. Nader onderzoek naar de kenmerken van de consulten en naar de variabelen die een rol spelen bij het toepassen van dwang is noodzakelijk

Mammary gland-specific ablation of focal adhesion kinase reduces the incidence of p53-mediated mammary tumour formation.

BACKGROUND Elevated expression of focal adhesion kinase (FAK) occurs in numerous human cancers including colon-, cervix- and breast cancer. Although several studies have implicated FAK in mammary tumour formation induced by ectopic oncogene expression, evidence supporting a role for FAK in spontaneous mammary tumour development caused by loss of tumour suppressor genes such as p53 is lacking. Alterations in the tumour suppressor gene p53 have been implicated in over 50% of human breast cancers. Given that elevated FAK expression highly correlates with p53 mutation status in human breast cancer, we set out to investigate the importance of FAK in p53-mediated spontaneous mammary tumour development. METHODS To directly assess the role of FAK, we generated mice with conditional inactivation of FAK and p53. We generated female p53(lox/lox)/FAK(+/+)/WapCre, p53(lox/lox)/FAK(flox/+)/WapCre and p53(lox/lox)/FAK(flox/-)/WapCre mice, and mice with WapCre-mediated conditional expression of p53(R270H), the mouse equivalent of human p53(R273H) hot spot mutation, together with conditional deletion of FAK, P53(R270H/+)/FAK(lox/+)/WapCre and p53(R270H/+)/FAK(flox/-)/WapCre mice. All mice were subjected to one pregnancy to induce WapCre-mediated deletion of p53 or expression of p53 R270H, and Fak genes flanked by two loxP sites, and subsequently followed the development of mammary tumours. RESULTS Using this approach, we show that FAK is important for p53-induced mammary tumour development. In addition, mice with the mammary gland-specific conditional expression of p53 point mutation R270H, the mouse equivalent to human R273H, in combination with conditional deletion of Fak showed reduced incidence of p53(R270H)-induced mammary tumours. In both models these effects of FAK were related to reduced proliferation in preneoplastic lesions in the mammary gland ductal structures. CONCLUSIONS Mammary gland-specific ablation of FAK hampers p53-regulated spontaneous mammary tumour formation. Focal adhesion kinase deletion reduced proliferative capacity of p53 null and p53(R270H) mammary epithelial cells but did not lead to increased apoptosis in vivo. Our data identify FAK as an important regulator in mammary epithelial cell proliferation in p53-mediated and p53(R270H)-induced mammary tumour development

Age and environment of Miocene-Pliocene glaciomarine deposits, James Ross Island, Antarctica

Knowledge of the late Miocene-Pliocene climate of West Antarctica, recorded by sedimentary units within the James Ross Island Volcanic Group, is still fragmentary. Late Miocene glacio-marine deposits at the base of the group in eastern James Ross Island (Hobbs Glacier Formation) and Late Pliocene (3 Ma) interglacial strata at its local top on Cockburn Island (Cockburn Island Formation) have been studied extensively, but other Neogene sedimentary rocks on James Ross Island have thus far not been considered in great detail. Here, we document two further occurrences of glaciomarine strata, included in an expanded Hobbs Glacier Formation, which demonstrate the stratigraphic complexity of the James Ross Island Volcanic Group: reworked diamictites intercalated within the volcanic sequence at Fiordo Belen, northern James Ross Island, are dated by Ar-40/Ar-39 and Sr-87/Sr-86 at c. 7 Ma (Late Miocene), but massive diamictites which underlie volcanic rocks near Cape Gage, oil eastern James Ross Island, yielded an Ar-Ar age of < 3.1 Ma (Late Pliocene). These age assignments are confirmed by benthic foraminiferal index species of the genus Ammoelphidiella. The geological setting and Cassididina-dominated foraminiferal biofacies of the rocks at Fiordo Belen suggest deposition in water depths of 150-200 m. The periglacial deposits and waterlain tills at Cape Gage were deposited at shallower depths (< 100 in), as indicated by all abundance of the pectinid bivalve 'Zygochlamys' anderssoni and the epibiotic foram Cibicides lobatulus. Macrofaunal and foraminiferal biofacies of glaciomarine and interglacial deposits share many similarities, which suggests that temperature is not the dominant factor in the distribution of late Neogene Antarctic biota. Approximately 10 m.y. of Miocene-Pliocene climatic record is preserved within the rock sequence of the James Ross Island Volcanic Group. Prevailing glacial conditions were punctuated by interglacial conditions around 3 Ma